Bedwetting, also known as nighttime incontinence or nocturnal enuresis is a common yet seldom talked about problem. It is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected. The secrecy and silence around bedwetting have the effect of making the child feel like they are the only one and something is wrong with them, worsening how they feel about themselves when that is hardly the case.
About 5-7 million children wet their beds most nights with twice as many boys as girls wetting their beds. Studies show that about 15% of children after age 5 are bedwetters, 7% around age 10, and approximately 2% at age 15. In general bedwetting before age 7 should not be worrying. As frustrating as it is for the parent, it’s important to remember that is it particularly embarrassing and stressful for the child as well, so some grace and patience is required. This is just another normal part of a child’s development.
Potential causes of bedwetting
Genetic predisposition
Three out of four children who wet the bed have a parent or first-degree relative who also wet the bed in childhood. Consider sharing your personal experience if you are the partner who struggled with it to help the child understand that it happens to others as well and will end as it did for you. It is also likely to help with the sense of shame they’re likely struggling with.
Anxiety
Children struggling with bedwetting are statistically more likely to have anxiety issues compared to those who don’t have anxiety. They are more likely to experience generalized anxiety, panic attacks, school phobia, social anxiety, and separation anxiety.
It may also be a result of emotional stress caused by major sudden changes in the child’s life such as a conflict between the parents, starting a new school, moving homes, or getting new siblings. Physical and sexual abuse can also lead to bedwetting.
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Bladder maturation
The child’s bladder may not be developed enough to hold urine produced during the night. It may also be a result of slower than normal development of the nervous system impairing the bladder’s ability to communicate with the brain when full.
Constipation
Chronic constipation can cause the stool to push up against the bladder, putting pressure that prevents the bladder from expanding all the way. This pressure causes uncontrolled bladder contractions during waking hours or sleeping hours.
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Deep sleep
Children who sleep deeply are more likely to wet the bed. They sleep so deeply that their brain fails to get the signal that their bladder is full.
Eating and drinking habits
What a child drinks and when has an impact on their likelihood to wet the bed. This is why parents restrict fluid intake in the evening and ensure children pee before going to bed.
Hormonal imbalance
During childhood, some children do not produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
Urinary tract infection (UTI)
A urinary tract infection (UTI) can lead to irritation as well as the frequency of the urge to urinate.
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Sleep apnea
One side-effect of sleep apnea is the production of a hormone that causes the kidneys to produce extra urine during sleep which can lead to bedwetting.
Other less common causes of bedwetting include
- Kidney issues
- Diabetes
Potential effects of bedwetting on children
- Guilt and embarrassment which can lead to low self-esteem.
- Loss of opportunities to participate in social activities like sleepovers and camping.
- Physical problems like rashes in the bottom and genital area especially if they keep sleeping for long in their wet clothing on a wet surface.
Solutions and how to stop bedwetting
Talk to your child to find out if there’s anything bothering them. Ask if they are worried or angry or afraid or even sad about something. Ensure they feel safe enough to share, emphasizing that it is not their fault, that you are not angry or ashamed of them. Maintain a supportive attitude, steering clear of punishment and any talk of disappointment. The key is compassion and empathy as they deal with this. If you know what’s causing them distress such as persistent conflict with your partner, get it together.
Improve sleep hygiene. This means creating a set of habits that facilitate a good night’s sleep. Develop routines before bed. Encourage them to pee before bedtime. Restrict their fluid intake in the evening and certainly before bed.
Cover the mattress with plastic to keep the mattress from getting wet nightly.
Speak to a doctor if the bedwetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stool, or snoring. Also, consider consulting your doctor just if it’s causing anxiety and social problems for guidance on how to help. Otherwise, don’t worry too much, bedwetting is one of those things that get better on its own.
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