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Overview

You’ve successfully potty trained your child. At this point, you’re probably relieved to no longer be dealing with diapers or training pants.

Unfortunately, bed-wetting is a common occurrence in many young children, even if they’ve been potty trained well during the daytime. In fact, 20 percent of 5-year-olds experience bed-wetting at night, which means as many as 5 million children in the United States are wetting the bed at night.

Bed-wetting isn’t restricted to kids 5 and under: Some older kids may not necessarily be able to stay dry at night. While younger children are the most likely to bed-wet, 5 percent of 10-year-olds may still have this problem. Here are some steps you can take to help your child overcome bed-wetting for better quality of life.

Step 1: Acknowledge the bed-wetting

Potty training doesn’t simply help stop your child from having accidents. When you teach your child how to use the toilet, they are also learning bladder training mechanisms. As potty training progresses, children learn to recognize the physical and mental signs and symptoms of when they have to go.

Nighttime bladder training is a bit more challenging. Not all children are able to hold urine during their sleep or are able to wake up when they need to use the toilet. Just as daytime potty training success varies by age, so does the battle against nighttime incontinence, or bed-wetting. Some children have smaller bladders than other children of the same age, which may make it harder.

Certain medications may offer relief, but the results are often temporary and never the first step. The best way to treat bed-wetting is through long-term solutions that can help your child learn how to wake up when they need to go.

The results of bed-wetting are frustrating for parents who have to constantly wash sheets and clothing. But the most damage is psychological. Children (especially older kids) who still wet the bed can experience embarrassment and even lowered self-esteem.

While your first impulse might be to avoid discussions about bed-wetting and to wash the sheets in silence, such lack of acknowledgement can make things worse. The best thing you can do is to tell your child that accidents are OK, and reassure them that you will find a solution together. Also let them know that many other kids wet the bed, and this is something they will grow out of.

Another thing to consider to help your child feel better is using bed protection or a room deodorizer.

Step 2: Eliminate drinks before bedtime

While your child may be accustomed to drinking a glass of milk or water before bedtime, this can play a role in bed-wetting. Eliminating drinks an hour before going to bed can help prevent accidents. It would also help if your child goes to the bathroom one last time right before going to sleep, and you can remind them to do this. It can help to make sure your child gets most of his fluid intake during the morning and afternoon, and a smaller portion with dinner. You may also want to eliminate nighttime snacks and desserts, as your child might get thirsty after eating more food.

Also, consider readjusting your child’s beverages. While milk and water are healthy choices, juices and sodas can have diuretic effects, which means that they can lead to more frequent urination.

Step 3: Set up bladder training

Bladder training is a process where your child goes to the bathroom at set times, even if they don’t think they need to go. This type of consistency can help stimulate bladder training and will help with bladder control.

While often done during the waking hours for daytime incontinence, bladder training for bed-wetting happens at night. This means you will wake up your child once or twice a night to go to the bathroom.

If your child still wets the bed on a regular basis, don’t be scared to try training pants again. Some brands, such as GoodNites, are even designed for incontinence in older children.

After going back to training pants for a while, you can start bladder training again. These “rest” periods can also help prevent discouragement in your child from several nights of bed-wetting.

Step 4: Consider a bed-wetting alarm

If bladder training doesn’t improve bedwetting after a few months, consider using a bed-wetting alarm. These special types of alarms are designed to detect the onset of urine so your child can wake up and go to the bathroom before they wet the bed. If your child starts to urinate, the alarm creates a loud noise to wake them up.

An alarm can be especially helpful if your child is a deep sleeper. Once your child gets used to the process, they may get up on their own to use the toilet without the alarm going off because the alarm helps train the brain to recognize their urge to urinate and to wake up for it.

Alarms have about a 50-75 percent success rate and are the most effective way to control bed-wetting.

Step 5: Call your doctor

While bed-wetting is a common occurrence in children, not all cases can be resolved on their own. If your child is over the age of 5 and/or wets the bed every night, you should discuss different ways to address this with the pediatrician. While uncommon, this could indicate an underlying medical issue.

Let your doctor know if your child:

  • frequently experiences constipation
  • suddenly starts urinating more frequently
  • starts having incontinence during the day, too
  • urinates during exercise
  • complains of pain during urination
  • has blood in the urine or underwear
  • snores at night
  • exhibits symptoms of anxiety
  • has siblings or other family members who have a history of bed-wetting
  • started bed-wetting again after no episodes for at least six months

Q:

When is it time to see the pediatrician if your child is wetting the bed?

Anonymous patient

A:

If your child is still wetting the bed at night after the age of 5, you should discuss this with your pediatrician. They can help come up with a plan that works best for your family. Your pediatrician will also help see if there is an underlying problem leading to it.

Another time to see your child’s pediatrician is if your child has already been fully potty trained during the day and night for over six months, then starts bed-wetting again. That may indicate a stressful event for your child is causing this to happen.

Nancy Choi, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Next steps

For most children (and their parents), bed-wetting is more of nuisance than it is a serious problem. But it’s important to look for the above signs to see if a medical issue is interfereing with your child’s ability to control their bladder at night. Be sure to discuss your concerns with your child’s pediatrician.

It can also help as you’re trying these steps to keep a calendar of wet and dry nights, to keep track of whether there has been improvement. If these first steps don’t work, your pediatrician can discuss other ideas as well as some medications that may help.