Joe Perno, M.D.
If your child wets the bed, he or she is not alone. About 5 million children in the United States wet the bed. Though most kids are toilet trained between ages 2 and 4 years, some children may not be able to stay dry at night until they are older. Children develop at their own rate. Joe Perno, M.D., medical staff affairs officer at Johns Hopkins All Children’s Hospital, answers questions about the topic.
What are the most common causes of bedwetting?
A typical cause is that the child is a very deep sleeper who does not awaken to the signal of a full bladder. The communication between brain and bladder takes time to develop and can occur at different ages. If one parent suffered from bedwetting, the child is more likely to also suffer. Some children’s bladders are small and cannot handle the amount of urine produced throughout the night. Some children drink excessive liquid before bed.
Occasionally medical problems can be the cause. One of the most common and simplest to fix is constipation, as full bowels put pressure on the bladder.
How do you make the transition overnight from diapers to underwear?
Just because a child is toilet trained during the day does not mean they are ready for underwear throughout the night. A nice transition can be the use of pull-ups or training pants rather than traditional diapers. The child can be encouraged to keep the pull-up dry. Once you have a steady streak of dry mornings, you can transition to underwear. That being said, the child may still have the occasional accident. It is important to always remain positive with the child.
When should you visit a doctor and discuss bedwetting?
Parents should try to work through the problem first. Limit liquids the child drinks after 6 p.m. Make sure the child voids immediately before bed. Consider waking the child a few hours into sleep to use the toilet. Consider using a bedwetting alarm, which senses urine and wakes the child thus helping them train to wake up.
Bedwetting can be discussed at each well child checkup. If the child has reached 6 years old and continues with bedwetting, there are medicines that may be considered as a bridge until the body solves the problem. Ninety-five percent of the time it resolves by age 10.
When a child suddenly has a reoccurrence of bedwetting after being toilet trained for over a year, should there be concern?
There could be a medical reason. As stated before, constipation would be the most likely cause. A urinary tract infection could also be the cause, especially if there are complaints of pain, foul smelling urine or frequent day-time urination. If there is blood noted in the urine or underwear, it could suggest a kidney problem. Family stressors such as the birth of a new sibling or divorce can contribute to regression also. All of these problems should be addressed with the pediatrician.
This information was shared on WTVT-TV’s Doc on Call segment, which is aimed at helping parents learn more about children’s health issues. The segment airs each Monday morning on Good Day Tampa Bay.