What is bedwetting?

Bedwetting happens when your child doesn't wake up during the night when they need to urinate (do a wee). This causes them to wet the bed.

Bedwetting is very common. It's also known as 'nocturnal enuresis'.

It's very common for children aged 6 years and under to wet the bed. But older children can wet the bed too. In fact, about 1 in 20 10-year-old children wets the bed. Some children can be affected into their teens.

This article is about bedwetting in children older than 6 years. Here is information on bedwetting in younger children.

What symptoms are related to bedwetting?

Bedwetting can happen every night, or just happen now and again.

Some children who wet the bed can have problems with wetting during the day. This may be:

• needing to wee often
• needing to wee urgently
• wetting during the day

Bedwetting can be upsetting for children, and distressing and frustrating for parents. But it isn't your child's fault. Bedwetting has nothing to do with bad behaviour.

Some children continue bedwetting from birth, while others start bedwetting again when they are older.

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What causes bedwetting in older children?

Bedwetting tends to run in families — if one or both parents wet the bed when they were young, then it is more likely to happen with their children.

Most children who wet the bed sleep very deeply and don't wake up when they need to urinate (do a wee).

Some children might make a lot of urine at night. This can happen if they don't make enough of a hormone called antidiuretic hormone (ADH) overnight. They might also have a small bladder that only stores a small amount of urine.

Bedwetting can also be related to:

• constipation in children
• emotional problems — sometimes a stressful event can cause an older child to wet the bed
• a medical problem (this is uncommon)

How is the cause of bedwetting in older children diagnosed?

Your doctor will ask about your child's bedwetting, including how often it happens. They will ask if your child has ever been dry overnight.

They may also ask about your child's:

• sleeping patterns
• bladder and bowel (toileting) habits
• whether they have any problems with wetting during the day
• how much they drink during the day
• what they usually eat

Your doctor will examine your child. In some circumstances they might recommend a urine test or other tests. But often further testing is not needed.

Your doctor might refer your child to a health professional with specialist training in children's bedwetting.

When should my child see the doctor?

It's a good idea to see your doctor if your child keeps bedwetting after about 6 or 7 years of age.

If your child starts wetting the bed again after a period of being dry, you should take them to your doctor for a check-up.

Also see your doctor if you are worried, or your child is upset about bed wetting.

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How is bedwetting in older children treated?

Bedwetting generally doesn't need to be treated before the age of 6 years. That's because it usually gets better on its own.

There are several treatments available for bedwetting in older children. For some children, your doctor may recommend you see a:

• paediatrician (children's doctor)
• physiotherapist who works with children with bladder control problems
• specialist nurse

Self-care at home

Here are some tips to help your child stay dry.

• Remind your child to go to the toilet before going to bed.
• Put a nightlight in the toilet and encourage your child to get up to wee during the night if they need to.
• Use nappies or pullups.
• Protect the mattress with a waterproof pad or cover.

Note that waking your child and walking or carrying them to the toilet does not help them become dry long term.

It's also important to:

• Encourage your child to drink plenty of water during the day.
• Make sure your child avoids any food or drinks that contain caffeine (for example, tea, chocolate or cola drinks) before bedtime.
• Ensure your child eats a healthy diet with plenty of fibre, to prevent constipation.

It's important to encourage your child to not feel embarrassed or ashamed about bedwetting.

Bedwetting alarms

Alarm therapy is the most effective treatment available for bedwetting in children older than 6 years. Both you and your child need to be motivated for a bedwetting alarm to work.

Bedwetting alarms work by teaching your child to wake up and go to the toilet when their bladder needs to be emptied. The alarms are designed to be loud enough to wake your child from sleep at the first sign of any moisture. Vibrating alarms are also available.

You can help your child by getting up with them when the alarm goes off and helping them change wet clothes and sheets. Nappies or pull-ups cannot be worn while using a bedwetting alarm.

It takes 6 to 8 weeks for bedwetting alarms to work. Using a reward chart for waking and using the toilet (even when your child is not completely dry) can be helpful. Keeping a diary to chart your child's progress is also usually recommended.

Your doctor can advise you whether your child could benefit from alarm therapy and how to use it.

Medicines for bedwetting

In most cases medicines are not needed for bedwetting. But it can be useful in some situations, including when a night alarm has been tried and not worked.

Your child's doctor may prescribe a medicine called desmopressin, which reduces the amount of urine (wee) made at night. Short-term use of this medicine may sometimes be tried for special occasions, such as sleepovers or school camps.

This medicine is only available on prescription and is not suitable for all children.

Tips for encouraging your child

Your child's self-esteem can be damaged by punishing or embarrassing them. It also hurts when siblings or friends make fun of them.

To encourage your child:

• Be understanding and don't punish your child for wetting the bed.
• Do not get angry — it does not help and may make your child more anxious.
• Do not shame your child — it does not help your child gain bladder control.
• Be patient and supportive.
• Remember that bedwetting is not your child's fault.

Resources and support

The Continence Foundation of Australia has:

• information on bedwetting
• information on bedwetting in languages other than English

You can talk to a nurse specialist by calling the National Continence Helpline on 1800 33 00 66.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.