Bed-Wetting (Nocturnal Enuresis)

  • Enuresis (nocturnal): Nighttime bed-wetting 
  • Enuresis (diurnal): Daytime urine accidents

Twenty percent of 5-year-old children and 3 percent of 10-year-olds wet the bed. As many as 1 percent of 18-year-olds wet the bed. It tends to be more common in boys. It is normal for children under the age of 7 or 8 to wet the bed.

Accidents are probably caused by many factors, not just one. Many children with nighttime urine accidents have an overactive bladder and a small functional bladder capacity. This means that a bladder may have many muscle spasms that cause an urge to empty the bladder often. The bladder is made of muscle and can grow and shrink as urine enters or leaves. The bladder in most cases is a normal size physically. However, it is not able to hold a normal amount of urine because of muscle spasms.

Other possible causes of nighttime urine accidents include hormonal factors, dietary factors, the effects of certain medications, timing of daytime fluid intake and emotional factors. Often, nighttime accidents are found to run in families.

Some children who have nighttime accidents will also have daytime urine accidents. Causes for this may include urinary tract infections, abnormalities of the urinary tract, problems with bathroom habits, or problems with the nerve control of the bladder.

Many children with bed-wetting will improve in time and for reasons that are not understood. It is important to tell your child that it is a temporary condition. Many children who wet the bed do not feel very good about themselves.

Sometimes parents place blame on their children who bed-wet, either knowingly or unknowingly. It is important to be patient with a child who bed-wets. A child does not wet the bed on purpose.

Several simple measures exist to help a child overcome bed-wetting. These include:

  • Encouraging intake of the majority of liquids during the early part of the day
  • Avoiding dietary bladder irritants such as citrus products (oranges, lemons, pineapples, grapefruits, limes, tomatoes), carbonation, caffeine and chocolate
  • Complete, unhurried bladder emptying at bedtime
  • Awakening and taking the child to the bathroom when the parents go to bed (about two to three hours after the child's bedtime)
  • Making sure the child is not overtired. If a child is overtired, bed-wetting is more likely to occur. If a child is not well rested in the morning, an earlier bedtime may be worth a try.
  • For children in whom these steps have not worked, other treatments may be useful. These include bladder exercises, alarm devices and medications.

When a child reaches the age of 7-8 years, still bed-wets and wants to do something about it, it is time to seek help. Children younger than this generally have neither the desire nor the maturity to work consistently at a bedwetting program. Either a pediatrician or a family doctor can evaluate the child.

Cincinnati Children’s has a specialty clinic to manage enuresis (wetting) issues. Your child may be referred directly to this clinic by calling 513-636-4975. If your area does not have such a specialty clinic, an appointment with a pediatric urologist or nephrologist may be helpful. A complete medical history, a physical exam and urine culture should be done. Further testing may be necessary if the child is also experiencing daytime accidents or urinary tract infections.

If your child is bothered by a wetting problem, professional help should be sought. A child's self-esteem can be severely affected by such a seemingly minor problem. Children who are helped to overcome their wetting often have a much brighter outlook on life. They develop a greater sense of self-confidence and flourish in other aspects of their lives. Seeking treatment for bed-wetting should not be avoided because of shame or embarrassment.

Last Updated 05/2015