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Most children are toilet trained during the day by about 3 years of age but many still wet the bed at night until around 5. Night-time bladder control is not something children can learn like they can with day-time toilet training. It usually happens naturally as their body matures.
Children stop wetting the bed at different ages. While a lot of children are dry at night by the time they start school, many children of primary school age still wet the bed at times.
Until the age of 10, about 1 in every 10 children wet the bed. It is important to not blame or punish them for something they can't control.
Bedwetting is nobody's fault. It is not caused by laziness or seeking attention. It is not something your child has control over.
Sometimes children wet the bed because they:
- haven't matured to the point where the bladder 'tells' the brain it is full, or the brain is able to 'tell' the bladder to hold on to the wee. The link between the brain and bladder develops at different ages and can't be changed or hurried up (see Toilet training).
- have trouble waking up when the bladder signals it is full
- have a bladder that can't hold a large amount of urine
- are constipated. A full bowel takes up more space in the pelvic area and the bladder can leak because there isn't enough space for it to fill up properly
- produce more urine at night than other children due to differences in hormone levels
- are unwell or over-tired.
Often, if a child does not stop bedwetting at a young age, there may be a family history of bedwetting. You may find that dad, mum, uncle or aunt used to wet the bed, and they may still have to get up at night to go to the toilet.
Children who wet the bed are sometimes dry when sleeping in a strange place. They may sleep more lightly if worried about wetting. When back home and relaxed they often wet the bed again.
Some children who have been dry might start wetting the bed again if something happens to make them very stressed, eg a new baby, starting school, family violence or family break-up. Bedwetting usually stops when they begin to feel more secure. Let your child know you understand and will do your best to help them get through the difficult times (see the Parent Easy Guides about dealing with difficult times).
Sometimes there is a physical cause, eg a bladder infection or they have become constipated. You might want to see your doctor if you've tried some of the strategies in this Guide but are still concerned.
Remain patient and reassure your child bedwetting is not their fault. If they become tense and anxious they may wet for longer and also become unhappy.
- Wait until your child wakes up dry most mornings. You could try a night without a nappy. Let them know it would be great if they didn't wet the bed, but if they do it's not a 'problem'. Prepare the bed so only the top sheet, towel or bed pad gets wet. If they're not confident, let them wear a nappy or 'pull-up' until they feel ready.
- Make sure your child has plenty to drink, eg 5 or 6 drinks spread evenly through the day. Don't restrict drinks in the evening. Water is best for children. Avoid drinks with caffeine, eg cola, coffee, tea or hot chocolate as the caffeine increases the amount of urine.
- Include more fibre and water in your child's diet if they are constipated. Treating constipation may stop bedwetting.
- Stick to a regular bedtime routine that includes a trip to the toilet before going to sleep.
- Explain in simple terms some of the reasons for bedwetting, eg 'While you're asleep your brain isn't getting the message you need to go to the toilet and so you don't wake up'. Or you could say 'Your bladder, where your wee is stored, hasn't grown large enough yet to hold all your wee through the night'.
- While some parents get their child out of bed at night to go to the toilet, children need to get used to waking up by themselves when their bladder is full.
To help save washing
- Cover the mattress with a waterproof mattress protector.
- Put an absorbent bed pad (available at pharmacies) over the bottom sheet. These pads hold a lot of urine but still feel dry to touch.
- If your child is scared of the dark, leave a night light on or give them a torch to go to the toilet. Encourage them to call you if they need help.
- Let them know if someone else in the family used to wet the bed as this can help them feel better. They might think it only happens to them.
- If your child wets during the night, make sure they have a shower in the morning so others don't tease them for being smelly.
Children are often upset and embarrassed when they wake up in a wet bed. They may also be worried about upsetting you. While older children can help by putting wet items in the laundry, it can feel like a punishment to younger children. Bedwetting may continue if your child is worried about upsetting you or being punished. Do things with your child that help them feel good about themselves.
Behaviour change programs such as 'star charts' don't work because your child can't control the bedwetting.
Check with your doctor if:
- your child is still wetting in the day by school age
- a dry child starts wetting again during the day or night and this continues
- you or your child are becoming very upset by the bedwetting
- your child is often constipated
- you have other concerns about bedwetting.
Children often worry about wetting the bed at school camps or sleepovers and may try to avoid going. Encourage them to attend and be part of the fun with their peers.
Teachers are used to dealing with bedwetting at camp without embarrassing the child. Discuss with the teacher how it can be managed then talk with your child about what they can do. They might want to try out different strategies at home before the camp. Make sure you pack plastic bags for wet items and enough clean clothing and underwear. Wipes may help keep your child from smelling. If your child is invited to a sleepover, talk to the parent in advance.
If your child is still very anxious about wetting the bed at camp or a sleepover, talk to your doctor to see if medication may help them while away from home.
While most children stop bedwetting as they get older, some don't. If your child is wetting the bed often past 7 years of age and it is worrying you or your child, it can help to talk with your doctor or a continence health professional trained in helping children. If needed, they can tell you about the different treatments and help you work out which would best suit your child. Bedwetting alarms can be useful for some children.
Talk with your child about how they are feeling and any ideas they have that might help. Don't dwell on the issue if it causes upset - this can be very sensitive for them. It is important to remind your child that bedwetting is nothing to be ashamed of, they just need a bit of extra help for their body to work best.
It's normal for parents to feel frustrated when bedwetting continues for a time. It's important to be patient and not punish, criticise or tease your child. Remember, it is not something your child can control.
Contact the Continence Foundation of Australia Phone 1800 330 066 if you would like advice from their free helpline, information and resources.