How Much Bedwetting Is Too Much?

February 12, 2020

Clinical Contributors to this Story

Harry P Koo, M.D. contributes to topics such as Pediatric Urology.

Kristin A Kozakowski, M.D. contributes to topics such as Pediatric Urology.

Does your child occasionally wet the bed? You may be concerned that they have a problem, but for many children, especially those under age 7, bedwetting isn’t something to be concerned about.

“Up to 15 to 20 percent of kids will have some degree of bedwetting,” says Harry Koo, M.D., chief of Pediatric Urology at Joseph M. Sanzari Children’s Hospital, part of Hackensack University Medical Center. “For a lot of children, it’s just a normal part of growing up.”

When to tell the doctor

There’s no set formula to determine if your child wets the bed often enough to mention it to the pediatrician. Age is one of the bigger factors: Your child may outgrow the habit over time, so it may not be worth mentioning until your child is around 2nd grade age.

“Wait until they’re 7, because until then it’s considered to be normal,” says Kristin Kozakowski, M.D., a pediatric urologist at K. Hovnanian Children’s Hospital, part of Jersey Shore University Medical Center. “For a 4-year-old who has barely been toilet trained for 2 years, it’s more expected.”

It’s also worth telling the pediatrician if your child is older than 5, went 6 months or longer without nighttime accidents, then regressed, or if your child has had urinary tract infections and also wets the bed.

Causes of bedwetting

Some children wet the bed because they drink too much in the evening or forget to use the bathroom before getting tucked in. Others sleep very deeply and produce more urine at night than they should; the combination leads to accidents. Still others have a family history of bedwetting. And some children wet the bed at night because they may have urinating issues during the daytime, such as resisting going to the bathroom.

“Kids that hold it all day are not really going to develop the bladder sensation to wake them up in the middle of the night, because they are dulling the sensation,” Kozakowski says.

Children who don’t have regular bowel habits may also wet the bed. “Because the bladder and rectum occupy the same pelvic region, if somebody has a lot of underlying issues with constipation or just inefficient bowel emptying, it can throw off how the bladder works,” Koo says.

Possible solutions

If your child wets the bed, some small behavioral changes like these may help:

  • Make sure that your child is well-hydrated throughout the day
  • Have your child empty their bladder about every 2 hours during the daytime and right before bed
  • Try to limit giving your child caffeinated beverages, especially in the evening
  • Restrict fluid intake for 2 hours before bedtime

Bedwetting alarms – which are designed to awaken children when they begin to urinate – may help children age 8 or older, but they aren’t universally effective, especially for deep sleepers. Prescription medication that stops your child from producing too much urine overnight may keep the bed dry, but it isn’t a long-term solution.

“It doesn’t actually correct the problem,” Kozakowski says.

How to react

Kids don’t have nighttime accidents on purpose; it’s beyond their control, and they shouldn’t be punished or belittled for it.

“Try to reassure the child that it’s normal, it happens to a lot of kids,” Kozakowski says.

If your child is anxious or embarrassed about bedwetting, a conversation with the pediatrician may help.

“Just having an expert tell the child, ‘It may seem that you’re the only one suffering from it, but you’re not,’ helps, giving the child reassurance,” Koo says.

Dr. Koo practices at Joseph M. Sanzari Children’s Hospital, part of Hackensack University Medical Center. To make an appointment, call 551-996-8090. Dr. Kozakowski practices at K. Hovnanian Children’s Hospital, part of Jersey Shore University Medical Center in Neptune. To make an appointment, call 732-613-9144. To find a Hackensack Meridian Children’s Health doctor near you, visit HackensackMeridianHealth.org/Kids.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.