"Bedwetting conversations can be a difficult topic—most kids have a hard time talking about it, and oftentimes, parents feel in the dark about how to navigate it. Parents should take heart, though, because it’s actually very common for kids to wet the bed.
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Nighttime continence develops after daytime continence (AKA potty-training) has been smooth sailing for some time, and each child develops nighttime continence on their own timetable. While daytime continence has some voluntary control involved, nighttime is completely involuntary, so each child truly develops this “skill” when they are neurologically and physiologically mature enough to maintain continence overnight. At a certain age though, many parents become concerned and start to wonder when bedwetting is “abnormal.” Here’s what parents need to know about bedwetting.
Nighttime bedwetting: what’s normal?
As stated above, there is not a “normal” age to achieve nighttime continence. In fact, research shows 20% of 5 year olds, 15% of 7 year olds, and 10% of 10 year olds still experience nighttime accidents. Nighttime continence tends to develop later for males than females, and it is typically something that your child will grow out of. When your child starts to become bothered by it or shows an interest in being continent overnight, that’s typically the right time to start focusing on it.
Factors that can impact bedwetting
There are many things that can contribute to nighttime accidents. First and foremost, it’s neurological immaturity. When we go to sleep, a specific part of our nervous system becomes responsible for maintaining continence, and until that specific part is developed, your child physically won’t be able to maintain continence. Once developed, there are other factors that can also contribute to nighttime accidents:
- Constipation and chronic stool retention can push against the bladder and cause irritation leading to accidents overnight.
- Other bladder irritants, such as citrus, carbonation, chocolate, caffeine, and dairy can also irritate the bladder.
- Sleep disordered breathing can impact the sleep cycle, thus disrupting the processes that contribute to overnight continence.
- Genetics also plays a huge role in bedwetting—chances are that if parents struggled with nighttime wetting, your children may also have similar symptoms.
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How to encourage nighttime continence
The first thing that I always recommend when focusing on nighttime accidents is to optimize daytime. As stated above, we can’t control nighttime, but we can control what happens during the day. For example, parents can:
- Make sure your child is having regular bowel movements and isn’t holding.
- Ensure regular voids so that the bladder is emptying multiple times throughout the day.
- Make sure your child takes their time in the bathroom and has the optimal potty position with supported feet so they can fully empty their bladder.
- Avoid the bladder irritants mentioned above and drink plenty of water during the day.
- While hydration is key to keep the bladder healthy, stop fluids about two hours before bed and ensure your child goes to the bathroom right before bedtime.
When these tips aren’t successful, talk to your doctor. There are many other things that could be recommended once other potential causes have been ruled out. For example, physical therapy, nighttime alarms, and medications are a few interventions proven to be effective.
What to avoid if your child wets the bed
While navigating bedwetting can be frustrating, there are a few things to keep in mind to promote a positive experience for your child:
- As much as possible, try to avoid punishing or shaming for nighttime accidents. Your child cannot control what happens to his or her body while they’re sleeping, and punishing accidents often leads to embarrassment and reluctance in reaching out for help when they’ve had an accident.
- Aim to include your child in all activities as you regularly would—for example, try not to limit sleepovers or vacations, if possible. Instead, try to come with discrete ways to don a pull-up or host sleepovers at your house, so that your child doesn’t feel limited by their bedwetting.
- I highly discourage putting your child in underwear overnight hoping it will lead to continence. Your child doesn’t know which way is up in the middle of the night, let alone what they’re wearing on their bottom. This will only lead to a large load of laundry.
Similar to any other milestone, nighttime continence develops on your child’s unique timetable. It can be a rather taboo topic to discuss, however it is very common! And until your child feels frustrated by it, it is likely something they will grow out of. Whenever you’re in doubt about whether or not your child’s voiding habits are typical, don’t hesitate to reach out to your child’s primary care physician, as there are many interventions to help.
