So you ditched the daytime diapers a while ago, but you’re still using training pants or dealing with wet bedsheets on the regular? Your child may have a problem with bedwetting. According to the Canadian Paediatric Society, bedwetting, also known as nocturnal enuresis, is an issue when it happens more than twice a week and continues after your child turns five years old. Here are some things you should know about your child’s bedwetting.
1. You’re not alone It might seem like you’re the only one changing sheets at 3 a.m. every day because bedwetting is not a topic that comes up in conversation at your PTA meetings, but 10 to 15 percent of five-year-olds and six to eight percent of eight-year-olds struggle with nocturnal enuresis. The problem is also more common among boys than girls.
2. It’s not laziness When parents see their kids go to the bathroom properly during the day, but soak the sheets at night, many assume it’s a problem of laziness, but bedwetting is involuntary. Lane Robson, a paediatric nephrologist at The Children’s Clinic in Calgary, says there are three main factors that come into play: a small bladder capacity, the pattern of pee production (often thrown off balance by eating or drinking habits) and the inability to wake up. Luckily, all of these factors can be addressed through lifestyle changes and training the body and brain.
3. It’s often genetic Research has shown that a family history of bedwetting increases a child’s likelihood of having bladder control issues at night. In fact, scientists have actually located the gene—chromosome 13q—that’s responsible for the problem. If either you or your partner wet the bed as a child, your kid is 25 percent more likely to have a problem; if you both wet the bed, the likelihood jumps to about 65 percent.
4. Poop is often the culprit It might seem counterintuitive that struggling to go number two leads to an uncontrollable release of number one, but it’s true. Constipation and solid bowel movements are a common cause of bedwetting, because an overloaded bowel can restrict the capacity of the bladder. In fact, in one particularly compelling study out of Wake Forest Baptist Medical Center in North Carolina, 30 kids aged five to 15 who struggled with bedwetting were treated with laxatives, and within three months, 25 of them were spending their nights dry. Many kids with constipation or hard bowel movements don’t show signs of bowel trouble (and to complicate matters, there are varying definitions of constipation), so don’t rule it out just because your child has never complained about it.
5. Water is not the enemy We all need water for proper bodily functioning—and that includes kids who wet the bed. Robson says that many kids who are frustrated about their bedwetting end up not drinking enough because they and their parents think water is the source of the problem. In reality, dehydration can cause hard, pasty poops or constipation, which can lead to bedwetting.
6. Hormones have a hand in it We all produce a hormone referred to as ADH (anti-diuretic hormone, also known as arginine vasopressin), which tells our kidneys how much water to conserve in our bodies. Normally, that hormone increases at night, which minimizes urine production. But research has shown that, among kids who suffer from bedwetting, ADH levels are consistent throughout the day and night. Medications have been developed to mimic the necessary hormonal increase, but they can’t cure bedwetting because as soon as a child stops taking the drug, the problem returns. Instead, using a bedwetting alarm, which trains a child to wake up when his bladder is full, can actually help his body learn to use those naturally occurring hormones, says Ontario-based bedwetting therapist Peter Grise.
7. It’s linked to other issues Once in a while, bedwetting can be related to a larger health problem. A 2013 study from the International Journal of Obesity found that bedwetting was almost twice as common in kids ages seven to 18 who were overweight and more than three times as common in those who were obese. And because diabetes is related to an excessive production of urine, it can also cause bedwetting. Sleep apnea and urinary tract infections are two other conditions that have been linked to poor nighttime bladder control. Talk to your doctor if you have concerns about underlying issues.
8. Your child just might not be ready Though Grise says the ideal time to start teaching kids how to stay dry at night is three years old, once they’re successful at staying dry through the day, many kids won’t grow out of bedwetting until around age five. Experts are eager to remind parents that if it’s not bothering your child, it’s not a problem. Your child might just not be ready yet, and you shouldn’t force it, says Grise.
9. Bedwetting can come back Once kids are able to stay dry through the night on a regular basis, you shouldn’t have to worry about wet sheets again, right? Unfortunately, some kids experience secondary nocturnal enuresis, which means they’ve had control of their bladder at night for several months or even years, then begin to have problems. This can be very difficult for the child and the family. Most often, it can be treated in the same way as primary enuresis (bedwetting that has occurred since infancy).