Bedwetting | Pediatric Urology | Children's Hospital at Dartmouth-Hitchcock (CHaD)
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Bedwetting

Bedwetting (enuresis) is the involuntary loss of urine (wetting) beyond the age when a child is expected to be toilet trained. This is generally considered to be by seven years of age for nighttime control.

Nocturnal enuresis is a very common problem. It occurs in about 15-20 percent of children five years old, 5-10 percent of children ten years old, and 1-2 percent of children fifteen years old. Each year 10-15 percent of these children will become dry at night. Learn more about the causes of bedwetting.

About 25-30 percent of children who are initially dry at night will develop nighttime wetting.

Types of enuresis

  • Nocturnal enuresis refers to wetting that occurs during the night or during sleep such as naps.
  • Diurnal enuresis refers to wetting that occurs when the child is awake.
  • Primary enuresis is when the child has never been dry for an extended time (3-6 months).
  • Secondary enuresis refers to wetting that begins after a child has been dry for 3-6 months.

Facts about enuresis

  • Nocturnal enuresis is more common in boys than girls.
  • Most children will outgrow bedwetting even without treatment. Unfortunately, we do not know at what age this will happen for a specific child.
  • Bedwetting should not be thought of as a behavioral problem. It is not the child's fault. It does not mean the child is lazy or bad. Children do not want, or like, to wake up in a wet bed.
  • Bedwetting can cause stress in the family and poor self esteem in the child if not managed properly.
  • Punishment or making fun of a child who wets the bed will only make the situation worse.

How will my child be evaluated?

  • A parental questionnaire
  • A detailed medical and voiding history
    • Families may expedite treatment by observing the child's voiding pattern and wetting pattern before the appointment, including information about how often the child urinates and how often they move their bowels (as well as the size and character of the bowel movement)
  • Physical examination
  • Urine tests (urinalysis and urine culture)
  • Other tests may be ordered if your child has other problems such as daytime wetting, other problems with urination, a history of urinary tract infections, chronic constipation, and/or soiling. Most children do not need additional tests.

Should my child be treated?

Not all children with night-time wetting need to be treated. Children should be treated if it causes a problem for both the child and the family. Several factors need to be considered in the choice of treatment. These factors include the child's age, how often the child wets, the child's motivation, other family factors, such as sleeping arrangements, and the family's schedule.

Treating bedwetting: general guidelines

  • Remember to have your child go to the bathroom right before going to bed.
  • Encourage your child to drink 6-8 oz. of fluid per year of age (example: 6 glasses for a 6-year-old) before 3:30 pm, and limit to 6-8 oz. of fluid total from 3:30 pm until bedtime.
  • Keep track of drinks. Avoid drinks with caffeine,carbonation, citrus and chocolate. These types of drinks increase the chance of an accident.
  • If your child wakes up at night for any reason, encourage him/her to get up and try to go to the bathroom. For the younger child, you may want to turn on a night light or put a potty chair in the room.

No one treatment works for all children. One or more of the following treatments may be recommended.

Summary

No one treatment plan works for all children. When your child is evaluated, we work to individualize treatment to fit the needs of the child and your family. It may take patience and time before your child becomes dry.

For further information or to schedule an appointment, please call (603) 653-9882.


Page reviewed on: Apr 29, 2009

Page reviewed by: Leslie T. McQuiston, MD

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