Children's Health

What is bed-wetting?

Bed-wetting is urination during sleep. Children learn bladder control at different ages. Children younger than 4 often wet their bed or clothes because they can't yet control their bladder. But most children can stay dry through the night by age 5 or 6.

Bed-wetting is defined as a child age 5 or older wetting the bed at least 1 or 2 times a week over at least 3 months. In some cases, the child has been wetting the bed all along. But bed-wetting can also start after a child has been dry at night for a long time.

Wetting the bed can be upsetting, especially for an older child. Your child may feel bad and be embarrassed. You can help by being loving and supportive. Try not to get upset or punish your child for wetting the bed.

What causes bed-wetting?

Children don't wet the bed on purpose. Most likely, a child wets the bed for one or more reasons, such as:

• Delayed growth. Children whose nervous system is still forming may not be able to know when their bladder is full.
• A small bladder. Some children may have a bladder that gets full quickly.
• Too little antidiuretic hormone. The body makes this hormone, which rises at night to tell the kidneys to release less water. Some children may not have enough of this hormone.
• Deep sleeping. Many children who wet the bed sleep so deeply that they don't wake up to use the bathroom. They probably will wet the bed less often as they get older and their sleep pattern changes.
• Emotional or social factors. Children may be more likely to wet the bed if they have some stress. For example, a child may have a new brother or sister.

Children who wet the bed after having had dry nights for 6 or more months may have a medical problem, such as a bladder infection. Or stress may be causing them to wet the bed.

How is it treated?

Treatment usually is not needed for bed-wetting in children ages 7 and younger. Most children who are this age will learn to control their bladder over time without treatment.

But bed-wetting in children older than 7 may be treated if it happens at least 2 times a week for at least 3 months. It also may be treated if it affects a child's schoolwork or relationships with peers. Treatment may focus on praise and encouragement, a moisture alarm, behavior therapy, or medicine. Several of these may be used.

If bed-wetting is caused by a treatable medical problem, such as a bladder infection, the doctor will treat that problem.

What can you do to help your child?

Help your child understand that controlling his or her bladder will get easier as your child gets older.