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Children’s Health Resource
Bedwetting in Children (Nocturnal Enuresis)
Bedwetting (nocturnal enuresis) is the involuntary passing of urine during sleep in children aged five and over. It affects around 500,000 children in the UK and is considered a treatable medical condition.
Published by Davina Richardson RGN RSCN BSc (Hons), Children’s Specialist Nurse
Clinically reviewed
Last updated April 2026
Source: Bladder & Bowel UK www.bbuk.org.uk
Contents
Frequently asked questions
How common is bedwetting?
What causes bedwetting?
Does it go away on its own?
What lifestyle changes help?
What does an assessment involve?
What treatments are available?
Desmopressin vs alarm: comparison
When to see a doctor
Glossary of key terms
Getting further help
Further resources
Frequently asked questions
Quick answers to the questions parents and carers ask most often. Click any question to expand the answer.
No. Bedwetting is a medical condition — not a result of laziness, naughtiness, bad parenting, or emotional problems. It happens because of one or more physical factors: producing too much urine at night and/or having a bladder that cannot hold enough urine, and being unable to wake when the bladder needs to empty.
Punishing a child for bedwetting is likely to make things worse by adding anxiety and stress. Reassurance, patience, and appropriate treatment are far more effective.
Bedwetting is considered a medical condition once a child has passed their fifth birthday. Before age five, it is generally regarded as a normal part of development. If your child is five or older and still wetting the bed two nights or more a week, you should speak to your GP or school nurse and ask for an assessment.
Avoid drinks and food for one hour before bed — but do not restrict fluids throughout the day. Not drinking enough during the day causes the bladder to adapt to holding smaller amounts, which can make bedwetting worse over time.
Aim for about 1.5 litres of water-based drinks spread evenly through the day for primary-school-age children (more for teenagers). The goal is to drink well during waking hours until an hour before sleep.
No. Waking or lifting a sleeping child to use the toilet does not treat the underlying causes of bedwetting and does not teach the bladder to hold on overnight. It may keep nights drier in the short term but does not lead to lasting improvement. It can also lead to disturbed sleep, making them more tired in the day.
If your child wakes independently during the night, encourage them to use the toilet at that point. The aim of treatment is for the child to sleep through dry — either by learning to wake to a full bladder, or by producing less urine, not by relying on being lifted.
Yes — this is a common cause. When the rectum is full of stool, it presses directly against the bladder, reducing the space available for urine storage and making it harder for the bladder to hold on overnight.
Constipation can also contribute to daytime urgency, frequency, and urinary tract infections. If your child is opening their bowels fewer than three times per week, or more than three times a day, is opening their bowels when they are asleep, is soiling (stools are going into their underwear), has regular tummy aches, or only passing hard, painful or loose stools, speak to your healthcare professional. Treating constipation often leads to a significant improvement in bedwetting.
The alarm usually takes several weeks of consistent use before dry nights become frequent — it is not an immediate fix. The process works gradually: the alarm wakes the child (or their parent) when wetting begins, and over time the brain learns to either wake before the bladder empties, or hold on through the night.
Early signs that the alarm is likely to work include the child waking to the alarm and being able to finish passing urine in the toilet, wetting occurring later and later in the night, and the volume of wetting reducing.
Yes — one of the practical advantages of desmopressin is that it may work immediately, on the night it is taken, making it well suited for occasions like school trips, sleepovers, or holidays where a wet bed would be particularly distressing.
Desmopressin needs to be prescribed so speak to your child’s GP or nurse about using desmopressin in this way. Remember that the no-fluid rule must still be followed strictly: no drinks for one hour before taking the dose and for eight hours afterwards.
If it does work for your child, it can be taken for up to 12 weeks and they must then have one week without it. They can restart it if they are wet two or more nights on the week without.
If either desmopressin or the enuresis alarm alone does not achieve dryness, using both together is a recognised and often effective next step. Some children also need treatment for constipation or for daytime bladder issues to be addressed before treatment for bedwetting is successful. Ask your GP or school nurse for a referral to a local specialist children’s bladder and bowel or enuresis service if first-line treatments have not worked — specialist services can offer more tailored assessment and support.
Children with disabilities, autism or ADHD can and do experience bedwetting. It should not be assumed to be an inevitable part of their condition. All children with bedwetting deserve an assessment and a discussion of treatment options.
