Brenda Cheer, Paediatric Specialist Continence Nurse & ERIC Nurse answers the three most commonly asked questions by parents about bedwetting.
1. Why is my child wet at night?
Bedwetting is a common childhood condition affecting about half a million children and young people in the UK. 1 in 15 seven year olds and 1 in 75 teenagers have night time accidents. Many people don’t realise just how widespread a problem it is because it’s not something we find easy to talk about.
The reasons why it happens are also often misunderstood with parents and carers mistakenly thinking there child is being lazy or will grow out of it eventually without needing treatment.
Here are three main reasons why children wet the bed:
- Their bladders don’t stretch enough to hold all the wee they make at night:
The cause of this could be constipation – a bowel full of poo is pushing on a child’s bladder limiting the space it has to stretch and fill causing day and night time accidents. An assessment by a doctor and laxative treatment is usually needed to sort out childhood constipation. For more help with spotting the signs that your child could be constipated head to: https://www.eric.org.uk/Pages/Category/bowel-problems
A child’s bladder may be ‘overactive’ and give an urgent signal to empty before it’s full. An overactive bladder usually holds lower than average amounts of wee. Signs of this are if your child is weeing over seven times a day; they can’t hold on even for short amounts of time or gets ‘caught short’ with very little warning.
Any underlying constipation daytime wetting issues should always be treated first as a priority over the night time. There is medication which can be prescribed for bladder overactivity for children over five years.
Keeping a child’s bladder healthy is really important and it’s a good idea to check how much a child who wets the bed is drinking and when. Children need around 6 – 8 drinks of water-based fluid spread throughout the day but need to stop drinking an hour or so before bed. Caffeinated or fizzy drinks particularly close to bedtime can irritate a child’s bladder and make it more likely that they will be wet.
- They produce too much wee at night:
The hormone vasopressin tells the kidneys to make less wee at night. If a child doesn’t produce enough vasopressin while they’re asleep, they keep making daytime volumes of wee which their bladder can’t hold. There’s no test for this hormone, but signs that it’s not being released in high enough quantities include large patches of light coloured wee in the bed or a very heavy pull up by the morning. Children who are low in vasopressin also tend to wet within a couple of hours of going to sleep.
- They don’t wake up when their bladder sends a signal that it’s full.
Some children just don’t wake up when their bladder tries to tell them it’s full or they wake just afterwards when it’s too late. This isn’t related to their depth of sleep but is connected to their ability to rouse from sleep to the full bladder signal.
Night time accidents can be caused by one or more of these reasons but the good news is that all are treatable. Bedwetting also runs in families. If one parent wet the bed, their child has a 40% chance of doing the same. If both parents wet the bed, there’s a 70% chance.
2.Is it a phase that they will grow out of?
The vast majority of children do eventually grow out of bedwetting, but this isn’t a reason to delay getting help. Many parents mistakenly take a ‘watch and wait’ approach thinking that the wetting will eventually get better, but for children who have always been wet and never or rarely have a dry night, it is even more important that they are seen by a health professional.
Left untreated, bedwetting won’t necessarily go away by itself for many years. Therefore it’s so important to seek help because support for this condition and treatment are out there and children may be suffering with this embarrassing problem needlessly. Families could be struggling on for years trying to cope with bedwetting when it may be a simple case of getting their child’s constipation sorted and making sure they drink more in the day.
According to NICE guidelines on bedwetting in the UK, all children over the age of five years who are still wetting the bed should have their bladder and bowels assessed by a health professional (such as a doctor or school nurse) so that the cause of the wetting can be found. Delaying treatment can make the problem worse and mean that a child is suffering with this issue for far longer than they need to.
3.What help is out there to get them dry at night?
There’s lots of information about the reasons why children are wet at night and the various treatment options on the ERIC website and ERIC has a bladder and bowel helpline which is answered by expert advisors.
Helpline: 0845 370 8008 (Calls to the helpline cost 9.6p per minute, plus the phone company’s access charge)
National Institute for Health and Care Excellence (NICE) guidelines
Bedwetting in under 19s – www.nice.org.uk/guidance/CG111
Guidance on the assessment, care and treatment of children and young people up to the age of 19 with bedwetting.
Parents and carers can take a look at these resources before booking an appointment with their doctor or school nurse.
ERIC, The Children’s Bowel & Bladder Charity is the only charity dedicated to the bowel and bladder health of all children and teenagers in the UK. ERIC has been raising awareness of bowel and bladder issues since 1988. ERIC provides expert support, information and understanding to children and teenagers and enables parents, carers and professionals to help them establish good bowel and bladder health.
About World Bedwetting Day:
World Bedwetting Day was initiated to raise awareness among the public and healthcare professionals that bedwetting is a common medical condition that can and should be treated.
World Bedwetting Day 2017 took place on Tuesday 30th May and occurs on the last Tuesday of May each year. The theme is: ‘Time to Take Action’, in recognition that much more can be done to diagnose and treat children who suffer from bedwetting.
For more information please visit World Bed Wetting Day.
Article written by Brenda Cheer, Paediatric Specialist Continence Nurse & ERIC Nurse