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Bedwetting is a problem for many school-age children and their families. The good news is that for many children the problem will resolve itself over time, or can be fixed through fairly simple treatment.
Bedwetting (also called nocturnal enuresis) is very common. As the following graph shows, almost a third of four-year-olds wet the bed. By the time they are 6, only one in 10 children wet the bed, and one in 20 by age 10. Bedwetting can sometimes continue into adolescence.
Percentage of children who wet the bed at different ages
Most children have no lasting problems from bedwetting; however, many will feel embarrassed or ashamed. It is important to reassure your child that they are not the only one who wets their bed. For younger children, there will most likely be many other bedwetters in the same class at school.
It is very common for children to become dry at night for a while and then to start wetting their bed again.
While not all causes of bedwetting are known, some of the possible factors are:
In some rare cases, there may be a medical problem that is the cause of the child's bedwetting.
Bedwetting is not often a behavioural problem and children rarely do it for attention. It is far more likely that they have little control or awareness when they are having accidents overnight.
You may wish to see a doctor about your child's bedwetting if:
If your child has been dry at night for six months then begins to wet their bed again, it is important to see a doctor for evaluation.
The doctor will consider your child’s details and determine if there is a physical problem that needs to be addressed.
Most children don't need rewards to motivate them to take part in treatment – the prospect of a regular dry bed is usually enough.
It can be helpful to keep a record chart of wet and dry nights. Your child should make the chart themselves and choose how to complete it. Some children like to put stars or stickers on for dry nights, or to colour it in or draw pictures. Choose something that fits in with your child's interests, for example, football stickers. Charts used on their own usually have little success, but in combination with other treatments they can be very useful.
It is important for your child to drink plenty of fluids spread evenly throughout the day. Don't try to restrict the amount of fluid your child drinks in the evening, as this will not help and can even delay the process of being dry at night. However, don't give drinks containing caffeine (coffee, tea, hot chocolate, caffeinated soft-drinks like cola etc.) late at night.
Bedwetting alarms are thought to be the most useful and successful first-step to treat bedwetting. Research has shown these alarms will help more than 80 per cent of children to become dry, and most children will then stay dry. Children using alarms are less likely to relapse compared to children taking medication.
A child using a bedwetting alarm needs a supportive and helpful family as it may take six to eight weeks to work.
Bedwetting alarms are available for hire. A rubber mat is placed in the bed under where the child's bottom will be, and is connected by a wire to a box with a battery-powered alarm bell. Some pads are smaller and can be fixed directly to your child's skin. These systems operate at low voltage and there is no risk to your child.
Most children with bedwetting do not need to take medication, but there are some occasions when it can be useful. Your doctor can advise you if this treatment is suitable for your child.
DDAVP (also called Minirin) is a medicine that helps a child's body make less urine at night. It will reduce the likelihood of your child's bladder overfilling during sleep.
DDAVP is usually reserved for children who have not become dry after using a bedwetting alarm – sometimes the two treatments are then given together. Some children use the medication for sleepovers or school camps.
It is safe to uses DDAVP, provided you never exceed the recommended dose, and you avoid excessive fluid intake in the evening after dinner. Be careful to follow the instructions provided with the medication.
DDAVP can work quickly. Some children will be dry after the first night. Many doctors recommend using DDAVP for three months, followed by a tapering off period to determine if your child can stay dry without medication. Some children will resume bedwetting when the drug is withdrawn. If your child becomes wet again, your doctor may ask you to restart DDAVP and try to stop it again every few months to see whether your child still needs it to stay dry.
Regardless of which treatment you will be using with your child, there are some general strategies that are useful throughout the treatment process.
When will my child grow out of bedwetting?
All children develop at different rates, and some children may wet their bed occasionally until the age of seven or eight. If this is happening regularly, see your GP. If your child is over six years old and bedwetting is causing problems for them (or for you), take them to the GP, especially if they were previously dry overnight.
My child has school camp coming up. How can I stop him bedwetting at camp?
You could start using a bedwetting alarm for two months before camp to help your child stop bedwetting – it may take six to eight weeks to work for your child. If that doesn’t work, your GP may be able to prescribe DDAVP for your child to use on school camp. If you don’t wish to use medication, you may like to try underwear pads for camp.
Developed by The Royal Children's Hospital General Medicine department. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.