Bladder & Bowel UK has a dedicated resource — Understanding Bedwetting in Children with Learning Disabilities (PDF) — which provides tailored guidance.
Absorbent products (nappies, disposable pants and bed mats) help with management of bedwetting. They protect the mattress, reduce laundry and keep children feeling dry and comfortable. They may help prevent rashes and reduce stress that may be associated with bedwetting.
You could consider a trial without them, to see if the bedwetting improves. If it does not, or if this is too difficult, continue to use them, but talk to your healthcare professional about assessment and treatment.
How common is bedwetting in children?
5-year-olds wet the bed
of 7-year-olds wet the bed
success rate for both main treatments
Bedwetting — medically called nocturnal enuresis — is extremely common and is considered a medical condition once a child has passed their fifth birthday. It affects approximately one in five 5-year-olds and around one in ten 7-year-olds.
It is important to understand that children do not wet the bed because they are lazy or naughty. Punishment makes the problem worse. Bedwetting is caused by problem with how the body makes and stores urine (wee) during sleep. Effective
treatments are available.
Key point: Bedwetting can run in families. If a parent or close relative wet the bed, their child is more likely to do so too.
What causes bedwetting in children?
There are two main reasons why children wet the bed, and both involve the bladder being unable to hold urine overnight— either because too much urine is produced, or because a normal amount is made but the bladder cannot hold well enough.
Producing too much urine at night
During sleep, the brain releases a hormone called vasopressin, which tells the kidneys to make less urine. Some children do not produce enough vasopressin, so their kidneys continue making as much urine at night as they do during the day. If the child is unable to wake up to the bladder signals, the bladder will empty while the child is asleep, causing bedwetting..
The bladder cannot hold enough urine overnight
Even when a child produces normal amounts of vasopressin, a smaller-than-average bladder — or a bladder with an overactive wall that twitches during filling — may not be able to hold all the urine produced. Many children with this pattern also experience daytime symptoms: urgency (a sudden, pressing need to go), frequency (going to the toilet more than 7times daily), or damp or wet underwear.
Why don’t children just wake up?
All children who wet the bed are unable to wake when their bladder needs to empty. If they could wake, they would simply go to the toilet.
Other contributing factors
- Constipation — a full rectum presses on the bladder, reducing how much urine it can hold overnight.
- Drinking too much before bed — a large fluid intake in the evening increases the amount of urine made overnight.
- Not drinking enough during the day — the bladder becomes used to holding smaller volumes and shrinks over time.
- Caffeinated or fizzy drinks — tea, coffee, cola, chocolate drinks, and energy drinks irritate the bladder lining and may make wetting worse.
- Urinary tract infection (UTI) — an infection irritates the bladder and causes it to empty more frequently.
- Family history — bedwetting often runs in families.
- Rarely, there is an underlying medical cause — see the red-flag section below.
Does bedwetting go away on its own?
Without treatment, many children will continue to wet the bed into late childhood or their teens — and occasionally into adulthood. Children who wet every night or most nights are the least likely to improve without active treatment.
It used to be thought that stress or psychological problems caused bedwetting. In reality, the opposite is often true: bedwetting itself causes significant stress and psychological difficulty for children and families. It is therefore important not to wait and hope the problem resolves, particularly once a child is distressed by it.
All children and young people with bedwetting should be offered a bladder and bowel assessment, and treatment options should be discussed whenever the wetting is worrying or upsetting for the child or family.
What lifestyle changes help with bedwetting?
Lifestyle modifications are often recommended first, either alone or alongside medication or alarm treatment. They can make a significant difference.
Drink enough in the day
Aim for about 1.5 litres of water-based drinks spread across the day for primary-school-age children (more for teenagers, active children and if the weather is hot). Regularly not drinking enough causes the bladder to get smaller.
Drink every two hours
Space drinks evenly through the day — roughly every two hours from waking. Try to include three drinks during school hours.
Stop drinks an hour before bed
Avoid all drinks and high-protein or salty foods for at least one hour before bedtime to help reduce overnight urine production.
Use the toilet before sleep
Make sure your child empties their bladder as part of their bedtime routine, immediately before going to sleep.
Avoid caffeine and fizzy drinks
Tea, coffee, cola, hot chocolate, and energy drinks all irritate the bladder lining. Stick to water or diluted sugar-free squash.
Good bedtime routine
A regular sleep time, no electronic screens in the hour.
