A nurse and a child sat next to each other. The child is looking at the nurse and grinning. The image is to illustrate why bedwetting should be treated.

Bedwetting may not get better without being treated

Many people believe that bedwetting is something that children will grow out of as they get older without any treatment. While this is true for many children who are only wet occasionally, it is less likely to be the case for those who are wet more often. Children who are wet five or more nights a week are the ones who are least likely to just become dry with time. If children are wet two or more nights a week after their fifth birthday, then the condition can be treated.

While bedwetting can be a difficult problem to manage and frustrating for both the child and their family, it is important to remember that bedwetting is a recognised medical condition. It is not caused by laziness, naughtiness or anything the child or the family has done or is doing that is wrong.

Bedwetting is difficult for children

While some children, particularly younger ones are not bothered by bedwetting, many find it distressing and difficult. It causes embarrassment and many worry about being teased or bullied if others find out. For this reason they may be reluctant to talk to anyone about it, including their healthcare professional. Anxiety about others finding out may also make them want to avoid normal childhood activities including sleepovers and residential trips with school, or groups such as brownies or cubs. Feeling the need to keep the wetting a secret is difficult for many, with bedwetting consequently affecting friendships and reducing individuals’ self-esteem.

Bedwetting can disturb sleep. Although the affected children are not able to wake up to their bladder signals, the messages from the bladder that wants to empty to the brain disrupt sleep. This means sleep for children affected by bedwetting is often of less good quality, resulting in tiredness during the day. That may, in turn, be associated with more difficulties with behaviour and learning in school than other children experience.

The good news is that successful treatment may help with all these problems.

Bedwetting is difficult for families

Many parents worry about the impact of bedwetting on their children. However, the bedwetting is not easy for families to manage either. Over a third of those responding to a Bladder & Bowel UK survey for World Bedwetting Week in 2022 said that they were worried about getting less sleep themselves due to their child’s bedwetting. Other issues highlighted in the same survey included additional washing, which, along with changing the bed more frequently, is time consuming. Having to purchase additional underwear or pyjamas and bedding were concerns and these, along with the increased laundry, have clear financial impacts, which are particularly difficult for many and compounded by the current rising costs of living. Some families chose to use disposable products to contain the wetting at night, but these also impact on family budgets.

Staying away from home is more problematic for families who have a child who is wetting the bed. Two thirds of families responding to the Bladder & Bowel UK survey said that they would take their own waterproof mattress cover with them when going on holiday and over half would take extra clothes.

Rarely bedwetting is a sign that there might be something else wrong 

Bedwetting, particularly if it starts again suddenly after a time of being dry at night, may indicate an underlying medical problem. Bedwetting may be a symptom of a urinary tract infection. Because bacteria that cause the infection irritate the bladder lining, affected children to need to go to the toilet more frequently than usual and with more urgency. If they are not able to respond to the sudden and unexpected need to empty their bladder while asleep they will wet the bed. 

Constipation is also linked with bedwetting. If the rectum (the part of the bowel near the bottom) is not emptied fully, or if stools build up there, then there is less space for the bladder to stretch and hold onto all the urine that is produced overnight, resulting in wetting. Constipation in children should be treated with laxatives, but these do need to be prescribed by a healthcare professional in all children under 12 years old. 

Very rarely bedwetting may indicate a more serious underlying health issue or be caused by stress. Therefore, if your child suddenly starts to wet the bed after being dry at night for weeks or months, ask their healthcare professional for advice.

Where can families go for help?

Children’s healthcare professionals should be able to offer an initial assessment and advice on simple measures that may help improve bedwetting. If these are not effective, they can provide further support and treatment or refer to a specialist service. Therefore, this World Bedwetting Week if your child is affected by bedwetting, ask their GP or school nurse for support.

You can also find more information on the Bladder & Bowel UK website – www.bbuk.org.uk/children-young-people/resources-for-children – or contact the Bladder & Bowel UK helpline for free confidential advice – www.bbuk.org.uk/enquiries. There is information on how to speak to your healthcare professional – www.stopbedwetting.org.

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