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Bedwetting in children under five years old

Children under five learning.

Time To Take Action: World Bedwetting Day 2021

For World Bedwetting Day 2021 Bladder & Bowel UK are releasing a series of blogs to help increase understanding of a problem that is not often discussed, but causes stress and distress throughout the world to children, young people, and their families as well as some adults.

What is bedwetting?

Bedwetting is also known as ‘enuresis’. It happens when someone passes urine during sleep. Traditionally it was thought to be the result of an emotional or psychological problem and treatment was not considered until children were at least seven years old.

It is now understood that bedwetting happens because of a combination of problems. Children who have bedwetting are unable to wake up when their bladder is full. However, most children do not need to wake up during the night to pass urine. This is because they are able to balance producing less urine during sleep with having a bladder that is working well enough to hold onto the urine they do make until morning. If either or both of these are upset, then the child needs to be able to wake to go to the toilet, in order to stay dry. If they are can not do this, then they will wet.

How common is bedwetting in children under five?

Bedwetting is most common in younger children, with as many as one in five children aged 4 ½ years old having at least occasional wet nights. Children who are only wet on some nights may get better with time, but those who are wet every night or most nights are more likely to continue to have the problem.

When can bedwetting be treated?

Bedwetting is now considered to be a medical issue from a child’s fifth birthday and full assessment and treatment should be available from this age. However, families can ask for basic advice and support before this.

What can families do about bedwetting?

There are several things that families can do to improve bedwetting in children of all ages:

  • Encourage your child to drink plenty of water-based drinks each day. These will help the bladder to work well and reduce the likelihood of constipation. (Constipation can cause bedwetting or make it worse)
  • Avoid giving your child a drink or food in the last hour before bedtime. Drinks and some foods, particularly those that contain a lot of protein or salt can make the bedwetting worse.
  • Have good bedtime routines. These include a regular time for going to sleep, avoiding electronic screens and TV for the last hour before bed and going to the toilet just before settling to sleep.

What else can families do for children under 5 years old who are still wet at night?

Toilet training can help the bladder to mature and to hold urine more effectively. If a child has not been toilet trained, including due to disability, then families can ask for support with this. It is possible that toilet training during the day may result in dry nights, over the following six months.

If children are over two years old and have toilet trained, but are struggling to stay dry and/or clean during the day, their healthcare professional may be able to offer some extra assessment and support. Solving the problem that is causing the daytime issues, may help with the night time wetting as well.

For children who have toilet trained, then a trial of at least two or three nights in a row without pull ups or nappies at night is usually suggested. It is a good idea to use a waterproof mattress protector if nappies are not going to be used. If the child is dry or less wet at night, or if the family can manage, then a longer trial without nappies or pull ups could be tried.

If the child wakes during the night, this may be due to bladder signals, so they should be taken to the toilet. However, children should not be woken during the night to use the toilet, nor should they be taken to the toilet without being woken. Although this may help to keep the bed dry if needed (for example when on holiday) it is no longer thought to be helpful as an intervention for bedwetting.

Where can I find more information?

Bladder & Bowel UK is a national charity that provides information that is free to access, download and print about bladder and bowel conditions and management solutions for people of all ages on their website here. Information on bedwetting is available here.

There is also information on bedwetting on the Stop Bedwetting website. There is information about World Bedwetting Day available here.

Bladder & Bowel UK produce a free quarterly electronic newsletter for the public called Talk About, which is full of interesting articles, suggestions and information for people affected by bladder and bowel conditions. To receive this fill in the form here and ask to be added to the mailing list.

You can contact the Bladder & Bowel UK confidential helpline by filling in the web form or phoning us on 0161 214 4591.

This World Bedwetting Day, Take Action, and contact your healthcare professional if bedwetting is a problem for you or your child.

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