Treat constipation
If your child is constipated, treating it may improve bedwetting. Ask your healthcare professional for advice.
Avoid lifting or waking
Do not wake or lift your child to use the toilet if they are not already awake — this does not teach the bladder to hold on overnight.
What does a bedwetting assessment involve?
Assessments are usually carried out by a specialist children’s bladder and bowel nurse or school nurse. The purpose is to understand how the bladder and bowel are working so the most appropriate treatment can be recommended.
Keep a bladder diary for 2–3 days — recording what and how much your child drinks, and how much urine they pass each time they go to the toilet.
Keep a bedwetting chart for 7–14 days — noting bedtimes, and wet or dry nights.
Record your child’s bowel movements for a 7-14 days, as constipation is a common contributing factor.
The nurse will also ask about your child’s general health, toilet training history, daytime bladder symptoms (such as urgency – having a sudden and desperate need to use the toilet, frequency – going to the toilet more than 7 times a day, or damp or wet underwear), and any relevant medical history.
Tip: Be open about any daytime symptoms too — telling the nurse about damp or wet underwear during the day will help them identify the most likely cause and the best treatment.
About us
Bladder & Bowel UK is a leading UK charitable service providing expert advice, support, and education on bladder and bowel health. We help children, young people, and adults manage conditions such as incontinence, constipation, and other continence issues through evidence-based guidance and practical resources.
Our specialist team supports individuals, families, carers, and healthcare professionals with reliable information on toilet training, bladder control, and bowel management. Through our confidential helpline, training programmes, and online resources, we aim to improve access to continence care and promote better bladder and bowel health for everyone.
At Bladder & Bowel UK, we are committed to raising awareness, reducing stigma around continence problems, and empowering people to seek help and live confidently.
Resource author
Davina Richardson RGN RSCN BSc (Hons)
Children’s Specialist Nurse
Bladder & Bowel UK
Davina is a specialist children’s nurse with extensive experience across acute care, children’s hospice services, and community nursing. Throughout her career, she has supported children with complex health needs, disabilities, and life-limiting conditions. She went on to establish and lead an NHS community bladder and bowel clinic for children, and has nearly 20 years’ experience working with children affected by bladder and bowel health issues.
Davina joined Bladder & Bowel UK in spring 2015. In her role, she provides expert advice, support, and information to children, young people, and families affected by bladder and bowel conditions. She also delivers education and training to professionals working in this field.
In addition to her clinical work, Davina has contributed to peer-reviewed journals and is actively involved in research projects focused on paediatric bladder and bowel health. She plays a key role in supporting service development within the NHS.
Davina has contributed to the development of national guidance and is an active member of several national groups. She serves as Paediatric Advisor to the Association of Continence Professionals and sits on the committee of the Royal College of Nursing Bladder and Bowel Forum.
Support
Our specialist team supports individuals, families, carers, and healthcare professionals. You are not alone!
When to start
From birth to night-time dryness
There is no single “right age.” This guide shows what you can introduce at each stage — and why starting early makes the whole journey easier.
Infant-led pottying
Hold your baby over a potty after feeds, on waking, or when they show signs of needing to go. Babies are born with some awareness of when they need to wee or poo — this helps them recognise those signals and understand that there is a right place to go. Many children using this approach are reliably clean and dry well before their second birthday.
Language, routine and environment
Use consistent words for wee, poo, potty and toilet. Change nappies in the bathroom, tip poo down the toilet and flush — so your child sees where it goes. Signs-based communication can start from 6–9 months for children who cannot yet speak.
Regular sitting and catching
Introduce regular sits on the potty after meals, drinks and on waking. Start fully clothed if your child is unsure — gradually reduce clothing. Use special toys only for potty time. When you are catching around half of all wees and poos, you are ready to remove daytime nappies.
Remove daytime nappies
Use washable trainer pants, not pull-ups. Maintain the routine everywhere — at home, at nursery, on visits. Putting a nappy back on, even briefly, can confuse your child and slow progress. Take your child to the potty or toilet regularly, gradually extending the gap to around 1.5–2 hours.
Night dryness follows naturally
Night dryness cannot be taught in the same way as daytime training. Most children become dry at night within months of daytime training. Support this with good daytime hydration, stopping drinks an hour before bed, and a toilet visit at bedtime. Bedwetting in children over 5 who have been dry in the day for six months is a medical matter — seek advice from your GP.
