What To Do With A Child Who Wets The Bed
What To Do With A Child Who Wets The Bed

What To Do With A Child Who Wets The Bed

Bedwetting in children is more common than you think. Known medically as nocturnal enuresis, most children outgrow this behaviour by the time they are five, but for some, it can continue. In fact, it’s estimated up to 10% of children still wet the bed at age seven, and it’s two to three times more likely in boys than girls. To find out more, we asked a midwife and nutritional therapist to share their insights.
Image: ISTOCK/CHRISTOPHER BERNARD
Image: ISTOCK/CHRISTOPHER BERNARD

It's More Common Than You Think

“Night-time continence (the ability to hold your wee overnight) is generally achieved between the ages of three and five, with boys and those with ADHD taking a little longer to tick this developmental box. However, bed wetting is still very common in the five-year-old child, with around one-in-five wetting the bed a couple of times a week. This drops to just under 10% of seven-year-olds wetting the bed occasionally. Frequent bed wetting is less common, but still affects almost 10% of five-year-olds and just over one in 100 10-year-olds, so if your child wets the bed, don’t panic – you aren’t alone.” – Rachel Fitz-Desorgher, ex-midwife & baby & parenting expert

It Isn’t Linked To Deep Sleep

“It’s a myth that bed-wetters sleep more deeply, and so fail to wake up when they have a full bladder. It’s not true. Children who wet the bed do not sleep more deeply – instead, they may have a simple developmental delay in the muscle control of their bladder, meaning it empties automatically as soon as it fills, without the child even being aware of it. In some children, the development of hormones which reduce the amount of urine we make overnight is delayed, so the bladder gets much fuller than it should. This explains why parents with bed-wetting children often remark on the enormous amount of wee produced during an overnight accident.” – Rachel

It's Not Linked To Stress

“Some parents assume that wetting the bed is a sign of emotional distress, and while stress can sometimes be a factor, it certainly is not the most common cause. In fact, it is far more likely to be the other way around, with bed wetting causing the upset. At the same time, some people still believe that bed wetters are lazy or naughty, preferring their nice, warm bed to getting up for a wee, but this couldn’t be further from the truth. Most bed-wetters feel very upset by their lack of dry nights. Children who wet the bed need love and support rather than blame and shame.” – Rachel

Most bed-wetters FEEL UPSET by their lack of dry nights. Children who wet the bed NEED LOVE AND SUPPORT rather than BLAME AND SHAME.

Your GP Can Help

“If your child is going away for the night – perhaps on a sleepover with friends or a school residential trip – then it could be a good idea to see your GP as they can prescribe a spray or melting tablets which provide a boost of the hormone which reduces the amount of urine produced overnight. These aren’t suitable for long-term use but are a way to give your child the extra confidence boost when away from home. Ask your GP about Desmospray and Desmotabs.” – Rachel 

Constipation Can Play A Role

“If a child is constipated or does not pass a daily large bowel movement, this can lead to congestion in the pelvis, which may put pressure on the bladder to urinate too often, with wee accidents happening both during the day and night. Laxatives are usually the initial treatment given by doctors. Magnesium supplements (try magnesium citrate) and eating flaxseeds, prunes and kiwi fruits can also help soften poo and help things flow through the bowel more easily. It could also be worth incorporating a probiotic – a certain strain called bacillus coagulans has been shown to aid constipation in children. Optibac’s Kids Gummies are an easy way to incorporate this strain into your child’s diet – it can help if taken daily for eight weeks.” – Lucinda Miller, naturopath & founder of NatureDoc

It's Worth Ruling Out An Infection

“If your child is frequently wetting the bed, it’s important they get tested by their GP for a urinary tract infection, especially if the urine is smelly or they also have accidents during the day. If there is an active infection, your GP will be able to prescribe a short course of antibiotics. Another bacterial infection to consider is streptococcus, which can be part of the picture in tonsillitis, a sore throat or scarlet fever. Some children experience a PANDAS (paediatric autoimmune neuropsychiatric disorder associated with streptococcal infection) flare-up for several weeks or months after the infection resulting in anxiety, OCD and tics. These symptoms are also often accompanied by sleep disturbances, bed wetting or urinary frequency. Again, seek support from your GP or a PANDAS specialist. Threadworm can also interrupt some children and over 50% of cases lead to disturbed sleep and bed-wetting.” – Lucinda

