Bedwetting

For Pediatric Appointments call our Camp Hill office (717) 763-1174 to be scheduled with Dr. Thomas Clements

Bedwetting, (primary nocturnal enuresis or PNE), is a common condition that affects some 7% of children between the ages of six and 12 years. Under the age of six, wetting the bed is not uncommon as children develop and mature at different paces.

Bedwetting is also a common cause of stress for parents and kids who experience this condition and may cause older kids to be embarrassed. Parents may experience feelings of frustration when they are faced with a situation where their child wets the bed at night yet has been fully toilet trained during the day for months or years.

Children mature at different rates. When bedwetting is a problem - Patience, understanding and persistence is important to overcoming this common childhood problem.

Education is key to helping your child deal with bedwetting issues.

In many cases of bedwetting, parents may take on the issue without help from a healthcare provider. Dr. Clements believes that parents may help their child deal with bedwetting when they are educated and have solid information.

What We Know About Bedwetting

98% of the time there is no specific cause, and treatment choices are similar.

By the age of 16, all but 1-2% of bedwetting resolves.

Hiding from the problem and hoping it will go away may make kids and parents miserable.

Although unusual, specific medical or surgical conditions can be found in children whose concern is bedwetting. Less than 1% of children who wet the bed have an underlying medical condition.

Bedwetting occurs in light and deep sleepers alike.

Bedwetting does tend to run in families with some reports showing 90% of kids with a family
history.

Children over age five who wet the bed may have bladders that still need time to mature.

Obesity, specific medications and diet may alter the normal nighttime regulation of urine production, leading to bedwetting.

Most kids who wet the bed empty their bladders at night most commonly when normal bladder volume is achieved, not because of a small or overfull bladder.

Bedwetting is a real problem for many children. It does not mean that your child is too lazy to get out of bed at night to use the bathroom or that being a deep sleeper leads to bedwetting. There are a number of factors that contribute to bedwetting from developmental delays to heredity, and many causes remain unknown.

When Is It Time To Seek Help?

Dr. Clements recommends parents let the child direct the treatment, particularly in children over the age of six. When the child asks for help, they are usually ready to accept it. The decision to seek treatment for bedwetting is a personal one and our team understands that each child is unique, as well as their condition.

If your child is six years or older, it might benefit you and your child to talk to a pediatrician or a pediatric urologist about bedwetting. Our pediatric specialist at Urology of Central PA understands bedwetting is a stressful problem that can affect the entire family. Typically, the child will get to the point where he or she is bothered by the condition (for example, when it gets in the way of sleepovers with friends).

Bedwetting Evaluation

Often there is no underlying cause of bedwetting that poses a medical concern and there is still much about bedwetting that we do not understand.

Your doctor will take a complete medical history and perform a physical exam to rule out any underlying conditions. Your doctor may also perform additional testing including a urinalysis to rule out infection.

You and your child may be asked these questions:
How often does your child urinate?
What color is the urine (dark yellow or pale/clear)?
Does the child complain about burning or pain when urinating?
Has anyone else in the family wet the bed as a child?

As part of your child's evaluation, you may also be asked to keep a Voiding Diary and/or a bathroom chart to track urinary patterns and bowel habits over a period of several days.

Helping Your Child Stay Dry

There are several approaches we take to helping keep kids dry at night.

Treatments vary and depend on any factors that may be causing your child to wet the bed at night. The best cure for bedwetting is time. As your child's body matures and develops, he or she will grow out of bedwetting.

There are several treatments your doctor will discuss with you to help keep your child from wetting the bed at night.

These include:

Behavioral Modifications
Your doctor may suggest changes to your child's daily routine including their diet:

Limit or avoid caffeinated drinks such as sodas and chocolate beverages, especially in the evening and before bedtime. Caffeine is a natural stimulant that can increase urination.

Limit the amount of liquid your child drinks in the evening and before bedtime to help keep the bladder from filling up overnight. Make sure your child urinates right before bedtime.

Keep a voiding diary will help you track patterns of your child's urination and bowel habits. For example, it might help you realize that your child wets the bed two or three hours after falling asleep each night. This will help you when using some of the bedwetting treatment approaches such as alarms or the self-awakening routine.

The Self-Awakening Routine
Helping your child learn to wake up when his or her body signals that they need to urinate at night can help your child with control. Work with your child on the self-awakening technique which includes:

Having your child lay quietly in his or her bed right before bedtime. When your child is relaxed, ask him/her to envision that he/she is sleeping and needs to urinate. Have your child get up and go to the bathroom to urinate. This behavior will help your child get in the habit of waking and going to the bathroom.

If you child wakes up at night for any reason (bad dream, couldn't sleep, etc.), have him or her go to the bathroom before returning to bed. Sometimes a child will wake up at night for one reason when they really just need to urinate. This will also help your child recognize his or her body's signals.

Bedwetting Alarms
For some children, a bedwetting alarm will help teach them to wake up when he or she needs to urinate. While some parents find these alarms helpful, other families find that the alarms wake everyone else up except the child who wets the bed. Keep in mind that every tactic to help your child overcome the bedwetting problem is based on individual preference.

There are two types of bedwetting alarms that you can try:

Special bedwetting alarms that have a sensor that is usually attached to a pad on your child's bed. When the pad gets wet from urination, a loud alarm or buzzer will sound and wake the child up. Some alarms vibrate instead of make a loud sound. The goal of this alarm is to wake the child up right when they begin to wet the bed so that can realize what they are doing, stop themselves from urinating and get up to go to the bathroom.

The alarm clock method - an alarm clock is set to go off about three or four hours after your child falls asleep. When the alarm goes off and your child is awakened, he or she will then have to go to the bathroom. Parents may need to wake with the alarm clock to ensure that your child gets up to use the bathroom rather than turning the alarm off and going back to sleep.

Along with bedwetting alarms, keeping a voiding diary will help you track patterns of your child's urination. For example, after keeping the diary for one week, you may notice that your child wets the bed two hours after he or she falls asleep. This information will help you know when to set the alarm or when to check your child's bed for wetness.