Dr. Deena Blanchard, pediatrician and font of knowledge, gives us the tools we need to stay calm and carry on.  


Wet sheet and wet pajamas at 2 a.m. with an embarrassed child are a common scenario in many households. But don’t worry; bedwetting is not a sign of potty training not working or a difficult child. In fact, bedwetting is a common part of child development. Most children achieve nighttime continence a while after they achieve daytime continence. Many children do not develop nighttime bladder control before age seven and a percentage even later than that.

How is bedwetting defined?

The medical term for bedwetting in nocturnal enuresis (NE). Bedwetting is defined as involuntary urination while sleeping. There are two types of bedwetting. Primary: in which a child has not had periods during which they were dry at night. Secondary: bedwetting that occurs after a child has been dry at night for a period of 6 months.

It is important to remember that children who wet the bed are not “doing it on purpose.” These children are deep sleepers and do not wake up when they need to void. Many children can stay dry during the day, when they are awake, but are not able to do so while asleep.

How common is bedwetting?

Bedwetting is common in early childhood and decreases in prevalence as children approach adolescence. A total of 10-15% of children will still wet the bed at age 6 years. This number decreases to 5 % by age 10. About 15% of children who wet the bed outgrow this annually so that by adolescence less than 1% of children continue to wet the bed. Bedwetting is more common in boys and typically occurs in children who have a relative who wet the bed. If one parent has prolonged bedwetting, it is thought that around 50% of their children will have it. If both a child’s parents wet the bed their children have a 75% chance of bedwetting as well.

Are there things I can do to decrease bedwetting frequency?

1. Remember, bedwetting is typically NOT your child’s fault. They are not aware that they need to urinate so be patient with them. Reassure your child that bedwetting is a normal part of growing up and will not last forever. Your child may find comfort in hearing stories and personal experiences from family members who have also wet the bed. Create a plan for an easy clean up if your child does wet the bed (waterproof mattress covers etc.) this can help decrease your frustration in the middle of the night.

2. Limit your child’s liquid intake in the two hours before bedtime. You do not need to limit their overall fluid intake for the day. You should focus on having them consume more fluid during daytime hours and less prior to going to sleep. Do not limit fluids if your child is participating in sports practice or games in the evenings.

3. Have your child void at the beginning of your nighttime routine and then void again at the end of the night time routine to fully empty their bladder (this is known as double voiding.) Remind your child that it is okay to get up to use the bathroom at night. Make sure the path to the bathroom has a nightlight so your child can see where they are going.

4. Trial a bedwetting alarm: These are small battery operated devices that connects to a mattress pad with a moisture sensor on your child’s bed. When the pad sense moisture an alarm goes off with the goal of waking your child to urinate. As many of these children are deep sleepers, an adult may need to respond to the alarm and take the child to the bathroom. You will need to be patient with moisture alarms. Most take at least 2 weeks to start working and need to be continued for about 12 weeks. These alarms can be effective in stopping bedwetting. However, a percentage of children will continue to wet the bed once the alarm is removed.

5. Medications: If your child is feeling embarrassed about bedwetting, it may prevent them from going on sleepovers and they may feel left out of activities. There are medications available to prevent bedwetting that can be taken on an as needed basis. As with all medications, these can have side effects. If you think your child can benefit form these medications, talk with you pediatrician or consult a pediatric urologist.

When should I call the doctor?

If your child wets the bed after age 8 years

If your child starts wetting the bed after being dry for over 6 months

If bedwetting is accompanied by pain with urination, excessive thirst, day time accidents, or snoring

It is affecting your child’s self-esteem

Has swelling of the feet on ankles

While bedwetting can be frustrating for parents it rarely is associated with any underlying medical condition. In fact, only about 1% of children who wet the bed have a medical problem associated with it. However, as children get older, their self-esteem can be affected by bedwetting and they may feel embarrassed. Provide your child with emotional support. Remember, in most cases dry nights are just ahead.

 

Deena Blanchard photoDeena Blanchard MD, MPH is a board certified pediatrician working at Premier Pediatrics. Dr. Blanchard has been with Premier since 2009. She completed her residency training at the Morgan Stanley Children’s Hospital of Columbia Presbyterian; where she was awarded Physician of the Year in 2007. There she served as a family advocate as part of the family advisory comity.  Prior to attending medical school, she completed her Masters of Public Health at Temple University with a focus on health education. Dr. Blanchard attended Medical School at Albert Einstein College of Medicine where she was awarded Alpha Omega Alpha and The American Women’s Association Glascow Rubin Achievement Award.  She currently guest blogs for many child-parent sites.

Premier Pediatrics is an established pediatric practice with locations in both Brooklyn and Manhattan. We have been tending to children for over 30 years with a strong focus on state of the art medical care and family wellness. We offer prenatal visits free of charge which can be scheduled by either calling the office 212-598-0331, 718-369-0817 or via our Prenatal Guide. You can LIKE us on Facebook.