Bedwetting: Why it happens

Bed-wetting is very common. Most often children wet the bed because their bodies are not yet physically capable of nighttime dryness. Unless your child has other symptoms, bed-wetting is almost always normal.

The important thing to remember is that bed-wetting is completely involuntary – your child can’t control it. But there are ways you and your child’s doctor can help.

Causes of bed-wetting

Why children wet the bed is not fully understood. For most children, bed-wetting is a normal developmental stage and likely related to one or more of these factors:

Your child’s body is still developing. It’s likely she wets the bed because her bladder, nervous system, and brain are still maturing. You can’t rush the physical development needed for nighttime dryness any more than you can rush a first tooth coming in.

Genetics factor in. If either parent experienced bed-wetting, a child is more likely to experience it as well.

Your child produces too much urine at night. His body may not yet be producing enough of a hormone that reduces the amount of urine the body produces at night. Your child sleeps very deeply. Some children are harder to wake than others and may sleep through the signal to the brain that the bladder is full.

Bed-wetting may happen when your child is overly tired, has a minor illness, or feels stressed. A big life change, such as a new sibling or school, may make bed-wetting more likely.

Medical conditions – most commonly constipation or urinary tract infections, which are easily treated – can sometimes be the cause. Bed-wetting can also be a sign of a more serious health condition, such as diabetes, but that is uncommon. If your child has worrisome symptoms in addition to bed-wetting, call your child’s doctor.

What has to happen so my child can stay dry at night?

Think about a potty training timeline having two separate milestones: daytime dryness and nighttime dryness. Most kids are able to stay dry during the day by age 4, but staying dry at night can take months – or even years longer.

Staying dry at night requires your child’s brain, muscles, and bladder to mature and work together. It’s a more complicated process than staying dry during the day and requires several physical developments:

Your child’s bladder needs to have enough capacity to store the urine produced at night.

His body needs to produce a hormone that causes the body to make less urine at night.

The nerves attached to his bladder need to send a strong enough signal to his brain to wake him up and tell him he needs to go to the bathroom.

His muscles need to be able to keep him from peeing until he gets to the bathroom.

When will my child stop wetting the bed?

About 90 percent of children outgrow bed-wetting on their own by the age of 7, according to the American Academy of Pediatrics. That’s why most doctors don’t routinely suggest bed-wetting treatments, such as a bed-wetting alarm, for children younger than 7.

Going back to overnight diapers or training pants, if they still fit and don’t leak, can take the pressure off and give your child a chance to mature physically before trying again. Another option is washable or disposable underwear designed for kids who wet the bed. Some come with insertable pads.

It can take some trial and error to figure out what nighttime protection works best for your child, and you may need to adjust as she grows.

What practical steps can I take to help my child not wet the bed?

Look at your child’s sleeping environment. Is the bathroom a long way from her room, or in an area of the house that she finds scary at night? Ask her gently if there’s any reason why she doesn’t want to go to the bathroom at night.

If she’s afraid of the dark, let her know it’s okay to wake you if she needs to go. Keep an eye on your child’s fluid intake. It’s important that kids drink enough water. But you can encourage him to drink more early in the day and see if that helps. Your child may still wet the bed, but he might be less wet.

Make sure your child goes to the bathroom right before bed, and if she wakes up during the night, ask if she’d like to use the bathroom. Offer to go with her if she’s reluctant.

How can I help my child through bed-wetting?

Stay calm, offer comfort and understanding, and reassure him it’s not his fault. Do not blame or punish your child. Bed-wetting is involuntary, and he can’t control it. Let him know that lots of kids wet their beds – he’s not the only one.

Use a reward chart. If your child is 5 or older, a reward chart to track your child’s progress may help. Just make sure you reward your child for things she can control. She can’t control bed-wetting, so don’t reward her for staying dry or take rewards away for wetting the bed.