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Bedwetting in children

Bedwetting in children, also known as nocturnal enuresis, can be a cause of concern for parents.

The National Institute for Health and Care Excellence (NICE) says children are generally expected to be ‘dry’ at night by a developmental age of five. However, historically treatment has usually only been offered to over sevens.

Usually, bedwetting is outgrown with time, and rarely is anything seriously wrong. Sometimes, though, medical help is needed. Here are some answers to many of the questions you may have about night-time incontinence or bedwetting in children.

How common is bedwetting in children?

Wetting the bed twice a week is how the NHS defines wetting the bed regularly. In statistics for England, this affects:

  • One in six five-year-olds
  • One in 10 seven-year-olds
  • One in 14 10-year-olds
  • One in 100 18-year-olds

What's "normal" when it comes to bedwetting?

The range is very wide regarding bedwetting. Typically a child becomes toilet trained between the ages of two and four. However, some won't be able to stay dry through the night until they are older.

Sometimes a child who has been dry at night will begin to wet the bed again. This may be triggered by family stress or school problems. As a bedwetter’s system matures, they are less likely to wet at night. By the teenage years, or much earlier, almost all bedwetters have outgrown the problem.

Most children of school age who wet the bed at night have what doctors term "primary enuresis." They have never had night-time control of their bladder. Family history also plays a role in night-time incontinence in children. If you were a bedwetter, don't be surprised if your child is too.

When should we seek medical advice about bedwetting?

Bring up the subject any time you are concerned about bedwetting, of course. However, if your child has been dry and then starts to wet the bed, seek medical advice promptly. Doctors can then evaluate your child to be sure the problem isn't due to an underlying condition. Only a small number of all bedwetting problems are traced to diabetes, infections, abnormalities of the bladder or kidney, or other medical conditions. If your child has any unusual symptoms such as burning while urinating or passing bloody urine, seek medical advice right away.

What causes primary bedwetting?

The cause is likely to be due to one or more of the following:

  • The child cannot go through the night without urinating.
  • The child does not wake when his or her bladder is full.
  • The child produces a large amount of urine during the evening and night hours.
  • The child has poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can. Parents are usually familiar with the leg crossing, face straining, squirming, squatting and groin holding that children use to stop themselves going to the toilet.
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