It’s a rare parent who hasn’t awakened to a soggy little person in the early morning hours. While bedwetting is usually associated with very young children, six to eight percent of eight-year-olds still wet the bed, according to the Canadian Paediatric Society. “It’s the kind of thing that isn’t talked about outside the family, so your child may think he or she is the only one this happens to,” says Dr. Howard Bennett, a pediatrician and author of Waking Up Dry: A Guide To Help Children Overcome Bedwetting (American Academy of Pediatrics).
Bedwetting, also known as nocturnal enuresis, is divided into two categories: Primary nocturnal enuresis and secondary nocturnal enuresis. The first afflicts children over age five who have never been consistently dry at night. “The brain may not be communicating with the bladder — we’re not sure why not — so the child is not getting the signal to wake up and pee,” says Katharine Saje, an advanced practice nurse at the urology clinic at The Hospital for Sick Children in Toronto. Heavy sleeping, small bladders, constipation and genetics may also be factors. “Three-quarters of children I see at my practice will have a parent or another close relative who was wet as a child too,” notes Dr. Bennett.
About 10 percent of the time, bedwetting falls into the secondary enuresis category, a condition in which a child who has been dry for six months suddenly starts wetting the bed. Underlying medical conditions, such as a urinary tract infection or diabetes, are more commonly seen with secondary wetting. But most often, the condition arises due to anxiety, resulting from a move, new baby, or trouble at school. That’s the case for Sandy Vogel* in Brandon, Man., whose son Jacob* is eight and wets the bed. “He was dry from about age four to age six, but then started wetting the bed after some bullying in Grade 1,” says Sandy. The family is now working with their pediatrician to help Jacob stay dry at night. “We give him lots of drinks during the day and we ask him to wait as long as possible before going to the washroom. Our pediatrician suggested these two things in tandem would help increase his bladder capacity,” says Vogel. Jacob also goes to the bathroom before and after reading a book at bedtime, plus his parents get him out of bed for another pee before they go to sleep.
The most important thing to remember is that kids who wet the bed are not doing it on purpose and shouldn’t be punished or made to feel ashamed, says Saje. There are a number of ways you can help your child stop wetting the bed, but only when he is ready. Signs of a motivated child include his communicating that he does not want to wet the bed and a willingness to make changes in his bathroom routine, such as limiting liquid at night. Saje also recommends following a consistent routine. “When your child wakes up wet, she should go into the bathroom to pee, because that completes the action. With the help of a parent, she should put the wet sheets in the tub until morning, when she can help wash them, and remake the bed. It’s not punishment at all, but it’s a way of training the brain.” Saje says that over time, the child learns that it is easier to use the bathroom than to wet the bed.
Studies also show that moisture alarms — which cause a buzzer to sound when a sensor placed in underwear or on the mattress detects the release of urine — are successful tools for teaching the brain and the bladder to communicate with each other at night, says Dr. Bennett. For events like overnight camp, your child’s doctor may prescribe desmopressin, a medication that decreases the amount of urine the body produces at night. Or, for sleepovers, you might ask your child to wear age-appropriate disposable nighttime training pants.
But the best way to help a bed-wetter is a positive attitude, says Vogel. “We keep reassuring Jacob not to worry and that he will be able to stay dry long before he goes off to university!”
The best thing to prevent urine stains on mattresses is a waterproof mattress cover, but if a mishap occurs, Dr. Bennett recommends removing stains and the associated smell with an enzyme formula product that neutralizes urine odour rather than covering it up. Many of these products are available online. Saje also suggests parents add a cup of vinegar to the wash with the wet sheets.
Bonnie Schiedel is a writer in Ignace, Ont., who, as a Brownie leader, has dealt with a few soggy sleeping bags at camp.
* Names changed upon request