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What to do when kids wet the bed

Devon Ebbing, MD

If your child wakes up in a soggy pull-up or urine-soaked sheets every morning, know that you’re not alone. Bed-wetting is very common in children. However, because most parents and kids do not talk about it openly, it can feel like an abnormal problem.

Most children learn to consistently pee in the potty during the daytime when they are between the ages of 2 and 4 years old. Some young children will stay dry overnight as well. However, around 20 percent of all 5-year-old children still wet the bed at night and have never experienced a consecutive string of dry nights. Nighttime bladder control can take time to develop, especially in boys, and pediatricians don’t expect it to happen until children are at least 5 to 7 years old. Although it is more uncommon, some children—who don’t have any developmental or medical concerns—continue to wet the bed until they are 12 to 14 years old.

What causes bed-wetting

Children wet the bed for a variety of reasons. Sometimes their bladders mature slower than usual or hold a smaller volume of urine. Sometimes their bodies don’t make as much vasopressin—the hormone that reduces urine production at night. The cause may also be genetic: A parent who wet the bed as a child is more likely to have a child who does the same. Deep sleep may also prevent children from recognizing when their bladders are full, though this theory is controversial.

No matter what, you can rest assured that bed-wetting in children is both normal and involuntary. Children should never be punished, spanked, or scolded for their inability to stay dry. Instead, they need time, patience, and understanding.

When to see a doctor

While bed-wetting can be embarrassing, and the extra laundry an inconvenience, I typically do not recommend using medications, as these often carry risks. Most children gradually outgrow bed-wetting without any treatment.

For children who are at least 8 to 10 years old and still struggling, it might be time to try bed-wetting alarms. These alarms sense moisture and teach children to wake up to use the toilet. You can also encourage children to drink most of their fluids early in the day and limit fluid intake after dinner. For these approaches to work, however, children need to feel motivated to address the situation and actively participate in the solution. Prior to turning 8 to 10 years old, success is often very limited and just a source of stress to families.

In a small number of instances, bed-wetting can be a sign of a more serious condition. Be sure to talk to your pediatrician if your child suffers from constipation; needs to urinate frequently or urgently, or experiences burning while doing so; is extremely thirsty during the day; or has swelling in the feet or ankles. Another cause for concern is a change in habits, such as waking up wet after weeks or months of staying dry.

For more information on bed-wetting, talk to your pediatrician.

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Dr. Devon Ebbing is a pediatrician at The Vancouver Clinic. She enjoys working with patients and their families to develop the right care plans for their unique needs.