Bedwetting in Kids: Causes & What to Do

Bedwetting, or enuresis (as it's known in the science world) affects millions of children worldwide.

So if your child is wetting the bed, they're not alone.

And you're not alone in this, either, mama.

There are lots of types of enuresis, and even more potential causes.

So if accidents are more regular than you'd like, read on for some answers.

In this article: 📝

What are the four types of enuresis?

Enuresis is just a fancy word for not being able to control urination.

This can be broken down into four different types:

• Diurnal enuresis: Involuntary wetting during the day.
• Nocturnal enuresis: Involuntary wetting at night.
• Primary enuresis: Involuntary wetting before or during potty training, before the skill is fully mastered.
• Secondary enuresis: Involuntary wetting after a period of dryness post-potty training. This can also be known as a potty training regression.
  Bedwetting, or nocturnal enuresis, can happen at either the primary or secondary stage.

If your child has never stayed dry overnight consistently, this would be classed as primary nocturnal enuresis.

If your child was dry overnight for a few weeks or more, then starts wetting the bed again, that's considered secondary nocturnal enuresis.

Typically, it's considered bedwetting only after an age at which staying dry overnight is developmentally achievable.

Pinpointing which type of enuresis your child is experiencing can help you figure out the best ways to deal with it.

Why do kids wet the bed?

There are lots of reasons why kids wet the bed, with a range of factors from developmental and genetic influences to emotional and psychological aspects.

Emotional stressors, changes in routine, and traumatic experiences are also recognized as potential triggers.

Your child could be experiencing one or a combination of things that are contributing to their inability to stay dry through the night.

Let’s explore some possible causes for bedwetting:

Can childhood trauma cause bedwetting?

The emotional toll of trauma can impact the nervous system, which can lead to disturbances in the regulation of bodily functions, including those linked to bladder control during sleep.

Bedwetting can be interpreted as a potential manifestation of the psychological distress associated with trauma.

In other words, wetting the bed could be your child’s way of expressing their inner turmoil, non-verbally.

Things like the loss of a loved one, enduring abuse, or witnessing a distressing event can cause extreme emotional distress which can cause sleep disturbances like nightmares or bedwetting.

Can a vitamin deficiency cause bedwetting?

Yes, it’s possible.

There have been links between vitamin B12 and folate deficiency to nocturnal enuresis.

But more research is needed before we can say they're definitely linked.

Can emotional stress cause bedwetting?

Absolutely.

Any type of change or disruption to your child’s normal routine can cause a potty training regression for both daytime and nighttime.

Is bedwetting caused by hormones?

Yes, so hormones could be the cause of your child's bedwetting.

As we grow and mature, we all begin producing more of a hormone called ADH, or antidiuretic hormone, which manages nighttime urine production.

The older we get, the higher the level of the ADH hormone we produce, and therefore the less urine our body makes overnight.

If your child hasn’t yet developed enough ADH, then this could be the cause of their bedwetting.

Can dehydration cause bedwetting?

It seems counterintuitive, but yes, dehydration can actually cause more potty accidents.

When the body is dehydrated, our urine becomes more concentrated and acidic, which can irritate the bladder and lead to spasms and involuntary release.

Dehydration also leads to constipation, and when there is a build-up of stool in the bowel, it puts extra pressure on the bladder, especially in a lying down position.

Is bedwetting a ADHD thing?

Sometimes, yes, bedwetting can be a sign of ADHD in children.

ADHD is usually a result of delays of the central nervous system and therefore can directly impact nighttime bladder control.

Kids with ADHD often have a hard time focusing and connecting their body cues to their brain signals which can make it more challenging to stay dry while they’re asleep.

One study found that 40% of children with ADHD also suffered from enuresis.

With such a high rate of connection, it suggests that the assessment for ADHD should include evaluation for enuresis and vice versa.

At what age is bedwetting a problem?

From a medical perspective, bedwetting isn't considered abnormal until after age five.

But sometimes, bedwetting can start affecting a child’s sleep habits or self-esteem earlier, in which case, it’s a problem!

Even if your child has a specific reason for their inability to control their bladder overnight, you can help them learn how to listen to their body during sleep and wake up to make it to the bathroom in time.

Our children are capable of a lot more than we give them credit for.

Oftentimes, continuing to rely on diapers or pull-ups just prolongs the problem.

The absorbent technology in today’s diapers doesn’t allow your child to feel wetness from an accident overnight, and therefore very little learning can take place.

Removing sleep diapers may result in wet sheets initially, but your child will be able to recognize what’s happening with their body more easily.

Here are some things you can do to help set your child up for nighttime dryness:

• Limit fluid intake between dinner and bedtime
• Use the toilet two times during their bedtime routine
• Give easy access to the bathroom
• Prevent excessive deep sleep

Is bedwetting a developmental delay?

Sometimes, yes, bedwetting is considered a form of a minor developmental delay, particularly beyond age five.

Other developmental delays or disabilities don't, in themselves, cause bedwetting.

What's the best way to stop bedwetting?

Stopping bedwetting involves a combination of understanding its underlying causes and implementing effective strategies.

If your child is five years old or older, it might be helpful to first consult with their doctor or other healthcare professionals to rule out any medical conditions contributing to bedwetting such as constipation, UTI, or an overactive bladder.

