Health conditions

Bedwetting

Bedwetting, also known as nocturnal enuresis, is very common in childhood.

Night time dryness usually occurs by the time children reach 5 to 5 and a half but happens at different ages for different children. It is a natural development that occurs when the mechanism controlling that part of the body matures.

Why do children wet the bed?

Bedwetting happens when children do not wake up when their bladder is full at night, and the bladder automatically releases the urine (wee).

Bedwetting is nobody’s fault. It is not caused by laziness or a desire to get attention. It is something that a child has no control over.

For most children who wet the bed, there is a family history of bedwetting. This means the child has at least one sibling, parent or extended family member, such as an aunt, uncle or grandparent who also wet the bed after the age of 5.

Children who wet their beds are usually normal and happy in all other ways.

What happens?

Children with nocturnal enuresis lack night-time bladder control at an age when this would be expected.

  • True bedwetters do not waken after wetting. They are not necessarily heavy sleepers nor are they being lazy and it has nothing to do with dreaming. Wetting the bed is quite unconscious; from the child’s point of view it is a matter of going to bed dry and waking up wet, with no recollection of it happening.
  • Some children who wet the bed produce more urine at night than others, due to a low level of a hormone which controls how much urine is made while the child is asleep.
  • Some children who wet the bed have bladders that cannot hold a large amount of urine.
  • Sometimes bedwetting can be due to a medical problem, so it is wise to check with your doctor
  • Sometimes children who wet the bed at home are dry when sleeping in a strange place. They may be a bit worried when sleeping away from home, and sleep more lightly for the first few nights.
  • Stressful events in a child’s life may interfere with the normal development of night time dryness. These events could include a new baby in the family, being unwell, family separation or break-up. Read more about promoting your child’s coping skills.

If the child is usually dry by day and passes urine normally, bedwetting is very unlikely to be the result of any bladder or kidney disease. However, if the child is ill or feverish, dribbles urine day and night or has pain, you should consult your doctor.

What you can do

Children need to know that bedwetting is a common childhood problem.

If a preschooler still wets the bed:

  • make sure the mattress has an adequate waterproof cover – a length of plastic, covered by a bath towel, over the bottom sheet
  • ensure the bed is warm and comfortable
  • try using 'pull ups' (a type of nappy) on your child
  • establish a routine of going to the toilet before bedtime
  • make sure the bed is low enough to get in and out easily
  • keep a low-powered globe or night light on
  • encourage an adequate and regular fluid intake throughout the day
  • avoid soft drinks containing caffeine – these can cause more urine to be produced, meaning your child may need to go to the toilet more often
  • limiting drinks or ‘lifting’ during the night does not help to achieve bladder control.

Small children are unlikely to be worried by wetting the bed unless Mum or Dad (or other extended family) makes a big issue of it.

It is not helpful to punish children who wet the bed, no matter how desperate you feel about the extra washing. There is no instant cure for wet beds when the child concerned just hasn't reached that stage of development yet.

Getting help

As children grow older, bedwetting is more likely to lead to loss of self-esteem and lack of confidence. It is a problem which causes stress for both children and parents. For older children it is better to seek treatment rather than thinking ‘they will grow out of it’ – some never do!

Help should be sought after the child reaches 5 and a half through a referral by your local doctor to a bedwetting (enuresis) service. These services are conducted by specialist nurses who can inform you of self-management programs and provide advice, support and strategies for the best possible chance of a successful outcome.

Bedwetting alarms

Bedwetting alarms are widely used and are considered the most effective and safe method of treatment. This device consists of a mat placed under the bottom sheet which activates a bell alarm when wet. Success depends on the bedwetting treatment being part of a supervised self-management program using high quality and reliable equipment.

Bedwetting alarms work by conditioning the child to wake when they want to pass urine.

When the child begins to wet, a bell rings and the child wakes. Because the feeling of a full bladder and the sound of the bell happen at the same time, the child’s brain associates one with the other. Eventually the child wakes when they feel the need to pass urine. The treatment programme takes approximately 6 to 8 weeks.

Other interim treatment methods that may suit your child include positive reinforcement and star charts (for under school age) or your doctor may suggest short term medication therapy (for school camps and sleepovers).

More information

Local community, school or child health nurse

  • See inside your baby's purple All About Me book
  • Look in the phone directory under child health centres
  • Visit your nearest child health centre

Local family doctor

Ngala Helpline

  • 8:00am– 8:00pm 7 days a week
  • Phone: 368 9368
  • Outside metro area – Freecall 1800 111 546 (free from land line only)
  • Visit the Ngala website (external site)

Parenting WA Line

  • Phone: 6279 1200 (24 hour service)
  • Outside metro area – Freecall 1800 654 432

Raising Children Network

WA Continence Advisory Service

  • Phone: 9386 9777
  • Outside metro area – Free call 1800 814 925

Continence Foundation of Australia

Remember

  • Reassure your child that bedwetting is common, and nothing to be ashamed of.
  • Don’t punish, criticise, tease or offer rewards for something your child cannot control.
  • Seek medical advice to be sure there is no physical cause.
  • Consider using a bladder training or alarm program if your child is over 5 and a half.
  • Help your child to feel as comfortable as possible about going to school camps and sleepovers.

© Women’s and Children’s Health Network, reproduced with permission. The South Australian Government does not accept responsibility for the accuracy of this reproduction


Acknowledgements
Child and Adolescent Community Health

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

See also

Link to HealthyWA Facebook page