Bedwetting (nocturnal enuresis) is a common problem that affects boys more frequently than girls, and a family history of the problem is frequent. Primary bedwetting occurs when a child has never been consistently dry at night; most cases are presumably due to immaturity in the development of normal bladder control. Approximately 15% of 5-year-olds will still have primary bedwetting, and about 15% of those cases spontaneously resolve each year thereafter. 

Secondary bedwetting occurs when a child who has been dry for at least six months begins wetting the bed again. This can often be a sign of an underlying medical condition, and your child should be seen by his or her physician to look for problems. 

As parents, I’m sure you have a lot of questions about bedwetting so we sat down with Dr. Irwin to get the answers to your most frequently asked questions about bedwetting. 

Q&A with Dr. Andrew Irwin

What’s your role at Pediatrics East, and how long have you been in it?    

I am a pediatrician at our Germantown clinic location. I joined Peds East back in 2014.

What is the number one reason for bedwetting?

There are numerous factors that are related to bedwetting. Unless there are other urinary concerns, isolated nighttime bedwetting is most often related to maturational delays of the nervous system and urinary system. There is also strong genetic correlation for bedwetting; roughly 50% of children who deal with prolonged bedwetting have a parent who also dealt with bedwetting as a child. Smaller bladder capacity, constipation, certain ENT conditions, and sleep disorders can also be associated with prolonged bedwetting. 

How common is bedwetting for kids who are daytime trained?

15% of 5-year-old children wet the bed; 1-3% of teenagers wet the bed. 

What is the average age for bedwetting to stop?

90% of children have stopped wetting the bed by 7 years old. But 1-3% will continue to do so until their teenage years.

At what age should a parent be concerned about their child wetting the bed?

Isolated bedwetting at night (nocturnal enuresis) is not cause for high concern; on the other hand, children having urinary accidents during the daytime as well should be evaluated for other genitourinary disorders and  behavioral disorders. I often tell families that bedwetting is mainly a laundry problem until it becomes a social problem. Parents can let their bedwetting child sleep in underwear instead of pull-ups, but that ultimately leads to changing bedsheets numerous times per week (if not daily)- and who wants more laundry?! The vast majority of children will outgrow bedwetting no matter what parents do. But bedwetting can be a concern for children and their parents when it affects their social activities (sleepovers, summer camps, vacations, etc.). When it has reached that point, we recommend meeting with your pediatrician to discuss management and treatment options. 

What are your tips for helping stop bedwetting?

Make sure your child is not constipated; if so, take care of that and you may also take care of the bedwetting. Limit sugar and caffeine intake late in the day. Have the child go to the bathroom twice in his/her bedtime routine (potty, brush teeth, PJs on on, read a book, pray, and potty again).

How can I help my child cope with bedwetting?

Don’t draw negative attention to it. Do not punish the child, as he/she has no control over this issue. Just as a child talks and walks at their own developmental pace, the neurologic connection between nervous system and urinary system can take longer to develop for some children. There are bedwetting alarms that have some proven success in helping children overcome bedwetting sooner rather than later. We also have two safe and effective medications that can help children stay dry at night until they have outgrown this condition (these are very helpful for the children who are eager to go to sleepovers, camps, etc).

Is bedwetting genetic?

Yes, you can refer to the answer above, but bedwetting can be linked to genetics. 

Is there anything else in regards to bedwetting you want to share with us?

Bedwetting is very common. 1 out of 6 kindergartners wets the bed at night- though the kids and their parents likely do not share that with everyone they know. But y’all are not alone! Try not to stress about it. Don’t hesitate to ask us about it- in the office or on the phone. As pediatricians, we spend a lot of our day talking about pee and poop!


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