Children's Health

Most children gain bladder control over time without any treatment. Bed-wetting that continues past the age that most children have nighttime bladder control-typically at 5 or 6 years of age-also will usually stop over time without treatment. If not, home treatment may be all that is needed to help a child stop wetting the bed. For more information, see the Home Treatment section of this topic.

If home treatment is unsuccessful, if the child and parents need assistance, or if the bed-wetting may be caused by a medical condition, medical treatment may be helpful. Medical treatment may help your child wet the bed less often or help him or her wake up to use the toilet more often.

If a child relapses after stopping a successful therapy, that same therapy usually is repeated.

Treatment for bed-wetting is based on the:

• Child's age. Some treatments work better than others for children of a specific age group.
• Child's and parents' attitudes about the bed-wetting. If gaining bladder control is seen as a normal process, it is usually easier for the child to stop bed-wetting.
• Home situation. If the child shares a bedroom with other children, certain techniques to arouse the child, such as dry-bed training or some moisture alarms, may not be practical.

Treatment for bed-wetting may include:

• Motivational therapy. This method involves parents encouraging and reinforcing a child's sense of control over bed-wetting.
• Moisture alarms, which detect wetness in the child's underpants during sleep and sound an alarm to wake the child.
• Desmopressin and tricyclic antidepressants. These medicines increase the amount of urine that the bladder can hold or decrease the amount of urine released by the kidneys.

Treatment for bed-wetting may be helpful if bed-wetting is affecting a child's self-esteem, performance in school, or relationships with peers.

The best solution is often a combination of treatments. Below are some suggestions for treatment options according to the age of your child.

• Ages 5 to 8: Help your child understand that wetting the bed is a normal part of growing up. Encouragement and praise may be all that is needed to help your child wake up before wetting. Children in this age group should be praised for dry nights and should take an active role in cleaning up after wetting.
• Ages 8 to 11: If your child still wets the bed, a moisture alarm may be a successful treatment option. It can be used in combination with occasional use of a medicine such as desmopressin, which can be helpful for social events such as camp or sleepovers.
• Age 12 and older: There can be significant emotional effects if bed-wetting persists at this age, so treatment can be more aggressive. If consistent use of moisture alarms does not work, the doctor may suggest medicine.