If soggy sheets and soaked pajamas are part of your child’s nightly routine, you’re not alone. The National Association for Continence estimates more than 5 million children in the U.S. wet the bed.
While bedwetting can be frustrating for both children and parents, the problem often resolves with time. Here’s what you need to know to get through the wet nights.
Why it happens
Joseph Barone, MD, a pediatric urologist and professor of surgery at UMDNJ-Robert Wood Johnson Medical School, assures parents that, as long as children are completely dry throughout the day and there are no other urinary symptoms, bedwetting is considered a “developmental delay” that is not linked to a medical problem.
“Bedwetting is not voluntary,” Barone explains. “It has to do with maturation of the central nervous system.” The development process can be delayed in some children, leading to bedwetting that persists beyond the early years.
Nighttime accidents that occur before age 4 are not classified as bedwetting, and 30 percent of 4-year-olds still wet the bed at night. In most cases, the child is completely free of daytime accidents. “Daytime and nighttime bladder control are totally different issues and require two separate treatments,” says Barone. “Only 20 percent of kids have both.”
Bladder control develops over time and is different for every child. Nighttime dryness is usually the final phase of bladder control. Bedwetting is more common in boys than girls and is hereditary in four out of 10 cases. It is sometimes seen in children who are heavy sleepers and who simply don’t wake up when they need to urinate.
Prevention, intervention, and treatment—>
Prevention and Intervention
Successful toilet training at an early age is the most effective defense, says Barone. “The best time for toilet training is between the ages of 27 to 32 months. Beyond that time, the incidence of these types of problems is going to increase.”
Regardless of age, parents can take some simple steps to reduce nighttime accidents. Barone suggests limiting fluid intake in the evening and making sure your child doesn’t become overly tired. Most important, he says, don’t add to stress. Putting your child in pull-ups is perfectly fine and can save embarrassment for him and the hassle of changing wet sheets for parents.
Treatments that Work
Although 99 percent of children eventually outgrow bedwetting, it’s still a good idea to seek professional help for cases that persist. “If you don’t seek treatment for a child who is wetting the bed at age 7, there’s a 50 percent chance he’ll be in the same spot by age 10,” Barone says. Some cases even persist into the teens. Talk with your pediatrician and determine next steps with her advice.
Bedwetting alarms are a first-line treatment that can cure nighttime incontinence. They have a small moisture sensor that is placed in pajamas and triggers an alarm at the first drop of urine. The devices are safe and effective when used correctly. “By the time they come to me, most patients have tried an alarm and have failed,” says Barone. “In 80 percent of cases, the alarm has been used incorrectly. It’s worth a trip to the urologist just to make sure you’re using it right.”
Medications for bedwetting are also available and used fairly frequently. Both DDAVP and Tofranil have received FDA approval to control bedwetting. Other medications may also be used to reduce bladder contractions and increase bladder capacity. They can be helpful for children with psychological issues, like anxiety, who find the alarms too stressful. Barone cautions that drugs don’t offer a cure. “Medications work in up to 60 to 70 percent of cases, but they really just put a band-aid on the problem.”
Bedwetting Facts
- Bedwetting runs in families.
- Bedwetting usually stops by puberty.
- Most bed-wetters do NOT have emotional problems.
Source: American Academy of Child & Adolescent Psychiatry
Nita Crighton is a registered nurse and mom of three from Harding Township
