The expected age of a child to be dry at night is five, but even by the age of 10, one in 20 children are still wetting the bed. So it's a very common problem for families but that doesn't stop bedwetting being incredibly distressing for children and their parents. Here are some of the best ways to cope.
Unsurprisingly, bedwetting can have an impact on a child's mental health as well as affecting self-esteem, causing shame and of course guilt for everyone in the family. Children with bedwetting naturally avoid social activities such as sleepovers and school trips and most feel different from their friends, assuming they are the only ones with this problem.
Of course, it also impacts on mum and dad with extra laundry, the expense of overnight pull-ups and the stress of worrying about your child. But there is hope: 99% of children grow out of bedwetting by adolescence, so stay optimistic and encourage your child to do the same. And thankfully, there are many solutions families can try.
Wait and see
It may not sound productive, but perhaps surprisingly, the first approach to try for bedwetting is simply to wait and see. This can be hard when everyone is desperate for a solution but it is absolutely worth a try.
Some children just take longer to have night-time control either because they have a small bladder capacity or they are less aware of a full bladder, so don't wake up easily when they need to go. Both these causes improve with age and essentially everyone needs to stay relaxed and not worry.
Remember this is no one's fault - it is so important to reassure your child about that too and never let them feel the blame.
Ensure there is easy access to the loo overnight - a potty in the room can help - and of course, always insist on a toilet trip before bed.
Using waterproof mattress covers and pads reduces everyone's anxiety and lessens the burden all round - this more relaxed approach will make it easier for you to watch and wait for the problem to resolve naturally with the least stress all round.
Some children are embarrassed to reveal a wet bed in the morning, and may want the chance to change their own bed to avoid embarrassment. If this is the case it is worth keeping clean bedding and pyjamas in their room where they can find them easily.
Positive rewards charts can be incredibly helpful and are recommended by experts in this area - star charts, not only for dry nights but also for helping change sheets and making loo visits before bed, are valuable and can really help children. They can also lessen the emotional impact of the issue, which is very important.
Don't restrict drinks
It may sound strange but don't try to restrict drinks - it actually doesn't help, although avoiding caffeine in children is a good idea. In fact, encouraging your child to drink enough during the day may prevent guzzling gallons before bed and this is worthwhile.
Many parents may try lifting for a loo trip when the child is half asleep or waking them to go to the toilet to preempt a wet bed - this is not thought to help in the long term, as it doesn't solve the problem of bladder training, but of course it may be useful and essential for short trips away.
The next stage of treatment would be a bedwetting alarm - this teaches children to recognise their need to pass urine and wake spontaneously. It does take commitment from the whole family but it is worth it as it works well.
The alarm works on the basic principle of conditioning: a sensor which detects wetness and activates when urine starts to pass. This wakes the child who gets up to wee. It is usually used for children who are seven upwards but this depends on maturity so may be used earlier. The sensor can be worn on pants or pyjamas, or placed under the bedsheet.
You can get them from a local NHS continence service via a GP referral or buy one from children's bedwetting and continence charity ERIC. The organisation has a fantastic array of leaflets and resources to help, as well as an advice line. The support network and tips from other families are very helpful. It is also useful to use their books aimed at children to explain the problem to your child.
Gradually, with use every night, a child should start to wake up with a full bladder before the bed is wet, and the problem is solved. This typically takes about 5-6 months and has a high success rate. And it works particularly well if you use it in combination with a reward system - praising not only dry nights but also smaller wet patches and waking up to the alarm. Some children can even respond after four weeks with parents noticing fewer alarm calls, smaller wet patches and good waking.
Medicines that can help
If alarms are not helping or for some reason not suitable, medication may be offered from a GP or a continence service. Desmopressin is used, which reduces the quantity of urine produced by the bladder at night. It can be very helpful for short periods such as holidays and sleepovers when a quick fix is needed. As a long-term treatment it is not actually as effective as an alarm but it has a success rate of around 70%.
Try to relax
All the bedwetting treatments can work well but don't panic if the problem starts up again after a period of dryness. This can be upsetting for all but try to stay relaxed.
Children who start bedwetting after being dry may have type 1 diabetes, a urinary infection, or constipation, or be under stress. So the first thing to do is to rule out any of those problems - it is easy to test for urinary infections and type 1 diabetes on a urine sample with your doctor, and to correct any constipation. A third of children with constipation will wet the bed, so correcting that can often help.
If no problem is found, go back to the solution such as the alarm that worked before - it will work again - and stay focused on bedwetting being no one's fault.
Whatever solution you try for your family, remember almost all children will have stopped wetting the bed by adolescence - stay positive!