Bedwetting 101: Causes, Coping and Curing

Written by: Lianne Castelino

Published: May 19, 2010

All parents deal with the trials and tribulations of toilet training. But some parents undergo different challenges that extend beyond the potty training time period, requiring much more than a quick rush to the bathroom with a leaking toddler in their hands.

Bedwetting, or nocturnal enuresis, commonly occurs during the potty training years between 24-36 months.

At two years of age, just 25% of children are dry by day and just 10% remain dry at night. 
By three years of age, 98% of kids are dry by day and 78% are expected to keep dry at night.

However, bedwetting has been known to occur well into the teen years – particularly among boys.

Dr. Benjamin Burko, Medical Director at Club Tiny Tots Medical Centre in Montreal, Quebec, Canada, explains that 3% of 10-year-old girls can experience bedwetting at night, compared to 7% of boys the same age.

“The frequency drops by about 1% per year, with the really late [children usually] achieving night time dryness around age 16 years old,” says Dr. Burko.

So what causes bedwetting? The reasons are many, with primary causes being an immature bladder, the way the bladder functions within the nervous system, and small bladder capacity. Unfortunately, these causes can all be linked to genetics – a parent.

“[Bedwetting] is very often inherited and at least one of the parents will report a similar issue as a child,” Dr. Burko says. “There are however, several important medical causes of nocturnal enuresis…these include diabetes, sleep apnea, seizures, and constipation, to name but a few.”

Coping with bedwetting is a sensitive issue and Dr. Burko states the more important thing to do as a parents is to “minimize the embarrassment and anxiety of the child,” play down your own frustration and make sure that your child doesn’t feel alone in their problem.

“Family members with a history of enuresis should be encouraged to share their experiences and offer moral support to the child,” Dr. Burko suggests. “The knowledge that another family member had and outgrew the problem can be therapeutic.”

More than that, a positive attitude and motivation for your child to remain dry are also critical. Dr. Burko stresses that children who wet the bed benefit from a caring and patient attitude by their parents; punishment has no role.

“Behavioral modification with positive reinforcement may enhance treatment results,” Dr. Burko says. “A positive approach by the physician is also important to instill confidence and enhance compliance. Many children have given up on the concept of dryness, and an optimistic attitude should be encouraged.”

More tips to overcome bedwetting from Dr. Burko:
1.     Rely on your doctor for support: If a child has never had daytime symptoms or has experienced significant dry spells in the past, it’s unlikely that there is a seriously structural abnormality. So, ask your doctor about possible causes so that your fears can be discussed and relieved. For the possibility of more serious causes, visit your doctor regularly for support.

2.     Pay attention and encourage your child’s healthy daytime pattern: Children should be encouraged to use the bathroom when they wake up, approximately every 1.5-2 hours, before leaving home, and always before bed. When at school, encourage them to use the bathroom at least twice a day. Write a discreet note for their teacher to help them out.

3.     Encourage your child to drink liberally during the day only: Children should drink generous amounts of healthy liquids during the day, but come evening at dinner and bedtime, fluid intake needs to decrease. However, make sure that restricting liquids isn’t presented as a punishment.

Dr. Benjamin Burko has been the Medical Director at Club Tiny Tots Medical Centre since 1997. In addition, Dr. Burko is an Assistant Professor in the Department of Pediatrics at McGill University and a Pediatrician at Montreal Children’s Hospital at the McGill University Health Centre. He has been in practice since 1993.


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