Bedwetting, now what?

Your child still regularly wets the bed when you expected them to be dry by this time. This can be very frustrating, but do not worry… more parents are dealing with the problem of bedwetting than you might think… We have looked at some scientific articles to answer all your questions and even help you on your way to possible solutions!

It is normal for small children to wet the bed. In general, children between 2 and 4 years old have learned to hold their pee during the day, but this is a bit more difficult to accomplish in the evening. Scientific studies show that 15% of 5-year-olds and 6 – 8% of 6-8 year olds still wet the bed regularly. There are many reasons why your child may not stay dry at night. In this blog you will find all the information you need!

What is bedwetting and what causes it?

Bedwetting, also known as nocturnal enuresis, is when a child unconsciously empties their bladder during their sleep. This is only seen as problematic if the child is of an age at which it can reasonably be expected that bedwetting no longer occurs.

The Dutch College of General Practitioners has drawn up the following conditions that define nocturnal enuresis:

  • 5 years or older
  • Bedwetting occurs at least twice a week
  • Over a three-month period

or

  • 7 years or older
  • Bedwetting occurs at least once a week
  • Over a three-month period

Do not worry if your child fits any of the above criteria. Many children wet the bed and it can usually be addressed effectively. It is important to get a better idea of the possible causes.

Primary or secundary bedwetting?

There are two types of bedwetting: primary and secondary. About 25% of cases are secondary. A child suffering from primary bedwetting has never had control of his bladder. Children dealing with secondary bedwetting have started wetting the bed again after having been dry for at least 6 months

The causes of primary bedwetting

Some parents may think that children wet the bed on purpose to ask for attention or because they are lazy, but in reality this it almost never the case. Most children experience bedwetting as problematic and embarrassing. We have listed the most common causes of bedwetting below.

Bed-time routine

It is important for a child to have a bedtime routine. This can prevent the vast majority of bedwetting incidents.

  • Do not drink anything an hour before bedtime
  • Take a good pee before going to sleep

More information about routines can be found here

Bladder capacity

Research shows that 75% of bedwetting children have a smaller bladder capacity than expected at their age. This might be the case for your child if they have to go to the toilet more than once per night.

On this page you can read all about what bladder capacity is expected at the age of your child. It also lists useful tips to identify bladder problems in your child.

Deep sleep

Is it difficult to wake up your child? A frequently cited study confirms many parents’ suspicion. Children who wet the bed often have a high wake-up threshold, as a result of which they do not properly process the signals of a full bladder. A bedwetting alarm is an effective method to teach a child to wake up.

We have written a useful article about how to lower your child’s wake-up threshold.

Heredity

You probably know that with your DNA you pass on some of your characteristics to your child, but did you know that your bedwetting history is one of them? If one of the parents used to have problems staying dry, a child has a 43 percent chance it has to deal with the same problem. If both parents suffered from bedwetting, the risk rises to 77 percent!

This does have one great advantage; you, like no other, can explain to your child that they are not alone!

Chronic constipation

A remarkable study has recently been published in which the cause of bedwetting was not found in the bladder, but in the intestines. If stool accumulates in the intestines, this can put pressure on the bladder. In a study that followed 30 constipated and bedwetting children while they got rid of their constipation, 83 percent (25 children) stopped bedwetting within 3 months! Many doctors do not include this in their diagnosis, which means that bedwetting can persist longer than necessary. Check out the necessary information to get an idea whether your child is constipated here.

Causes of secundary bedwetting

If your child starts wetting the bed again after having been dry for at least 6 months, they are suffering from secondary bed-wetting.

Sressful situations and emotions

It is often said that there is a direct link between bedwetting and stress. However, it has been proven that this is preceded by a change in behaviour. An example of behavioural change is an increased salt intake. Like adults, many children that experience stress have an increased appetite for salty snacks. Add to this a small bladder and a wet bed is often inevitable.

