Nighttime bedwetting, also known as nocturnal enuresis, is a common condition that affects many children as they grow. Most children achieve nighttime bladder control between the ages of 5 and 7, but it’s normal for the process to take longer in some kids. While frustrating for both parents and children, bedwetting is usually not a cause for concern until after age 7 and is rarely due to any underlying medical issue.
What is the normal age for nighttime dryness?
Most children stay dry at night starting between ages 5 and 7. However, it’s completely normal for the process to take longer in many kids. Here are some general nighttime dryness age guidelines:
- By age 5 – About 80% of children will stay dry throughout the night
- By age 6 – About 85% of children will stay dry throughout the night
- By age 7 – About 90% of children will stay dry throughout the night
As you can see, even at age 7 about 10% of children continue to wet the bed at night. Bedwetting past age 5 does not necessarily indicate any medical issue. Development and maturation varies a lot among individual children.
What causes bedwetting?
There are a few reasons why children may continue to wet the bed past the normal ages:
- Delayed development – Some children’s bodies simply mature at a slower rate, and their bladder control takes longer to develop.
- Genetics – Bedwetting often runs in families. If parents wet the bed when they were young, their children are more likely to as well.
- Difficulty waking – Some heavy sleepers do not wake up to cues that their bladder is full.
- Small bladder capacity – Some children have lower overnight bladder capacity compared to peers.
- Stress – Stressful events or changes in routine can trigger regression to bedwetting.
In most cases, there is no medical cause for bedwetting. Less commonly, conditions like diabetes, urinary tract infections, sleep disorders or constipation/stool retention can contribute to the problem.
When to see a doctor
It’s a good idea to have a child evaluated by their pediatrician if:
- Bedwetting continues past age 7
- Bedwetting resumes after at least 6 months of nighttime dryness
- There are other signs like new daytime accidents, pain or difficulty peeing, or strong urine odor
- Bedwetting occurs along with snoring, breathing issues at night, excessive daytime sleepiness or behavioral problems
The doctor can check for any underlying issues and provide guidance on next steps. Most underlying causes like UTIs, constipation or sleep apnea are readily treatable.
Tips for helping a bedwetting child
If your child is still wetting the bed, here are some tips that may help:
- Stick to a bathroom routine before bed like having them use the toilet, brush teeth, then straight to bed.
- Limit fluid intake in the evenings but don’t restrict water altogether.
- Wake them once or twice at night to go to the bathroom.
- Use nightlights and clear paths to the bathroom to make middle-of-the-night toilet trips easier.
- Consider washable mattress protectors and moisture-wicking sheets to make cleanup easier.
- Have them use the bathroom right before you go to bed yourself.
- Reward and praise dry nights rather than punishing wet ones.
Stay positive, reassure your child this is normal, and don’t limit water during daytime hours. With time and maturing bladder control, most kids achieve nighttime dryness.
Bedwetting alarms
For children past age 7 who remain wet at night, bedwetting alarms are often the go-to treatment. These devices have a moisture sensor that clips to the pajamas. When wetness is detected an alarm goes off to wake the child so they can finish going to the bathroom. Over time this conditions the brain and bladder to wake up before an accident occurs.
Studies show bedwetting alarms help achieve nighttime dryness within just a few months in many children. They should be used in conjunction with other positive reinforcement techniques. Talk to your pediatrician or urologist to see if an alarm could benefit your child.
Medications for bedwetting
In some cases medicines may be prescribed to help with bedwetting. These include:
- Desmopressin (DDAVP) – A synthetic hormone that reduces urine production overnight.
- Imipramine – An older tricyclic antidepressant that can relax the bladder and help children sleep through the night.
Medications are considered second line options and are typically used along with alarms for a few months. They may help achieve initial dryness but long term results are best with alarms. Talk to a doctor about potential medication options.
When is bedwetting not normal?
While bedwetting up to age 7 is normal, some specific situations should prompt earlier evaluation:
- New onset primary bedwetting after age 5
- Bedwetting every night without any dry nights
- Strong urine odor or abnormal color
- Daytime wetting or accidents
- Bedwetting accompanied by new constipation
- Signs of sleep disordered breathing like snoring or apnea
- Bedwetting associated with major stressors or changes in routine
Bring up any of these scenarios with your pediatrician. While not always the case, they can occasionally signal an underlying medical condition requiring specific treatment.
