Bedwetting in children
How can I help the doctor resolve my child's bedwetting?
To help resolve your child's bedwetting, be a good detective at home. Be prepared to answer these questions:
- Is there a family history of bedwetting?
- Do certain conditions or foods and drinks trigger more bedwetting episodes?
- Are there any unusual symptoms such as bloody urine?
What happens next?
Your doctor may arrange urine tests to see if there is a urinary tract infection, which can trigger bedwetting. The doctor may also request other tests to check the health of your child's urinary tract system. They will discuss the options with you and may refer you to a local enuresis clinic. Experts at the clinic can teach your child exercises to control the bladder. Over time your child will be able to hold more urine and recognise when they feel the urge to urinate, even when they are asleep.
What else can be done about bedwetting in children?
To reduce bedwetting, your doctor or enuresis nurse may suggest a variety of measures, such as the following:
- Limit caffeine-based fluids before bedtime and encourage fluids during the day.
- Use an alarm device that wakes up the child as soon as wetness is detected. This is “conditioning training”, which, if used steadily and consistently for three to four months can often be effective.
- Try prescription medication that forces the body to produce less urine at night. This is not usually considered until the child is at least seven years old and other methods have failed.
NHS bedwetting guidance
In NHS guidance issued in 2010, The National Institute for Health and Care Excellence (NICE) advised health care workers to:
- Not exclude under sevens from treatment on the basis of age alone
- Tell the child and parents or carers that bedwetting is not the child’s fault, so punishment should not be used
- Encourage parents to reward their children for agreed behaviour rather than for dry nights, such as going to the toilet before sleep, taking medication or for helping to change the sheets
- Discuss with the child’s parents or carers whether they need support, particularly if they are having difficulty coping with the bedwetting, or if they are expressing anger or blame towards the child
- Address a child’s excessive or insufficient fluid intake or abnormal toilet habits before starting bedwetting treatment
- Refer children who have not responded to the different treatment options to a specialist. Other conditions may be diagnosed, such as overactive bladder, an underlying disease or social and emotional factors