What is bed-wetting?
Bed-wetting is involuntary urination while asleep. Also known as nighttime incontinence or nocturnal enuresis, it is often just a normal part of a child’s development.
Most children are fully toilet trained by age four, but there’s no timeline for developing complete bladder control. By age five, bed-wetting remains a problem for only about 15 percent of children. At this age, your child may still be developing nighttime bladder control. Generally, bed-wetting before age six or seven isn’t cause for concern. Between the ages of eight and 11, fewer than five percent of children are still wetting the bed.
If bed-wetting continues, treat the problem with patience and understanding. Bladder training, moisture alarms or medication may help reduce bed-wetting.
When to see a physician
Most children outgrow bed-wetting on their own. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.
Consult your child’s physician or Dr. Gordon M. Castleberry if:
- Your child still wets the bed after age six or seven
- Your child starts to wet the bed after a period of being dry at night
- The bed-wetting is accompanied by painful urination, unusual thirst, pink urine or snoring
Causes of bed-wetting
Any one of a variety of factors may be the cause if your child has a problem with bed-wetting:
- A small bladder. Your child’s bladder may not be developed enough to hold urine produced during the night.
- Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
- A hormone imbalance. During childhood, some children don’t produce enough anti-diuretic hormone to slow nighttime urine production.
- Stress. Stressful events, such as starting a new school, sleeping away from home, or becoming a big brother or sister, may trigger bed-wetting.
- Urinary tract infection. A urinary tract infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, bloody urine and pain during urination.
- Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep — often because of inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, and daytime drowsiness.
- Diabetes. For a child who’s usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
- Chronic constipation. A lack of regular bowel movements may make it so your child’s bladder can’t hold much urine, which can cause bed-wetting at night.
- A structural problem in the urinary tract or nervous system. While it is rare, bed-wetting can be related to a defect in the child’s neurological system or urinary system.