dealing with bedwetting in older children

Dealing with Bedwetting in Older Children

This article, “Dealing with Bedwetting in Older Children,” is a comprehensive resource on kids’ health, covering an array of topics pertaining to children’s well-being. From anxiety in children to exercise for kids with asthma, this content strives to provide informative insights into various health concerns. One noteworthy topic discussed is bedwetting in older children, shedding light on the causes, treatments, and helpful tips for parents navigating this common issue. Additionally, this content offers a symptom checker and a health service finder to assist parents in seeking appropriate medical support for their children. With a wide range of valuable information, this article aims to serve as a reliable guide for parents in understanding and addressing their children’s health needs.

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Dealing with Bedwetting in Older Children

Understanding Bedwetting

Bedwetting, also known as nocturnal enuresis, is a common issue that affects many older children. It is important for parents and caregivers to understand the condition in order to provide appropriate support and management strategies. Bedwetting refers to the involuntary release of urine during sleep. While it is considered a normal part of a child’s development to have nighttime control over their bladder, bedwetting can persist beyond the expected age range in some children, causing emotional distress and disruption to their daily lives.

Definition of Bedwetting

Bedwetting is characterized by the recurrent occurrence of involuntary urination during sleep, typically at night. It is considered a common condition in young children and is generally expected to resolve with age. However, when bedwetting continues to occur in older children, it can be a source of embarrassment and frustration.

Normal Development of Nighttime Control

The development of nighttime bladder control varies among children. Most children gain this ability between the ages of three and five. However, it is not uncommon for a child to continue experiencing bedwetting up until the age of seven. As the child grows older, their bladder capacity increases, and they develop the ability to wake up when they need to use the bathroom. This natural development of nighttime control can be influenced by various factors, and when it is delayed, bedwetting may persist

Primary vs Secondary Bedwetting

Primary bedwetting refers to a child who has never achieved consistent nighttime bladder control, while secondary bedwetting occurs when a child regresses after a period of being dry at night. Secondary bedwetting can be triggered by various factors, such as stress, changes in routine, or the presence of an underlying medical condition. Understanding whether the bedwetting is primary or secondary is important in determining the appropriate management approach.

Frequency of Bedwetting

The frequency of bedwetting episodes can vary from child to child. Some children may wet the bed occasionally, while others may experience nightly bedwetting. Understanding the frequency can help parents and caregivers assess the severity of the bedwetting issue and determine the level of intervention required.

Psychological Impact on the Child

Bedwetting can have a significant psychological impact on older children. It can lead to feelings of embarrassment, shame, and low self-esteem. Children may also experience increased anxiety and fear of social situations, particularly sleepovers or overnight camps. It is crucial for parents and caregivers to provide emotional support and foster open communication with the child to help them cope with the psychological effects of bedwetting.

 Bedwetting in Older Children


Causes of Bedwetting

Understanding the underlying causes of bedwetting is essential in developing effective management strategies. Bedwetting can be influenced by a combination of physiological, genetic, and psychological factors.

Physiological Factors

Physiological factors related to the development and functioning of the urinary system can contribute to bedwetting. These factors include a small bladder capacity, an inability to hold urine for an extended period, or an overactive bladder. Additionally, some children may have difficulty recognizing and responding to the signals from their bladder during sleep, leading to bedwetting.


Bedwetting tends to run in families, suggesting a genetic component to the condition. If one or both parents experienced bedwetting as children, their child may be more likely to also experience bedwetting. While genetics can play a role in bedwetting, it is not the sole determining factor, as other environmental and psychological factors can also contribute to the condition.

Hormonal Imbalances

The production of ant-diuretic hormone (ADH) plays a crucial role in reducing urine production at night. In some cases of bedwetting, there may be a deficiency in the production of ADH, resulting in excessive urine production during sleep. Hormonal imbalances can disrupt the normal regulation of urine production and contribute to bedwetting.