Coping strategies for parents
Here are some tips for parents coping with a bedwetting child:
- Use a plastic mattress cover and waterproof pad to simplify cleanups.
- Have replacement pajamas, underwear and sheets ready so your child can help change the bedding when accidents happen.
- Emphasize it’s not their fault and this is a common, temporary phase.
- Try rewards instead of punishments. Celebrate dry mornings with a small treat or fun activity.
- Be understanding on occasions like sleepovers or campouts.
- Talk to other parents and know you’re not alone. Many have been through this too.
With patience and a nurturing environment, children eventually outgrow bedwetting in nearly all cases. Stay positive and consult your pediatrician if needed.
Nighttime wetting solutions
Here is a table summarizing some solutions that may help with nighttime wetting:
| Solution | How it Helps |
|---|---|
| Bedwetting alarms | Wakes child through alarm when moisture sensed so they can finish voiding in toilet. |
| Fluid restriction in evenings | Reduces amount filling bladder overnight. |
| Scheduled nighttime awakenings | Opportunity for bathroom use before accident. |
| Medications like desmopressin or imipramine | Reduces urine production and/or relaxes bladder. |
| Positive reinforcement | Rewards and encouragement for dry nights. |
| Routine with bathroom visit right before bed | Empties bladder before sleep. |
Using a combination of these techniques under a doctor’s supervision can help achieve dryness.
Frequently asked questions
Is bedwetting normal at age 6?
Yes, bedwetting is still considered normal and common at age 6. Approximately 85% of 6 year olds are dry through the night. Nighttime dryness may not be achieved until ages 7 or 8 in some children.
What causes a child to start wetting the bed again?
Regression or restarting bedwetting after a period of nighttime dryness is usually triggered by stress or changes to routine. Major disruptions like a new baby, move, new school, family discord, or Vacation can all commonly lead to temporary loss of nighttime bladder control.
Can bedwetting be caused by a UTI?
Yes, urinary tract infections (UTIs) can sometimes contribute to bedwetting or cause regression. The infection leads to more urgent and frequent urination. Evaluating for and treating a UTI can help resolve associated bedwetting.
What percentage of 7 year olds wet the bed?
Approximately 10% of 7 year olds continue to experience some bedwetting during the night. Nighttime dryness is achieved in most children by age 7 but it is still considered normal for accidents to occur in a minority at this age before bladder control is fully established.
Is primary bedwetting genetic?
Yes, there is often a strong genetic component to primary bedwetting (never consistently dry at night). Children have a much higher rate of struggling with bedwetting if one or both parents also wet the bed when they were young.
Can food allergies cause bedwetting?
In some cases, food sensitivities like lactose intolerance have been associated with increased bedwetting. The gastrointestinal symptoms may contribute to urgent urination or make bladder control more difficult overnight.
Is bedwetting a sign of diabetes?
Frequent nighttime urination and bedwetting can occasionally be a sign of diabetes mellitus. The excess glucose in the blood can cause increased urine output. Bedwetting associated with increased thirst or any other concerning symptoms warrants medical evaluation.
Can bedwetting be caused by constipation?
Yes, chronic constipation and stool retention can put pressure on the bladder leading to bedwetting. Treating and preventing constipation often resolves associated loss of bladder control at night.
Is bedwetting normal at 8 years old?
While most 8 year olds have achieved consistent nighttime dryness, bedwetting is still considered normal and common at this age in approximately 5% of children. Each child’s development is unique, so persistent bedwetting at age 8 is not necessarily abnormal.
Can anxiety cause bedwetting?
Yes, anxiety disorders and high levels of psychological stress can be associated with bedwetting struggles. The links between brain, emotions, and bladder control make anxiety a potential contributing cause.
Conclusion
Achieving nighttime bladder control is an important developmental milestone that occurs between ages 5 and 7 in most kids. While frustrating for children and parents, bedwetting up to age 7 is very common and not indicative of any medical problems in most cases. Patience, understanding, and positive reinforcement will help most children eventually achieve dryness. Consult a pediatrician if bedwetting persists past 7 years old or is accompanied by other concerning symptoms.