When my middle child turned 3, we made the big move of wearing underwear at night. He had proven he was ready by making it through the night for a few weeks with a dry pull-up in the morning. My excitement for him had to be somewhat tempered because my 6 year old was still having problems with wetting the bed.
Most children achieve daytime control over their bladder by age 4 with nighttime control occurring months to years after that. Bedwetting, or “nocturnal enuresis” in medical lingo, is relatively common in childhood – it occurs in 15 percent of 5 year olds. In most children, it “spontaneously resolves” (just stops), declining in incidence by about 2 to 3 percent each year with only about 1 percent of 15 year olds still experiencing it. Bedwetting is more common in boys and in kids whose parents also wet the bed.
In most cases, nothing is seriously wrong. The immature connections in the brain just have trouble registering when the bladder needs to empty. However, if your child has gone a sustained period of time with nighttime dryness and then begins to wet the bed again, something medical (like a urinary tract infection) or a social stressor (like starting school) could be the cause.
As a parent, you can help your child stay dry through the night. Steps you can take include:
- avoiding caffeinated beverages, especially later in the day
- limiting liquids in the hours leading up to bedtime
- encouraging your child to void regularly during the daytime
- promoting regular bowel habits as well to avoid constipation
- having your child “double void” before bedtime (they go to the bathroom as usual during their routine and then one more time right before they hop into bed)
- placing nightlights in the hallway and bathroom so that if they get up in time, reaching the bathroom will be easy and fear free
- using thick, absorbent underwear — pull-ups should be avoided for long periods of time but are great for occasions like sleepovers and vacations.
Some more practical things to keep your frustration to a minimum:
- Put a plastic liner along with a waterproof pad underneath their sheets so that even if you have to do a load of laundry, your mattress will be unharmed.
- Lay out an extra pair of pajamas, and a laundry basket by your child’s bed. If they wet the bed in the middle of the night, they can strip the sheets off and change into a fresh pair of pajamas on their own; this also helps give them a sense of control over the situation.
You can also talk to your pediatrician about bedwetting alarms and whether one would be beneficial to your child.
Even worse than the constant washing of the sheets is watching your child feel embarrassed and ashamed by what is happening. Children don’t wet the bed on purpose so even though it is frustrating, do your best to not admonish or tease your child. Praise them when they do have those nights that they wake up dry and remind them that with time and patience there will be many more.
Maya Neeley is a pediatrician specializing in hospital medicine. She adores her husband and four young boys and loves spending time with family and good friends. As a child, she always dreamed of becoming a children’s book illustrator, but for now she just dreams of getting a good night’s sleep.