Bed Wetting: Why it Happens and How to Handle It

Bed Wetting Why it Happens and How to Handle It-MainPhoto

Bed Wetting Why it Happens and How to Handle It-MainPhoto

Your child may wet the bed – or accidentally pass urine – at night while he is sleeping. This is called nocturnal enuresis. It’s not at all unusual for a child to wet the bed at night until he is five or six years old. Once a child has reached school age, however, he should not be having frequent trouble controlling his bladder or bowel movements. If he is, it may be due to a physical or psychological problem, and you may want to discuss this with your pediatrician.

This decision support guide will help you to determine whether your child’s bed-wetting is normal, and to know when to contact your pediatrician for medical care. Please note, this guide is not meant to take the place of a visit to your pediatrician’s office.

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Before we begin, a few questions.

First of all, is your child toilet trained?

Yes, my child is toilet trained.

No, my child is not toilet trained.

You’ve said that your child is toilet trained.

Is your child having accidents during the day as well?

Yes, my child is having daytime accidents.

No, my child is not having daytime accidents.

You’ve said that your child is toilet trained and is not having daytime accidents.

Has your child always had nighttime accidents (since toilet training), or is this new (i.e., he was dry at night for months or years)?

My child has always had nighttime accidents.

The nighttime accidents are something new.

You answered that your child has been dry at night for several months or years and recently has started to wet the bed again. Children who stay dry at night for months or years and then begin to wet the bed again may have an illness.

Do any of these statements describe your child?

  • He has a fever (a temperature of 100.4 F or 38 C or greater).
  • He has to urinate more often than usual.
  • He says it hurts or burns when he urinates.
  • His urine smells strong, funny, or bad.
  • His urine looks pink or red.
  • He is complaining of pain below his belly button or in his lower back.

Yes, at least one of those statements describes my child.

No, none of those statements describe my child.

Since none of those statements describe your child’s condition, it is unlikely that he has a urinary tract infection.

Does your child show any of these symptoms?

  • He has to urinate more often than usual.
  • He is extremely tired.
  • He is extremely thirsty.
  • He has lost weight for no apparent reason.

Yes, this describes my child.

No, my child doesn’t show any of these symptoms.

Call your doctor. Your child may be suffering from diabetes — too much sugar in the blood — and needs medical care.

You state that your child isn’t unusually tired or thirsty, hasn’t lost weight unexpectedly, and doesn’t have to urinate more often than usual. These symptoms sometimes are a sign of diabetes.

Does your child have seizures?

Yes, my child has seizures.

No, my child does not have seizures.

Call your doctor. Children who have seizures often lose control of their bladders. If your child has seizures and isn’t staying dry at night, it could be that the seizures are not being controlled as they should.

Your child is wetting the bed but does not have seizures.

Is your child constipated (having hard, infrequent bowel movements)?

Yes, my child is constipated.

No, my child is not constipated.

Your child is having new nighttime accidents but doesn’t have seizures, isn’t constipated, and doesn’t have any signs of a urinary tract infection or diabetes.

Does any of the following describe your child?

  • He is having weakness, especially in his legs.
  • He is having trouble walking, running, or doing any of his usual activities.
  • He has been having stool in his underwear.

Yes, one of those describes my child.

No, none of those describe my child.

Your child is wetting the bed but does not show any signs of a urinary tract infection, diabetes, seizures, constipation, or a neurologic problem.

Has your child been having bad stomachaches?

Yes, my child has been having bad stomachaches.

No, my child isn’t having bad stomachaches.

You’ve said that your child doesn’t have bad stomachaches.

Have there been any recent changes in your child’s life at home or at school that could be causing him any stress or anxiety?

Is he acting more sad, worried, or angry than usual?

Yes, there have been changes or stress in my child’s life.

No, there are no changes or stresses in my child’s life.

You do not think that there have been any changes or unusual stresses in your child’s life. Try to be sure that your child isn’t holding something back from you. Some children feel reluctant to discuss uncomfortable or stressful things.

It’s unclear what is causing your child’s bed-wetting. It would be a good idea to call your doctor to go over your child’s story and symptoms again and to decide whether and when an office visit makes sense.

Your child’s bed-wetting may be related to these changes or stresses. For example, if there is a new baby on the scene, older kids often “regress,” or start to act like younger children again. Call your doctor if these symptoms get worse or if they go on for longer than a week or two.

You should also call your doctor if your child develops fever, stomachache, pain with urination, weakness, or any of the other symptoms we’ve discussed.

Call your doctor immediately.

While it’s very uncommon, it’s possible that something in your child’s belly could be growing and pressing on his bladder.

Call your doctor immediately. Your child could have a neurologic problem that is causing his bed-wetting.

Call your doctor. Sometimes constipation can lead to bed-wetting.

Call your doctor. Your child may have a urinary tract infection.

It is very common for young children to have trouble staying dry at night.

Is your child younger than six years old?

Yes, my child is younger than six years old.

No, my child is older than six years old.

Children under the age of six, especially boys, frequently have trouble controlling their bladder at night.

Does any of the following describe your child?

  • He is constipated.
  • He is having burning with urination or urinating more frequently than usual.
  • His urine looks pink or red or has a bad smell.
  • He is having accidents during the day as well.
  • He is having stomach pains.
  • He is having weakness in his legs or any trouble walking or running.
  • He is having bad headaches.
  • He is having staring spells, or unusual movements of his hands, arms or legs, or has been making unusual noises.
  • He is always thirsty, drinking much more than other children.
  • He has lost weight, has less energy than usual, or seems ill in any way.

Yes, one or more of those describes my child.

No, none of those describe my child.

You’ve said that your child has had nighttime accidents since he was toilet trained, is less than six years old, and doesn’t have any signs of a medical problem.

Most likely, your child’s bed-wetting is entirely normal and should go away by itself. Make sure you have a plastic cover on your child’s mattress. Try not to scold your child for accidents. He most likely can’t control them! Instead, be very positive with him whenever he has a dry night. To help him stay dry, limit fluid intake before bedtime.

Call your doctor if you have any concerns about your child, or if he is continuing to wet the bed after age six.

Does any of the following describe your child?

  • He is constipated.
  • He is having burning with urination or urinating more frequently than usual.
  • He is having accidents during the day as well.
  • He is having stomach pains.
  • He is having weakness in his legs or any trouble walking or running.
  • He is having bad headaches.
  • He is having staring spells, or unusual movements of his hands, arms or legs, or has been making unusual noises.
  • He is always thirsty, drinking much more than other children.
  • He has lost weight, has less energy than usual, or seems ill in any way.

Yes, one or more of those describes my child.

No, none of those describe my child.

You’ve said that your child has had nighttime accidents since toilet training and is more than six years old. You’ve also said that your child doesn’t show any signs of a medical reason for his bed-wetting.

Give your doctor a call to discuss. While bed-wetting regularly past the age of six can certainly happen, especially if the mother or father had the same problem, it can be embarrassing and emotionally difficult for the child.

Talk with your doctor about the available treatments, such as enuresis alarms and medications. Together, you and your doctor can decide what makes sense for your child.

Call your doctor today to discuss and make an appointment for your child. There could be a medical reason for his bed-wetting.

Call your doctor. While daytime as well as nighttime accidents are common and usually not a cause for alarm, they can be a sign of a more serious problem, such as infection, bladder dysfunction, or even a neurologic problem.

If your child is not toilet trained, it’s unrealistic to expect that he will be dry at night.

Call your doctor for advice on toilet training, especially if your child is past his fourth birthday.

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