Bedwetting advice

A multinational survey in 1998 found that 15% (one in seven) of seven-year olds are regular bedwetters and that the number is slightly higher in boys than in girls

More than half-a-million under 16s in the UK wet the bed regularly, and up to 2% of over-16s continue to wet the bed on a semi-regular basis

What are possible causes?

Very often the problem is due to slow development of the regulatory system that allows the bladder to gradually distend over many hours without emptying. This slow development can be hereditary so it is not unusual to find that a parent also used to wet the bed after reaching toddler age

Fairly rarely, bedwetting can be a sign of an underlying medical problem, such as urinary infection, diabetes, kidney disease or a congenital abnormality of the urinary tract. In these cases, you might often (although not always) expect to find difficulties with bladder function in the daytime as well as at night

Because of possible medical problems it is a good idea to check things out with your GP in order to exclude medical problems, even though this is a rare occurrence

Where children have been dry at night for some time before starting to wet the bed, there is almost always some underlying emotional stress or anxiety. The following are very frequent background issues in cases of anxiety: a new baby, problems at school, upset in a friendship, bullying, family difficulties, death of a family member or friend or even a pet, a house or school move. In fact anything which disrupts the child's emotional stability can be the cause or an exacerbating factor

What can be done?

Play detective: try to discover any pattern which is related. Are there more or fewer wet beds if there has been a difficulty at school, or if one parent rather than another puts them to bed, if they go to bed earlier or later, if they wet at night or the early morning, for example. The more information you have, the easier to know the next step

Try not to make an issue of it, since your child is not doing it on purpose and will be at least as disturbed by it as you are, even though in some cases they may seem not to be bothered

Understand that by getting angry, shouting or complaining or suggesting that they do it on purpose will surely make matters worse since their anxiety levels will be increased by this response

Certainly, NEVER punish them

What options are there?

An enuresis alarm which makes a noise and wakes the child as soon as they start to wet the bed. The most commonly used type has a sensor that is placed between the bottom sheet and the mattress. Success rates vary wildly with these

Medication Desmopressin is a drug which can be given to children aged five or over as a tablet or in the form of DesmoMelts which dissolve under the tongue. This acts by reducing the amount of urine that is produced overnight. This has a success rate of around 70%, and works pretty well immediately if it's going to work at all. Treatment is usually continued for three months, and then is stopped to see if the problem has resolved. There are possible side-effects (headache, stomach ache and feeling sick) but they are not that often experienced

Hypnotherapy this works exceptionally well where anxiety and stress are either causal or exacerbating factors. Where cases are more severe, I see people in person but a remarkable number of children respond to a specially written CD. I have produced two CDs, one for age group 6-9 years and one for age group 10-15 years and these are available from our websites www.firstwayforward.com/childcds or www.firstwayforwardcds.com. Remember that children’s maturity varies tremendously, so check the description for content. The advantage of this method is that they are completely natural and safe, no drugs are involved and children enjoy listening to them as they drift off to sleep

Useful tips

• Use a mattress protector rather than protective pants. The problem with protective pants is that they keep the body so comfortable that the child is unaware if they are wet or dry.

• If they are wearing snug protection they will not be aware when the bladder first starts to release and won't learn to be able to control it at this stage

• Check that they are not constipated, since a full bowel can press on the bladder and increase the urge to urinate

• Check that they drink a lot of water during the day and restrict fluids after their evening meal. Offer just sips of water if they are still thirsty

• Avoid caffeine-containing drinks such as tea, coffee or fizzy drinks

• Ensure that the child goes to the toilet very last thing before sleep. Sometimes they might go to bed early and read but they should be encouraged to go just before they settle down for sleep

• It is often helpful to take them to the toilet when you go to bed yourself. This is very rarely really disturbing since they do it almost as if in a dream and drift off to sleep again as soon as their head hits the pillow

• Leave a light on if there is the slightest anxiety concerning the dark so that they can get up to go to the toilet easily during the night. (Remember that your child may sometimes deny they are scared of the dark for reasons of saving face)

• Encourage them to help with changing the sheets to the degree that this is suitable for their age and capabilities BUT DO NOT MAKE IT SEEM LIKE A PUNISHMENT. They will feel more involved in trying to help with the problem and be less likely to think that you are annoyed with them because of all the extra work they are causing you

• Some people use gold star progress charts which can work well if there are some dry nights but are quite discouraging if there are either none or very few

• A useful website: www.eric.org.uk
This organisation gives practical advice to families who have a bedwetting or daytime wetting child or teenager. They are also helpful with advice for special needs children. You can get advice over the phone, and/or buy relevant products, such as bed protection. They also recommend the CDs I'm Dry at Night and Control your Bladder - Good Morning which were featured in an article in Woman magazine in October 2005. Check out our Media Coverage page