Doctors’ Notes


Bed Wetting

Bed wetting may be the most common issue in all of pediatrics that parents and children don’t talk about.

Over half of three-year-olds still wet occasionally at night, and we consider it normal for children to wet occasionally up to eight years of age. About 15% of kids who wet will outgrow it each year, but 3% of kids are still wetting at night by the time they become teens. 1% are still wetting on occasion by the time they graduate high school.

There is a strong genetic component to bed wetting. If both parents wet the bed as children, their children have an 80% chance of wetting the bed, too. One of the best predictors of when a child will outgrow bed wetting — it’s not perfect, but it’s the best we have — is to see when the parents outgrew wetting, because children often stop wetting around the same age their parent(s) did.

The other big genetic factor is gender; bed wetting is twice as common in boys. And, one final note: children with ADHD are more likely to wet at night and take longer to stay dry as well.

There are many reasons why children may take longer to stay dry at night. Some experts believe a child’s bladder and the nerves that control the bladder mature more slowly. Some children are deep sleepers, and simply may not wake when their bladders fill. There are other, less common reasons as well.

Some Non-Medical Things You Can Do to Help

  • Avoid caffeine. Caffeine can increase urine production, so stay away from caffeinated drinks (pop, iced tea, etc.) and snacks (chocolate, etc.) in the evening.
  • Encourage your child to empty his bladder before he goes to bed, and encourage him to use the toilet if he wakes up at any point during the night. Make it easy for him to find the bathroom by using a nightlight if necessary. As rustic as it may sound, leaving a bucket in a boy’s bedroom is just fine if it’s a far walk to get to the bathroom.
  • Limit drinking in the evening. Some experts recommend cutting off drinks after dinner (or limiting to just sips). You have to be careful with this one, though, especially in hot months or with children who are active in sports or activities. Becoming dehydrated is much worse than wetting the bed!
  • Cover the mattress with a plastic mattress cover, and be sure your child takes a bath/shower in the morning so she doesn’t smell like urine in school.

When to Call Our Office

The good news is that most children outgrow bed wetting on their own, and just require support until they do.

While it doesn’t pose any health risks, many children feel guilty and embarrassed about wetting at night, which can prevent them from participating in social activities like going away to camp, attending sleepovers, and so on. If you or your child are concerned about bed wetting at any age, or if children are still regularly wetting beyond eight to ten years old, it’s a good idea to talk with one of our providers, because there may be things we can do to help. This typically involves taking a thorough history and exam to be sure there aren’t any physical causes for the bed wetting.  Sometimes bed wetting alarms or medications may be helpful for some circumstances, and we can help talk with you to see if they may be appropriate for your child’s situation.

Two Final Notes

1. It’s not typical for a child who has been regularly dry to suddenly start wetting at night. In cases like that, we should see the child in the office to help determine the cause of the change.

2. Remember, in most cases, children don’t like being wet at night, and it upsets them at least as much as it upsets you. Most bed wetters are embarrassed about their problem, and wish they could stay dry; they need encouragement, patience, and support, not blame, teasing, or punishment. Things will get better with time, and we’re always available to help if you need us.

Dr. Albert Wolf, a proud Kids Plus Doc since 2000, is a Senior Partner and Chief Financial Officer of the practice.