ISTOCK/ OZGURCANKAYA

Encouraging Independence From An Early Age Is A Good Idea

“By approaching daytime toilet independence with ease and confidence, you can help your child apply their daytime skills to night-time. As soon as your child can stand with help, instead of lying them down for nappy changes, let them toddle or crawl to the loo and then let them stand, holding onto a chair or the side of the loo, while you take their nappy down. Encourage them to help with the wiping and flushing and ask them to take the bagged nappy to the bin. Toddlers crave independence and love to help in this way – this teaches them that it’s their body to take care of. This is a journey not a race, and by starting in this way, the transition to full toilet daytime independence as toddlerhood continues is gentle and compassionate. Children gradually learn that wet pants need changing, toilets need flushing and hands need washing.” – Rachel

Set Up Their Bedroom For Success

“Think about transferring this respectful approach to night-time. First, protect their mattress – this will save you money and reduce your anxiety. If your bed-wetter produces lots of overnight wee, buy a soft waterproof protector for both their duvet and pillow. Brolly’s bed protection sheets are great, as are Hippy Chick’s duvet and pillow protectors. Ensure your child has an accessible night light they can control, a potty and paper in their room in a spot they have decided on, knows where wet pyjamas can be put if an accident occurs, and how to place a dry towel over any damp areas in the bed. This means a situation can all be dealt with without fuss or drama in the morning. Finally, your child needs to know they can always call if they need help. The younger the child the more support you should expect to give, with a three-year-old needing full support, a five-year-old needing as much as they ask for, and an older child needing loving reassurance that you trust them to manage without waking you, but that they can call if they get stuck.” – Rachel

A Supplement Can Support Neural Development

“Omega-3 fatty acids are key for development and are known to help with maturing the central nervous system, which in turn helps with the development of bladder control. Omega-3 is found in oily fish, organic whole milk, some eggs, flaxseeds, hulled hemp seeds, walnuts and chia seeds. If your child doesn’t eat these foods regularly, consider topping them up with a good-quality omega-3 supplement. Vitamin D also plays a role in central nervous system development and a study found children with very low vitamin D levels in their blood were more likely to continue to bed-wet for longer. Omega-3 and vitamin D appear to work in synergy, so are worth taking in tandem. One study found 45% of seven to 15-year-olds became dry through the night within eight weeks when taking a daily 1,000iu vitamin D supplement as well as 1,000mg of omega-3 daily.” – Lucinda

OMEGA-3 and VITAMIN D supplements work in tandem to help MATURE THE CENTRAL NERVOUS SYSTEM, which in turn helps with bladder control.

Forcing A Mid-Sleep Toilet Trip Won’t Help

“Despite what you might have been told, waking a child to wee in the middle of the night is not helpful. Firstly, the child might not need a wee at all, secondly, you will disturb their sleep, and thirdly, because children rarely wake properly when lifted, you are simply teaching your child to pee in their sleep. Remember you want your child to learn to spot the ‘need to wake and pee’ signals by themselves. You doing the thinking for them might guarantee dry beds in the short-term, but ultimately your child learns nothing.” – Rachel

Punishment Is Never Appropriate

“Children need understanding, compassion and respect in the face of challenges, along with support to gain good strategies and the skills and autonomy to take care of themselves as they grow up. Asking for a child’s help to change the bed should never be done with anger or in a way that embarrasses or shames them, but in a straightforward manner that reassures them that learning takes time. If you do ask for their help to change the sheets, say something like, ‘Oops, I see you didn’t make it to the loo last night and your sheet is wet. Wet sheets need changing. Give me a hand, you know where the dry sheets are.’ This can be a lovely way to guide an older child towards being able to deal with their own night-time accidents whilst they develop the ability to stay drier for longer.” – Rachel

Ultimately, Try To Be Patient

“Most bed-wetters get dry eventually, and the more parents relax, realise this is simply a developmental stage, with some children taking longer than others, and focus on independence rather than dryness, life can feel a whole lot easier. Remember it’s a journey, not a race, and your job is to simply, calmly and kindly support your child as they become independent.” – Rachel

For more information or to book a consultation with Lucinda, visit NatureDoc.co.uk. You can hear more from Rachel at TheBabyShow.co.uk and follow her on Instagram @RachelFitzD. For further support, visit ERIC.org.uk, the UK’s leading bladder and bowel charity which offers support and help for parents whose children wet the bed.

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