Bedwetting: When should you be concerned?

Bedwetting.

It’s the problem that many families have faced, but people rarely talk about. It can leaving you feeling like you are out on an island all by yourself.

Guess what? You’re not as alone as you think.

Here are the percentages of kids who are still wetting the bed at various ages:

• 5 years- 15 percent
• 7 years - 10 percent
• 10 years - 5 percent

Up until 10 years of age there is probably at least another boy or girl in your child’s class at school who is going through the same thing, it just doesn’t come up at the PTA meeting.

For the most part, the problem is just delayed maturation of a child’s ability to stay dry. This is evidenced by the fact that almost every case eventually resolves on its own without treatment. While the maturation may not happen fast enough for parents who are changing the sheets every morning (or even in the middle of the night), for most, it will happen.

If you want to blame someone for the problem, blame genetics.

There is often family history of delayed nighttime dryness. This is tricky to prove because this could be simply a result of the fact that it is so common. There have been some studies implicating genetics as a possible cause.

Some people will describe their children as “really deep sleepers,” but most kids are and it’s probably a bias based on the fact that most families with kids who are dry through the night don’t try to wake their kids up for anything.

So when should you call the doctor?

• The child is starting to wet after a period of being dry.
• The child has day-time accidents as well.
• The child has burning or pain with urination.
• The child is excessively thirsty and urinating frequently.
• The child has associated constipation.
• The child has other associated symptoms for which you are concerned.

There are some basic strategies to use in order to help your child stay dry:

• Limit or stop fluid intake after dinner.
• Have the child go to the bathroom regularly during the day and several times close to bed time.
• Children should not receive caffeinated or sugary beverages.
• Move toward underwear as soon as reasonable.

You can talk about further interventions with your pediatrician. Here's some advice I give parents:

Bedwetting alarms that wake children when they have wet the bed are the most consistently proven method to resolve bedwetting.

Medications for use with bedwetting can be used for temporary dryness, but have not shown to be effective for eliminating bedwetting long-term. Once you stop the medicine, it tends to come right back.

Most cases of bedwetting will resolve on their own, you should not blame yourself or your child. Punishment does not work!

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.