Bladder Capacity and Control

Delayed development of bladder capacity and control can be a contributing factor to bedwetting in older children. Some children may have a smaller than average bladder capacity, leading to a higher likelihood of bedwetting. Additionally, if a child has difficulty sensing the fullness of their bladder or lacks the ability to hold urine for an extended period, bedwetting may occur.

Deep Sleep Patterns

Children who experience deep sleep patterns may have difficulty waking up when they need to use the bathroom. Deep sleep can make it challenging for a child to recognize the signals from their bladder and prompt them to wake up to urinate. As a result, bedwetting may be more prevalent in children who experience deep sleep patterns.

Urinary Tract Infections

Urinary tract infections (UTIs) can cause irritation and inflammation in the urinary system, leading to bedwetting. UTIs can result in an increased urgency to urinate and can disrupt the normal functioning of the bladder. If a child’s bedwetting is accompanied by other symptoms of a UTI, such as pain or burning during urination, it is important to consult a healthcare professional.


Chronic constipation can contribute to bedwetting in some children. When the colon is full, it can put pressure on the bladder and interfere with its normal function. Additionally, constipation can disrupt the nerves and muscles involved in bladder control, leading to bedwetting.

Food and Fluid Intake

Certain foods and fluids can act as diuretics, increasing urine production and potentially contributing to bedwetting. Caffeinated beverages, such as soda or tea, can have a diuretic effect and increase urine production. Additionally, consuming large amounts of fluids close to bedtime can put additional pressure on the bladder and increase the likelihood of bedwetting episodes.

Stress and Anxiety

Stress and anxiety can have a significant impact on a child’s overall well-being, including their bladder control during sleep. When children experience stressful or anxiety-provoking situations, their bodies can produce an increase in urine production, leading to bedwetting. Addressing and managing stress and anxiety in children can be an important aspect of treating bedwetting.

Environmental Factors

Environmental factors, such as disruptions in routine or changes in living situations, can contribute to bedwetting. Some children may experience bedwetting during periods of transition, such as starting a new school, moving to a new home, or the birth of a sibling. These environmental factors can cause emotional distress and disrupt a child’s normal bladder control during sleep.


 Bedwetting in Older Children

Medical Conditions and Bedwetting

While bedwetting is often considered a normal developmental issue, it can also be a symptom of an underlying medical condition. It is important to be aware of potential medical causes of bedwetting and seek appropriate medical evaluation and treatment if necessary.


Uncontrolled diabetes can lead to increased urine production, resulting in bedwetting. In children with undiagnosed or poorly managed diabetes, excessive thirst and frequent urination may be present. If bedwetting is accompanied by other symptoms of diabetes, such as weight loss or increased hunger, it is crucial to seek medical attention.

Urinary Tract Abnormalities

Structural abnormalities in the urinary tract can interfere with bladder control and contribute to bedwetting. Conditions such as urinary tract infections, bladder outlet obstruction, or anatomical abnormalities can lead to bedwetting. A thorough evaluation by a healthcare professional can help identify any underlying urinary tract abnormalities.

Structural Abnormalities

In some cases, structural abnormalities in the urinary system can contribute to bedwetting. Conditions such as an enlarged prostate gland in males or anatomical malformations in the urinary tract can disrupt the normal functioning of the bladder, leading to bedwetting. Identifying and addressing these structural abnormalities may be necessary to effectively manage bedwetting.

Sleep Apnea

Sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, can be associated with bedwetting. The disrupted sleep patterns caused by sleep apnea can interfere with the regulation of bladder control during sleep, increasing the likelihood of bedwetting episodes. Assessment and treatment of sleep apnea may be necessary in managing bedwetting in children with this condition.

Neurological Disorders

Certain neurological disorders can impact bladder control and contribute to bedwetting. Conditions such as spina bifida, cerebral palsy, or spinal cord injuries can affect nerve function and disrupt the normal signaling between the bladder and the brain. Identifying and addressing the underlying neurological disorder is essential in managing bedwetting.

