Clinical Reference Systems: Pediatric Advisor 10.0
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Why does my child wet the bed?

Wetting the bed (also called enuresis) is a very common problem. It is normal for a child to wet the bed even at age 6. Most children who wet the bed have small bladders. Their bladders cannot hold all the urine made in a night. Also, they may be deep sleepers who do not wake up when their bladders are full. Most children who wet the bed have healthy kidneys. They do not have emotional problems.

It is important to help the child in the right way. If not, he could have emotional problems later on.

How long does it last?

Most children who wet the bed stop between ages 6 and 10. Even without help, all children get over it at some time. It is important to help the child stop without making him feel badly about himself.

How can I help my child?

• Help your child get up to urinate (pee) during the night.
• Make it easy to get to the toilet. Put a night light in the bathroom. If the bathroom is a long distance away, use a portable toilet in the room.
• Have your child drink a lot during the morning and early afternoon. The more your child drinks, the more urine your child will make. More urine leads to larger bladders.
• Don't let your child drink too much during the 2 hours before bedtime.
• Make sure the child urinates before going to bed. Sometimes the parent needs to remind the child. Older children may feel better having a sign at their bedside or on their bathroom mirror.
• Take your child out of diapers or Pull-ups. Your child may not feel the need to get up at night.
• Praise your child on mornings when he wakes up dry.
• Be gentle when your child has a wet night. Most children who wet the bed feel guilty and embarrassed about this problem. They need to be supported and encouraged. It does not help to blame, punish, or tease. Pressure will only cause the bed-wetting to go on longer.

What if my child is already 6 years old?

When your child reaches 6 years, here are some extra things you can do to help:

• Help your child wake up by himself. You can help your child learn to wake himself up at night. Have him practice this way at bedtime:
  1. Lie on your bed with your eyes closed.

  2. Pretend it's the middle of the night.

  3. Pretend your bladder is full and you have to go.

  4. Pretend your bladder is trying to wake you up.

  5. Pretend your bladder is saying, "Get up before it's too late."

  6. Then run to the bathroom and empty your bladder.

  7. Remind yourself to get up like this during the night.
• Practice in the daytime. Tell your child:
  1. Whenever you have to pee and you're home, go to your bedroom rather than the bathroom.

  2. Lie down and pretend you're sleeping.

  3. Tell yourself this is how your bladder feels during the night when it tries to wake you up. After a few minutes, go to the bathroom and pee (just like you would at night).
• Wake your child up at night. Wake your child up when you go to bed. Let him find the bathroom and use the toilet on his own.
• Have your child change his wet clothes at night.
  • If your child feels any urine leaking out, he should try to stop the flow of urine.
  • Have your child hurry to the toilet to see if he has any urine left in his bladder.
  • Make sure he puts on dry clothes.
  • Have him put a dry towel over the wet part of the bed.

What if my child is 8 years old or older?

Try all the suggestions. You may want to talk to your doctor about using alarms or medicine.

Call your child's doctor during office hours if:

• There is pain or burning when your child urinates.
• The stream of urine is weak or dribbly.
• Your child also wets during the daytime.
• Bed-wetting is a new problem (your child used to stay dry).
• Your child is over 12 years old.
• Your child is over 6 years old and is not better after 3 months of following these ideas.