Bedwetting in Older Kids

Your school-age child is still wetting the bed, sometimes several times a week. You may feel like no one else has this issue, but rest assured, you’re not alone. Bedwetting affects many older kids and some teens — but thankfully, it’s a condition they almost always outgrow.

Here’s what you need to know about this common problem.

Bedwetting in Older Kids

Almost all kids have occasional accidents at night after toilet training. But according to the American Academy of Pediatrics, nighttime bedwetting is common even after preschool.

At age 5, about 20% of kids wet the bed. At age 7, it’s about 10%. Most people don’t realize that teenage bedwetting is not unusual. By their late teens, 1-3% of kids still wet the bed.

Doctors don’t know why, but bedwetting (medical name: nocturnal enuresis) is more common among boys than girls. It also tends to run in families. If you wet the bed as a child, it’s more likely your kids will too.

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Types of Bedwetting in Older Kids

There are two types of bedwetting in older kids.

Primary enuresis

This is when a child has never had complete bladder control at night. They’ve never had a long period when they didn’t wet the bed. It is the most common form of bedwetting in older kids.

Secondary enuresis

This is when a child or teen has nighttime bladder control for at least six months, then begins wetting the bed again. Stress is the most common reason for this type of bedwetting. It can also result from a urinary tract infection or other medical problems.

What Causes Bedwetting?

Doctors aren’t always sure what causes bedwetting in older kids. But they do know that the brain and bladder aren’t communicating well.

In babies, the connections between the bladder and the brain aren’t fully formed, so the bladder releases urine whenever it feels full. As kids get older, the nerve connections between the bladder and brain form, and they gain control over when they urinate. They develop daytime control first.

It takes some kids much longer to develop nighttime control. Again, doctors don’t always know why. Some kids’ kidneys may make more urine at night, or their brains simply don’t get the message to wake up to urinate.

What Are the Risk Factors for Bedwetting in Older Kids?

Some kids are more likely to wet the bed than others. Bedwetting may result from a combination of factors. Risk factors for bedwetting include:

  • Genetics. If you wet the bed as a child, your kid is more likely to have nighttime accidents. If both parents wet the bed, their child has a 70% chance of doing the same.
  • Hormones. Anti-diuretic hormone causes the body to make less urine when sleeping. Some kids don’t have enough of this hormone, so their bodies make too much urine or don’t adequately concentrate urine at night.
  • Constipation. The bladder and bowels are close, so if your child’s bowel is overly full, it can press on the bladder. That pressure can make your child lose bladder control.
  • Drinking too much liquid before bedtime. Caffeinated and fizzy drinks especially irritate the bladder, making your child need to urinate more.
  • Being a very deep sleeper. Many kids and teens sleep very deeply. Their brains may never get the message from the bladder that it’s time to get up and urinate.
  • Poor sleep schedules. Not getting enough sleep, especially during the high school years, can contribute to alternating periods of extremely deep sleep. During those times, bedwetting is more likely.
  • Defects of the urinary tract. While rare, your child may have had a flaw in their urinary tract since before birth, which may cause their bedwetting.
  • Medical problems. Urinary tract infections, kidney disease, and diabetes can raise the risk of bedwetting.
  • Stress or emotional upset. Stressful or emotional situations like losing a loved one, divorce, or moving houses can bring on bedwetting.
  • A small bladder. Some kids and teens have relatively small bladders that simply can’t hold much urine and may contribute to bedwetting issues.

Treatment for Bedwetting in Older Kids

The good news is that almost all kids eventually grow out of bedwetting. Your child may not need any medical treatment.

Parents need to remember that kids don’t wet the bed on purpose. They don’t have any control over it. Your child already feels bad about bedwetting; shame or punishment won’t help the situation.

Reassure your child that bedwetting in older kids is common, and it’s not their fault. Here are some positive strategies you can use at home to help your child get over their bedwetting:

  • Reduce fluids. Your child should stay well-hydrated throughout the day. But limit drinks, especially caffeinated ones, starting a couple of hours before bedtime.
  • Encourage them to use the bathroom regularly. That means throughout the day and right before they go to bed.
  • Keep a chart or diary. Track when your child went to bed, what they ate and drank, and how often they urinated or passed stool during the day. Note any signs or symptoms of constipation, as this may contribute to bedwetting. This will help you and your child see patterns that caused them to have accidents or stay dry at night. You can also show the chart to your pediatrician.
  • Use a bedwetting alarm. These devices fasten to a child’s underwear and vibrate or sound when wet. In time, your child’s brain may link the alarm to the need to get up and go to the bathroom.
  • Alleviate stress. If your child’s bedwetting comes on suddenly after a long period of being dry, it may be from stress. Figure out why your child feels anxious and implement some tactics to deal with the stressful situation.

Should I Seek Medical Help for Bedwetting in Older Kids?

Yes, you should talk to your child’s pediatrician about their bedwetting. They will want to rule out any medical problems, like a UTI or constipation. But doctors will usually recommend non-medical, home treatments for bedwetting.

If your child doesn’t respond to at-home help, your doctor may want to further evaluate your child and discuss medication options that may be available. These medications decrease the amount of urine your child produces at night.

However, it’s important to note that bedwetting medications aren’t a cure. Once your child stops taking the medicine, the bedwetting will usually return unless your child has naturally outgrown it.

Sources

American Academy of Pediatrics, Bedwetting in Children & Teens: Nocturnal Enuresis, Link

National Library of Medicine, Bedwetting, Link

American Academy of Family Physicians, Enuresis, Link

National Association for Continence, Bedwetting in Teens: Possible Causes and What to Do About It, Link

Kidshealth.org, Bedwetting (Nocturnal Enuresis), Link

National Institute of Diabetes and Digestive and Kidney Diseases, Bladder Control Problems & Bedwetting in Children, Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.