This post has been written by Davina Richardson, Children’s Specialist Nurse at Bladder & Bowel UK about bedwetting in childhood. When a baby is first born their bladders are small. Therefore, they do not hold very much urine (wee) and do not fully empty with every wee. As babies are fed throughout the twenty four hours they produce lots of wee at night.
As the baby grows, so does the bladder. By the time a child toilet trains at two to three years old, the bladder is able to hold enough wee to last about one and a half to two hours. By this age children are no longer having an overnight drink or feed, which helps to reduce the amount of wee produced while they are asleep. In addition, the brain makes a special chemical messenger, called vasopressin, that tells the kidneys to make less wee during the night. As this system develops and the bladder grows, the child should become dry at night.
Bedwetting is very common, particularly in children under five years of age, but from five years it is considered to be a medical condition. Many children will get better with time, but this is most likely to happen if the child is dry for four or more nights a week. Children who are wetting most or every night are less likely to ‘grow out’ of the wetting.
Children cannot be trained to be dry at night in the same way as they are toilet trained in the day. Things that help children to become dry at night include:
- Encouraging a good fluid intake during the day: five year olds should be having six drinks evenly spaced through the day, with a total intake of about 1.25 mls. Children aged 7 – 12 years should have about 1.5 litres per day and teenagers should have about 2 litres per day, with more if it is hot or they are very active. Teenage boys usually need about 2.5 litres per day
- Avoiding drinks in the hour before bed – if children are drinking well during the day, they should not be thirsty at bedtime
- Avoiding food in the hour before bed, particularly food with a lot of salt or protein
- Avoid fizzy and caffeinated drinks (tea, coffee, hot chocolate, cola and energy drinks)
- Making sure your child uses the toilet just before they go to sleep
- If your child uses nappies or pull ups try a few nights without them
- If your child is constipated then ask their health care professional for advice.
It is not recommended to wake children at night to take them to the toilet.
If children are still wetting the bed at five years old then assessment and treatment is available. Your healthcare professional should be able to provide advice and support or refer you to a specialist clinic.
World Bedwetting Day with the theme ‘Time to Take Action’ is designed to raise awareness of bedwetting. If you’re looking for further advice on bedwetting in childhood, visit Bladder & Bowel UK’s resources page.