Bed-wetting, also known as nighttime incontinence or nocturnal enuresis, means passing urine without intending to while asleep. This occurs after the age at which staying dry at night can reasonably be expected.

Children usually learn to control their bladders between the ages of two and four. Most children are generally fully toilet-trained by five years old. However, there isn’t really a target date for having complete bladder control. It is common for children to wet the bed between the ages of four and six as they grow and adjust to their bodies at their own pace. Most children gain control of their bladders by the age of seven, but accidents can still happen after and through their teenage years.

Bed-wetting isn’t a sign of problems with toilet training. It’s often just a typical part of a child’s development. However, there are some signs that there may be an underlying medical issue causing bedwetting. They include:

• Pain while peeing
• Changes to the frequency of when and how much peeing occurs during the day
• Having a small stream of pee
• Lack of bowel movements during the day
• Changes to the color of urine
• Mood changes

The most common cause of childhood bed-wetting is a lack of bladder control. However, bedwetting can be a symptom of an underlying medical condition, such as:

• A urinary tract infection
• No awareness of having a full bladder
• A small bladder
• A hormone imbalance
• A problem in the urinary tract or nervous system
• Sleep apnea
• Diabetes
• Ongoing constipation
• Obstructive sleep apnea
• ADHD

A healthcare provider can diagnose bedwetting after a physical exam and taking a complete medical history. They may offer to conduct tests, such as a urine test, a blood test, or an imaging test, to determine if there is an underlying medical condition that is causing your child to wet the bed. If your healthcare provider suspects that emotional or psychological factors have been causing bedwetting, they may recommend consulting with a mental health professional.

The treatment for bedwetting varies based on the cause. Treatment options could include:

• Behavioral changes before or during bedtime, such as:
  • Limiting fluids before bedtime
  • Going to the bathroom before bedtime
  • Setting an alarm
  • Bladder therapy
• Taking medications that can reduce nighttime urine production
• Managing or treating any underlying medical conditions
• Talking with a mental health professional, such as a psychologist or therapist, to manage your child’s stress, trauma, or emotional challenges

A child can be embarrassed by soggy sheets and pajamas. It is important not to get upset if your child wets the bed. If your child does continue to wet the bed, treat the problem with patience and understanding. Although bedwetting can’t always be prevented, you can reduce your child’s risk of bedwetting by:

• Avoiding drinking a lot of fluids two hours before bedtime and avoiding caffeinated beverages
• Going to the bathroom before bed
• Making sure the bathroom or toilet is easily accessible
• Wearing absorbent pants at night
• Using positive reinforcement or affirmations to acknowledge when your child wakes up dry
• Avoiding any shaming or making fun of someone in your family or friend group who has wet the bed

If your child is experiencing symptoms of bedwetting, you can visit the pediatrics unit at Flushing Hospital or call (718) 670-5000 to schedule an appointment.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.