Exploring potential treatment options like behavioral therapies, alarms, or medications may be necessary.

No matter what the cause of your child’s bedwetting, it's crucial to always encourage a supportive and non-judgmental environment, as stress and anxiety can further contribute to the problem.

Here are some tips to help improve bedwetting:

• Remove diapers and pull-ups. This will help your child to be more aware of their body’s urges and make it easier to feel when they’ve had an accident. It also sets clear expectations that your child should at least be trying to make it to the toilet to pee. Sometimes kids begin to rely on their diapers and pullups as a crutch and continue to use them even when they are capable of staying dry. Research also shows that the earlier you begin nighttime potty training, the earlier your child will attain nighttime dryness.
• Establish a consistent bedtime routine, including regular bathroom breaks before sleep. This ensures your child’s bladder is as empty as possible before climbing into bed.
• Limit fluid intake in the evening, especially caffeinated or sugary beverages, which will reduce the likelihood of nighttime accidents. Generally, sticking to four ounces or less between dinner and bedtime is recommended.
• Invest in moisture-wicking mattress covers and protective waterproof bedding to minimize the discomfort associated with wetting the bed while protecting the mattress, making the experience less distressing for your child and for you.
  If your child doesn’t see improvement with traditional mitigation techniques, consider trying a bedwetting alarm.

When used consistently, these devices are one of the most effective treatments for bedwetting.

Keep in mind that it can take several weeks to see results, so patience and commitment are key.

Positive reinforcement and patience are fundamental in supporting your child through the process of overcoming bedwetting, promoting confidence, and instilling a sense of accomplishment as progress is made.

Should you punish a child for wetting the bed?

No, punishing a child for bedwetting typically won't achieve anything.

Bedwetting is almost never intentional.

Remember the definition of enuresis: involuntary urination.

Bedwetting isn’t your child’s fault.

Punishment can’t help your child stay dry overnight.

In fact, it'll just add shame and embarrassment which can put additional pressure and stress on your child, making the problem even worse.

That being said, it's okay to track your child’s progress and offer praise for dry nights, or nights that they were able to wake up and make it to the bathroom in time.

This can give your child added motivation and empowerment.

When should I take my child to the doctor for bedwetting?

There are a few cases when you should take your child to the doctor for their bedwetting, to explore other treatment options or underlying causes:

• If your child isn’t seeing any progress with traditional nighttime toilet training techniques (like the ones above)
• If it's starting to affect your family dynamic
• If it's affecting your child’s sleep routine or their self-esteem
• If your child is over the age of seven

What foods help with bedwetting?

While specific foods aren't directly linked to bedwetting, maintaining a balanced and healthy diet can contribute to overall bladder health.

Opt for foods rich in vitamins and minerals, such as fruits, vegetables, and whole grains, to support your child's body to function healthily.

A diet with a decent amount of fiber can also promote regular bowel movements, reducing the likelihood of constipation, which can contribute to bedwetting.

Staying hydrated is crucial, but managing fluid intake, especially in the evening, minimizes the risk of nighttime accidents.

Foods with high water content, like watermelon and cucumber, can contribute to proper hydration without overloading the bladder before bedtime.

While diet alone might not be a "cure" for bedwetting, a holistic approach, including a nutritious diet, can complement other strategies, like behavior modification and medical interventions, to tackle bedwetting once and for all.

What foods should you avoid to stop bedwetting?

While there aren't any foods that can help prevent bedwetting, there are certain foods or drinks that may make bedwetting worse, like:

• Caffeinated drinks, like coffee, tea, and sodas. These can act as diuretics, increasing urine production and potentially triggering nighttime accidents.
• High-sugar foods. Too much sugar in a child’s diet can cause fluctuations in blood sugar levels and potentially impact bladder control.
• Spicy or acidic foods, like citrus fruits and tomatoes. If urine becomes too acidic, it can irritate the bladder and make the urge to urinate more intense and harder to control.
• Salty and processed foods. These foods can lead to dehydration, concentrating urine, and putting additional strain on the bladder.
  While every child’s responses to specific foods vary, paying attention to dietary triggers and making adjustments as needed can be a valuable component of your strategy to manage bedwetting.

Can you control bedwetting?

Yes, it is possible to control bedwetting with a combination of strategies and interventions.

But it's important to remember that the definition of bedwetting (or enuresis) is involuntary incontinence.

Behavioral approaches, like establishing a consistent bedtime routine, encouraging regular bathroom breaks before sleep, and limiting fluid intake in the evening, can help improve bladder control.

And bedwetting alarms, which alert your child at the first signs of moisture, have proven effective in helping people wake up when their bladder is full.

In more long-term or challenging cases, medical interventions, like medications or therapies addressing underlying causes, can help.

Above all, maintaining open communication, providing emotional support, and fostering a non-judgmental environment are essential to managing and ultimately controlling bedwetting.

It's super important to recognize that every child may respond differently to various strategies, and consulting with doctors or the professionals at Potty Training Consultant can help tailor an effective plan based on specific needs and circumstances.

Bedwetting is a very common condition, so if your child is struggling with what seems to be a never-ending cycle of wet sheets or diapers, you’re certainly not alone.

Understanding the potential causes, adopting an approach that is right for your child, and offering them ongoing emotional support can make navigating this tricky part of childhood more manageable.

You've got this.