Kidney Problems

Some kidney disorders, such as chronic kidney disease or urinary reflux, can contribute to bedwetting. Kidney problems can affect the normal functioning of the urinary system, leading to an increased likelihood of bedwetting. It is important for children experiencing bedwetting to undergo thorough medical evaluation to rule out any underlying kidney issues.

 Bedwetting in Older Children


Psychological Factors and Bedwetting

In addition to physiological and medical factors, psychological factors can play a role in bedwetting. Understanding and addressing these psychological factors can be essential in effectively managing bedwetting in older children.

Stress and Emotional Distress

Stressful or emotionally distressing events can trigger or exacerbate bedwetting in some children. Issues such as family conflicts, school pressures, or major life changes can result in psychological distress that impacts bladder control during sleep. Identifying and addressing sources of stress and providing appropriate support to help children manage their emotions can be crucial in managing bedwetting.

Behavioral Issues

Behavioral issues, such as oppositional defiant disorder or conduct disorder, can be associated with bedwetting. These behavior problems can contribute to stress and emotional disturbances, which in turn can affect bladder control. Addressing behavioral issues and providing appropriate behavioral interventions may help manage bedwetting in children with behavioral challenges.

Trauma or Abuse

Children who have experienced trauma or abuse may be more likely to experience bedwetting. Traumatic events can disrupt a child’s normal psychological and emotional functioning, leading to disturbances in bladder control during sleep. It is important to provide a safe and supportive environment for children who have experienced trauma or abuse and to seek appropriate therapeutic interventions.

Anxiety Disorders

Anxiety disorders, such as generalized anxiety disorder or separation anxiety disorder, can contribute to bedwetting. Children with anxiety disorders may experience heightened levels of stress and worry, which can impact their bladder control during sleep. Addressing and treating anxiety disorders through therapy or medication can be an important aspect of managing bedwetting in these children.

Attention Deficit Hyperactivity Disorder (ADHD)

Children with ADHD may be more prone to bedwetting due to difficulties with impulse control and hyperactivity. The challenges associated with ADHD can disrupt a child’s ability to recognize and respond to the signals from their bladder during sleep. Implementing strategies to manage ADHD symptoms, such as medication or behavioral therapy, may also help improve nighttime bladder control.

Psychological Assessment and Intervention

In cases where underlying psychological factors are suspected to contribute to bedwetting, a comprehensive psychological assessment may be beneficial. A qualified child psychologist or psychiatrist can evaluate the child’s emotional well-being and identify any psychological factors influencing the bedwetting. Based on the assessment, appropriate interventions, such as therapy or counseling, can be implemented to address the psychological aspects of bedwetting.

 Bedwetting in Older Children

The Impact of Bedwetting on Older Children

Bedwetting can have a significant impact on older children, affecting various aspects of their lives. Understanding the potential effects can help parents, caregivers, and healthcare professionals provide appropriate support and interventions.

Emotional and Psychological Effects

Bedwetting can cause emotional distress for older children, leading to feelings of embarrassment, shame, and low self-esteem. The recurring episodes of bedwetting can make children feel different from their peers and create a sense of isolation. It is important to address the emotional and psychological effects of bedwetting and provide support to help children develop a positive self-image.

Self-Esteem and Social Implications

Bedwetting can impact a child’s self-esteem and social interactions. Children may feel ashamed or embarrassed about their bedwetting, leading to a reluctance to participate in social activities or sleepovers. It is crucial for parents and caregivers to foster a supportive environment and encourage open communication to help children navigate the social implications of bedwetting.

Academic and Performance Challenges

The disruption caused by bedwetting can extend to academic and performance challenges for older children. Poor sleep quality resulting from bedwetting can lead to daytime sleepiness, difficulty concentrating, and decreased academic performance. It is important to address these challenges and provide strategies to help children manage the impact of bedwetting on their academic endeavors.