There are many other behaviours that may arise from stress. In this article we will address this further.

Urinary tract infection (UTI)

When a child has a urinary tract infection, they feel a frequent need to urinate, which makes your child more likely to wet the bed at night. Fortunately, a urinary tract infection can be treated with antibiotics.

Because this is a common problem, we have some useful tips for you.

Overactive bladder

An overactive bladder will create a sudden urge to go to the toilet. This mainly occurs in children between 3 and 8 years old. The bladder quickly contracts, causing tension to build up faster than normal. If this problem does not subside within a few weeks, it is important to take action.

More information about an overactive bladder resulting in bedwetting can be found here.

Diabetes

In rare cases, type 1 diabetes or childhood diabetes can be a reason a child starts wetting the bed. A well-organised life is the key to success for a child with diabetes. You will find some useful tips here.

Sleep apnea

About 10% of children snore. In about 10% of cases, snoring is causes by apnea. Obstructive sleep apnea is caused by a narrowing of the airways and can have unpleasant consequences for the overall health of your child.

Always contact the doctor if you suspect your child may be suffering from sleep apnea.

Help your child with these 7 tips

  1. Support your child and let them know that you understand that they do not wet the bed consciously. It is very harmful to your child’s learning process to punish your child after a bedwetting incident.
  2. Agree on a bedtime routine. Even though it is not a miracle cure, adhering to a bedtime routine considerably reduces the chance of bedwetting!
  3. Involve your child in changing the bed to make them aware about the consequences of bedwetting.
  4. Be patient. It is unrealistic to expect your child to achieve dryness overnight. Every child progresses at a different speed.
  5. Fight bullying within the family or at school. Being bullied with bedwetting is disastrous for the child’s self-image and confidence. Zero tolerance with regard to bullying is crucial to prevent child trauma.
  6. Try to see the bigger picture. Bedwetting is a normal thing that has affected even the most famous and important people in this world. Count your blessings if this is the biggest inconvenience you have to deal with!
  7. It is never a bad idea to contact your doctor to rule out any physical abnormalities.

Walking the path towards dry nights together

Bedwetting alarm

Scientific research has conclusively established that the bedwetting alarm method is the most effective and safest way to eliminate bedwetting in a sustainable way. A study of 505 children shows that 79% stayed dry for at least 14 consecutive days after 10 weeks.

Because there is no chance of side effects, the bedwetting alarm is available without a prescription. The offer is so great that there is no doubt that you will find a bedwetting alarm that meets your and your child’s needs. Bedwetting alarms are subject to innovation in the same way as our smartphones. The newest generation is completely wireless and easy to use. To help you on your way to find the bedwetting alarm that suits you best, we have made an overview of all the pros and cons of the bedwetting alarms currently on the market.

Medication

In some cases, like a sleepover or summer camp, medications can be useful to achieve temporary success. It is important to determine if the benefits outweigh the possible side effects.

Imipramine/ amitriptyline

Imipramine belongs to a group of tricyclic antidepressants. It controls the amount of naturally occurring substances in the brain that play a role in moods and emotions. It is not known how imipramine works in bedwetting. It appears not to be effective for all children. Source: Apotheek.nl

In some cases, this medicine is very effective, but it does have potential drawbacks. Check out this page where we have investigated this matter further.

Minrin/ Desmopressin

When taken before bedtime, Desmopressin decreases urine output at night. Desmopressin does not completely resolve bedwetting. People do urinate less at night and the bed will get wet less often, but it usually does not remain completely dry. Bedwetting often returns after stopping with the drug. Source: Apotheek.nl

This drug can be a good temporary solution if your child is going for a sleepover, but because of the possible side effects we do not recommend it for longer use. In this article we have explored the pros and cons further.

To summarise

Bedwetting can have various causes. It is good to rule out some of the causes that could be harmful to your child. If in doubt, always contact your doctor or a urotherapist!