By age 3 or 4, most children are able to sleep through the night without wetting the bed. But 5 to 7 million children -- mostly boys -- older than age 6 are not able to stay dry. Bed-wetting can be exhausting and upsetting for the whole family. The good news is that it usually does not signal an emotional or physical problem. Most children outgrow the tendency by puberty.
Nighttime bed-wetting (nocturnal enuresis) usually occurs because the child's bladder is not yet large enough to hold a full night's output of urine, or because he has not yet developed the urge to wake up in response to a full bladder.
Studies also show that children who wet the bed may have an abnormally low level of an antidiuretic hormone (ADH). This hormone helps the kidneys retain water, reducing the amount of urine filling the bladder. This tendency is often associated with a family history of bed-wetting.
- Bed-wetting is not something that's in your child's control, so punishment for wet nights and rewards for dry nights are not helpful or appropriate. Children are usually embarrassed by this problem, so it's unlikely that your child would be wetting the bed on purpose. Reassure him that he's not the only one with this problem -- there are probably other kids in his class who also wet the bed.
- Discourage him from drinking large amounts of fluids before bed, especially caffeinated sodas. However, don't be too rigid. If he's genuinely thirsty, let him have a drink.
- Have him go to the bathroom right before he goes to bed.
- Wake him up to use the bathroom before you go to bed.
- If these methods don't work, your pediatrician may recommend a bed-wetting alarm. With this device, a lightweight alarm (worn near the shoulder) is attached to a sensor that clips on the child's underwear. A buzzer sounds at the first drop of urine. Over time, children learn to sense the need to wake up on their own, so they don't wet the bed.
- As a last resort, your pediatrician may recommend DDAVP, a synthetic antidiuretic hormone, which is a prescription medication. It's available as tablets and as a nasal spray.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.