Effects on Family Dynamics

Bedwetting can also impact family dynamics, as it may require additional time and resources to manage the condition. Parents and siblings may experience disrupted sleep, increased laundry, and additional stress associated with bedwetting. Open communication and a supportive family environment are vital in helping the entire family navigate the challenges presented by bedwetting.

When to Seek Medical Help

While bedwetting is commonly considered a normal developmental issue, there are instances where medical attention may be necessary. Parents and caregivers should be aware of certain signs and indicators that warrant seeking medical help.

Age Considerations

The age of the child is an important factor in determining when to seek medical help for bedwetting. While bedwetting is common in younger children, it becomes less typical as a child grows older. If bedwetting persists beyond the age of seven or eight, medical evaluation is recommended to identify any underlying causes.

Persistent Bedwetting

If bedwetting continues to occur several times a week and is persistent despite efforts to manage and address the issue, medical evaluation may be necessary. Persistent bedwetting can indicate an underlying medical condition or psychological factors that require further assessment and treatment.

Physical Symptoms

Certain physical symptoms accompanying bedwetting may warrant medical attention. If a child experiences pain or discomfort during urination, blood in the urine, or frequent urinary tract infections, it is important to consult a healthcare professional. These symptoms may indicate an underlying medical condition that needs to be addressed.

Signs of an Underlying Condition

If bedwetting is accompanied by other symptoms or signs of an underlying condition, medical evaluation is crucial. Symptoms such as excessive thirst, weight loss, fatigue, or failure to thrive may indicate the presence of a medical condition, such as diabetes or kidney problems. Identifying and treating the underlying condition can help manage the bedwetting effectively.

 Bedwetting in Older Children


Tips for Managing Bedwetting

Managing bedwetting involves implementing strategies to support the child and reduce the occurrence of bedwetting episodes. The following tips can be helpful in managing bedwetting in older children:

Establishing a Bedtime Routine

Establishing a consistent bedtime routine can help regulate a child’s sleep patterns and reduce the occurrence of bedwetting. Encourage the child to use the bathroom before bed and create a calm and relaxing environment to promote quality sleep.

Monitoring Fluid Intake

Monitoring and managing fluid intake, particularly in the evening hours, can help reduce the likelihood of bedwetting. Encourage the child to drink plenty of fluids throughout the day but limit their intake in the hours leading up to bedtime.

Encouraging Regular Toileting

Encourage the child to follow a regular toileting schedule, including using the bathroom before bed. Creating a routine around toileting can help train the bladder and reduce the occurrence of bedwetting episodes.

Bedding Protection Strategies

Using bedwetting alarms, protective mattress covers, or absorbent underwear can provide practical solutions for managing bedwetting. These strategies help protect the child’s bedding and provide comfort and reassurance during the bedwetting journey.

Reward Systems and Motivation

Implementing a reward system can provide positive reinforcement for dry nights. Recognize and celebrate each dry night, and provide incentives to motivate the child to continue working towards nighttime bladder control.

Natural Remedies

Some natural remedies, such as herbal supplements or homeopathic remedies, are believed to help manage bedwetting. However, it is crucial to consult a healthcare professional before using any natural remedies to ensure they are safe and appropriate for the child.

Avoiding Blame or Punishment

It is essential to create a supportive and understanding environment when managing bedwetting. Avoid blaming or punishing the child for their bedwetting episodes, as this can create additional stress and emotional distress. Instead, focus on providing education, support, and reassurance to help the child feel empowered and motivated to overcome bedwetting.


 Bedwetting in Older Children

Creating a Supportive Environment

Creating a supportive environment is crucial for helping older children manage bedwetting. The following strategies can help foster understanding, empathy, and support:

Open Communication

Encourage open and honest communication with the child about their bedwetting. Discuss their feelings, concerns, and any challenges they may be facing. Regularly check in with the child to ensure they feel heard and understood.

Understanding and Empathy

Demonstrate understanding and empathy towards the child’s experience with bedwetting. Let them know it is a common issue and that they are not alone. Validate their feelings and provide reassurance that bedwetting is a temporary condition that can be managed.

