Dear Justin,
I am a mother of 6 year old boy. I was wondering if you could give me some advice on kids bed wetting. I have been using nappies in the night time for my son. Recently both my mother and my friend told me that if I keep using nappies in he will never be able to learn to control in the night time.
Should I continue using nappies or change the sheet whenever my son wets the bed?
Regards,
X
Dr Justin responds:
While bedwetting is inconvenient and sometimes embarrassing (usually more for us as parents than for our children), it is fairly normal in children up to the age of five, and remains common enough for doctors to be generally unworried about it through until around age eight or nine. Bedwetting issues are more common in boys than girls, but both genders can be susceptible to it, with just under 10% of children still having issues with bedwetting at age 5-6 years, even if they have their daytime bladder control completely sorted out.
Please be aware of the following:
First, it is always best to have a chat with your GP if you are concerned. They can test for infections or other medical, physiological, or hormonal issues. Also, be mindful that bedwetting is not usually related to any psychological distress or physiological distress. It certainly can be and if you are worried about either of these issues, you should seek help, but there are many more potential causes of bedwetting than psychological trauma, or physiological difficulty.
Three Reasons for Bedwetting
It is generally thought that there are three key reasons bedwetting occurs.
The first is that your child might simply have a small bladder. There isn’t anything we can do to improve that situation.
The second is that your child may be constipated. If he isn’t pooing regularly and well, this can impact on his ability to control his water-works. Improving his diet can help with this.
Third, and this is important, a lot of children who are still bedwetting beyond the age of six or seven years are waiting for an antidiuretic hormone to be produced by the brain. This hormone keeps urine production to a minimum during the night, but when the body is not making enough of it, the bladder fills up and your child will wet the bed unless the discomfort of a full bladder is enough to wake him.
Since most young children will sleep through just about anything, a full bladder is typically not enough to get them up in the middle of the night, and so they wet the bed instead.
Some researchers also point to parents’ bedwetting as children, suggesting it is a heritable characteristic. If you or your husband were bedwetters, there is a strong chance your children will experience the same issue.
What can you do?
Since most of the causes of bedwetting are beyond anyone’s control, there is not much you can do. Some people will suggest that reducing fluid close to bed time is a good idea. This is sensible, but we should not go overboard on this. If your child is thirsty then he should be allowed a drink. He needs to be able to be responsive to his body’s signals and fluid deprivation may make things worse, rather than better.
Some parents will wake their children in the middle of the night and put them on the toilet. Again, this reduces the opportunity for the body to respond to signals from the bladder to the brain. Of course, if you’re awake yourself, it may not be a terribly problematic strategy, but it is not going to fix the problem. It simply means you become the hormone that wakes the child when his bladder needs emptying rather than his brain doing it. We get better results once his brain figures it out.
There are bed-wetting alarms that are on the market. Once urine comes in contact with the mattress pad, an alarm sounds. Some people love them. Others do not. Do your research before trying one.
Beyond these less than ideal ideas, visit the GP, and keep going with the nappy. Some children simply take longer than others to get their bodies on top of this issue. I recommend you use mattress protectors to save yourself lots of mattress moving, and to improve hygiene.
Lastly, please do not make your son feel bad or guilty for his bedwetting. And avoid punishing him for it. It is not his fault. He can’t do anything about it and is probably self-conscious and concerned/embarrassed as it is. By all means, teach him how to deal with it. That might include teaching him how to soak his clothes or sheets in the laundry sink if there’s an accident, but this should not be about guilt, shame, or punishment. It’s just about helping him clean things up if something goes wrong.
If your son is still wetting the bed by age 8, then professional intervention might be needed. Similarly, if he stops wetting and then starts again after several months, get help. Or if it is causing problems for him or you as his parents, it is worth a trip to the medical centre for a visit with a GP or a paediatrician. Other than that, be patient, work with him, and make sure he feels loved, not judged.