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Managing bedwetting at Christmas

Davina Richardson, Children’s Continence Nurse at Bladder & Bowel UK, talks about how to support your child who experiences bedwetting at Christmas.

Enuresis, or bedwetting is a common condition in children and young people, that can be distressing and frustrating for them and for their families. Furthermore, it can embarrassment and fear of others finding as well as be a cause of low self-esteem. Bedwetting at Christmas can be a problem for some children, but the holiday can also represent a chance for the situation to improve.

What is bedwetting?

Bedwetting, also known as enuresis or nocturnal enuresis, is a medical condition where the bladder empties during sleep. It is not caused by anything that the child or young person, or their family is doing wrong or not doing and it is not a result of laziness. While it can be made worse by stress, it is not usually caused by this. Rarely it can be linked to other medical conditions. Therefore, if your child has suddenly started wetting after a period of being dry, you should ask your healthcare professional for advice.

Why it might be a good time to talk about bedwetting at Christmas

Children spend most of the Christmas holidays at home with their family.  Most children need support to establish good drinking and toileting patterns and this is easier when everyone has time at home. Also, although there may be more sweets and chocolates around, traditional festive foods tend to include lots of fruit and vegetables. These can help to prevent constipation, which may make bedwetting worse.

The holidays can be a good time to start using a bedwetting alarm. This is because if you and your child are disturbed by the alarm during the night, you may be able to catch up with lost sleep by getting up a bit later in the morning on days that they do not have to be at school and you do not have to be at work.

If you have tried the initial adjustments to your child’s routine and the bedwetting is not improving and they are over five years old, then you can ask their healthcare professional for assessment and further treatment.

What causes bedwetting?

There are different reasons why children and young people may not be able to stay dry at night. If the child’s brain is not able to fully wake them up to the signals from the bladder that it needs to empty, then the bed will get wet.

Bedwetting may happen because the bladder is not working well enough to be able to hold all the urine that is made overnight. Some children with bedwetting also have problems with bladder function when they are awake. These children may experience some dribbling of urine or wetting during the day, may go to the toilet more often than usual (frequency) or have to get there quickly (urgency). Another cause of bedwetting is that the kidneys are making too much urine overnight, so the bladder cannot hold it all.

Is there anything that can be done to help with bedwetting at Christmas?

Encouraging children to drink well during the day helps the bladder to work well and hold urine more effectively during the day and at night. Most primary school age children should be drinking about 1.5litres of water-based drinks a day, with teenage girls having 1.5-2 litres and teenage boys 2 -2.5litres a day, divided up into a drink about every two hours, or six to eight drinks a day.

Drinks that are fizzy and drinks that contain caffeine, such as tea, coffee, hot chocolate, cola and many energy drinks, should be avoided. This is because fizzy drinks and caffeine can irritate the bladder lining and make wetting worse.

The last drink should be had about an hour before bedtime. Stopping drinks too early in younger children may make it more difficult for them to drink as well as they should during the day. Older children, who go to bed later, may stop drinks up to two hours before bedtime.  Drinking late in the evening does not give the kidneys enough time to get rid of any excess fluid before sleep, so may make bedwetting worse.

Emptying the bladder just before settling to sleep is also important, particularly for children who play or read in bed.  Avoiding watching TV or spending time on electronic tablets, computers, phones etc just before sleep may also help as the type of light that they emit can affect production of the chemical that helps to control the brain sleep-wake cycle.  A good bedtime routine can also be helpful. This is because some children are more prone to wetting if they are very tired due to late nights, others are more prone to wetting if they go to bed early due to being very tired, as they are in bed and their bladder must hold on for longer.

Constipation can also impact on the bladder, as the full bowel can put pressure on the bladder. Therefore, it is important to try to prevent constipation through a good fluid intake, as described above, and by ensuring that your child is eating a healthy diet that includes fruit and vegetables. If you think they may be constipated, then do speak to your healthcare professional, as children with constipation do usually need to be treated with laxatives.

Is there any other treatment for bedwetting?

If the measures outlined above do not help, then medication or an alarm may be appropriate. There is a medication called Desmopressin that helps to tell the kidneys to make less urine overnight. This is available on prescription from your healthcare professional and there is more information about it in the Bladder & Bowel UK leaflet.

Alarms are devices that make an intrusive noise when the child starts to wet. They can be attached to pyjamas (body-worn alarms) or have a mat that goes under the top sheet (bed mat alarms). The noise is designed to wake the child as their bladder starts to let go, so that they can get up and go to the toilet. They can take some time to be effective. While it is not clear exactly how they work, they do help some children to learn to wake to the bladder signals, others learn to hold on all night.

Some children may need other medication to help the bladder work well and some children need to have more than one treatment. Therefore, bedwetting in children over five years old should be assessed by a healthcare professional.

Where can I find more information about bedwetting?

There is more information about bedwetting on the Bladder & Bowel UK website. There is also information on the website at stopbedwetting.org.

Where can I get more advice and help?

Your child’s GP, school nurse or health visitor should be able to provide more information and initial assessment. They may be able to refer your child to a local service for support. You can also contact the Bladder & Bowel UK helpline for free confidential information and advice via the webform or on the telephone at 0161 214 4591


For more information and resources for professionals working with bladder and bowel issues, visit our professionals’ section here. 

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