Sibling and Peer Support

Educate siblings and classmates about bedwetting to foster empathy and support. Encourage siblings and peers to be understanding and avoid teasing or making fun of the child who experiences bedwetting. Sibling and peer support can boost the child’s self-esteem and create a more inclusive and compassionate environment.

Educating Teachers and Caregivers

Inform teachers, daycare providers, and other caregivers about the child’s bedwetting. Sharing information about appropriate management strategies and any necessary accommodations can help ensure consistent support for the child in various settings.

Bedwetting Alarms

Bedwetting alarms are devices that emit a sound or vibration when the child starts to wet the bed. These alarms work by conditioning the child to wake up when they sense the first urge to urinate. Bedwetting alarms can be effective in helping older children develop nighttime bladder control. However, they require consistent use and commitment from both the child and the parent or caregiver.

Bladder Training Techniques

Bladder training techniques involve gradually increasing the time intervals between bathroom visits during the day. This training helps the child build bladder capacity and control, reducing the likelihood of bedwetting. Bladder training can be complemented by regular toileting before bedtime.

Medication Options

In some cases, medication may be recommended to manage bedwetting. Medications such as desmopressin or anticholinergics can help reduce urine production or relax the bladder muscles, respectively. Medication should only be considered under the guidance and supervision of a healthcare professional.

Preventing Bedwetting at Sleepovers and Camps

Participating in sleepovers or overnight camps can be a source of anxiety and concern for children experiencing bedwetting. Parents and caregivers can implement preventive strategies, such as sending absorbent underwear, discussing the issue with the event organizers, or suggesting alternative sleeping arrangements, to help children feel more confident and comfortable in these situations.

Dealing with Bedwetting Emotionally

Offer emotional support and reassurance to children dealing with bedwetting. Encourage them to express their feelings and let them know that bedwetting does not define their worth or abilities. Engage in open conversations about bedwetting to help children understand that they are not alone and that many others have overcome this challenge.

Bedwetting Resources and Support

It can be helpful to seek additional resources and support to navigate the challenges of bedwetting. Online support groups, books, websites, and counseling services can provide valuable information, guidance, and emotional support for both children and their families. Consulting healthcare professionals and pediatric experts can also provide specialized advice and recommendations based on the child’s specific needs.

 Bedwetting in Older Children


When to Involve a Healthcare Professional

In some cases, bedwetting may require the involvement of healthcare professionals with specific expertise. The following situations may warrant involving a healthcare professional:

Initial Assessment by a Pediatrician

If bedwetting persists and does not improve with at-home management strategies, it is appropriate to consult a pediatrician. The pediatrician will conduct a thorough evaluation to identify any underlying medical or psychological factors contributing to the bedwetting.

Referral to a Pediatric Urologist or Nephrologist

If the pediatrician suspects an underlying urinary tract abnormality or kidney problem, a referral to a pediatric urologist or nephrologist may be necessary. These specialists can further investigate and provide specialized care for the child’s specific needs.

Consultation with a Child Psychologist or Psychiatrist

In cases where psychological factors are believed to contribute to bedwetting, a consultation with a child psychologist or psychiatrist may be beneficial. These professionals can assess the child’s emotional well-being, provide counseling or therapeutic interventions, and help manage any psychological conditions that may be influencing the bedwetting.

Continued Monitoring and Follow-up Care

Children with persistent bedwetting may require ongoing monitoring and follow-up care. Healthcare professionals can provide guidance and support throughout the bedwetting journey, ensuring that any underlying medical or psychological issues are appropriately managed.

In conclusion, bedwetting in older children can have a significant impact on their emotional well-being, social interactions, and overall quality of life. Understanding the causes, implementing effective management strategies, and providing a supportive environment are essential in helping children overcome bedwetting. By seeking appropriate help and support from healthcare professionals, parents, and caregivers can guide their children towards achieving nighttime bladder control and improving their self-esteem and confidence.