Nocturnal Enuresis (Bedwetting in Children)

Nocturnal enuresis is the medical term given to children ≥ 5 years old who persistently wet the bed more than 2 times per week. While considered taboo by some, bedwetting beyond 5 years old is quite common, and each year 15% of children will outgrow it. The following information and tips may help parents and caregivers navigate their child through this potentially stressful time:

  1. Wetting the bed is common
  • Bedwetting is more common than you think. Nocturnal enuresis is experienced by:
    • 10-15% of 5 year olds
    • 6-8% of 8 year olds
    • 1-2% of 15 year olds
  • Bedwetting is twice as common in boys than girls
  • Should be regarded as a normal part of bladder development
  1. Punishing or humiliating a child will not help
  • Emotional and behavioural problems are not the cause of bedwetting
  • Despite this, up to one third of parents will use a punishment as their primary way of dealing with bedwetting
  • Punishment can result in children developing psychological problems
  1. Family education/support is crucial
  • An intolerant attitude on the part of the parents predicts early dropout from treatment
  • Adopt a “no blame, no shame” policy
  • Strong genetic component to bedwetting; chances are a parent had an issue as a child as well – empathy and reassurance are important
  1. Engaging your child in their care is important
  • Motivational therapy
    • Award stickers or a prize for ‘"x” number of consecutive dry nights
    • Keep a calendar
  • Responsibility training
    • Allow young children to help strip wet sheets off bed
    • Encourage older children to take part in washing of sheets
  • Voiding diary
    • Use a diary to help track trends in voiding and effectiveness of interventions
  1. Consider non-pharmacological treatments
  • Reduce the amount of liquids consumed prior to bedtime
  • Encourage child to go to the bathroom just before going to bed
  • Avoid foods that may irritate the bladder - chocolate, caffeinated sodas/carbonated beverages, tea and coffee
  • Try a voiding alarm ($80-$120)
    • Lightweight, battery-operated, portable device worn by child
    • Alarms when child starts to void (very sensitive to moisture)
    • The only therapy shown to have long-lasting effects
  1. If all else fails, speak to your child’s healthcare provider
  • Drug treatment should be based on your child’s age, and the impact that bedwetting is having on their quality of life.
  • Parents and children should be reminded that every year, 15% of children will outgrow bedwetting without treatment.
  • If a child is ≥ 5 years old, and their bed wetting is having a significant impact on their quality of life, then drug treatment can be an effective option
  • Options include: desmopressin, oxybutynin/tolterodine or imipramine. Your child’s healthcare provider can help you determine the best option.
Back to top