Ask Dr. Peltier
My 6-year-old is still wetting the bed and it’s getting to be very upsetting for all of us. What can we do?
Bedwetting is one of the most common and aggravating childhood problems parents and children face. Fortunately, most children outgrow it without medical intervention. For others, fairly inexpensive, simple measures can help.
Bedwetting is common after potty training through age 4, diminishing over time. By age 7, however, it’s a bigger concern – largely due to the embarrassment factor. That’s when I begin to discuss interventions with the families.
Until then, I recommend waterproof bedcovers, nighttime training pants and waiting until your child outgrows it. About 15 percent of these children do each year. Also:
Avoid caffeinated drinks, particularly at night.
Limit other fluids before bedtime (especially irritants such as citrus and carbonated drinks).
Try bladder training. When your child feels the urge to go during the day, have him or her hold off for a short time. Gradually lengthen that holding time.
Remember your child is not doing this on purpose. Punishment won’t help, but rewards might. I recommend praise for staying dry at night. Try sticker charts and rewards for milestones such as a week without accidents.
Bedwetting before age 7 can be more serious if it coincides with daytime accidents. I’m also concerned if a child has had dry nights for at least six months and redevelops bedwetting. Urinalysis can rule out a more serious unlikely cause such as diabetes or urinary tract infection.
One theory is that children are prone to bedwetting because they sleep too deeply. Heredity certainly is a factor. Among children with one parent who wet the bed as a child, 50 percent have the problem. If both parents did, 75 percent of their children do, too. When neither parent wet the bed, 15 percent of children still do.
Regardless of the cause, once children are old enough to change their own clothes and bedding, I recommend an alarm system to help them overcome bedwetting. These systems wake the child with vibrations or sounds at the first sign of moisture. The child then can finish in the bathroom and do the cleanup. Eventually, most will wake when they feel a full bladder, even without the alarm. Studies show these systems, usually costing under $100, can reduce bedwetting by 80 percent for six out of 10 children.
While drugs can combat bedwetting, I don’t routinely recommend them because the problem usually recurs when you stop the drug. I will consider using medication for special occasions like sleepovers or camping trips.
Patience is your best ally. In almost all cases, children do outgrow it.
Christopher Peltier, MD, is a pediatrician with Pediatric Associates of Mount Carmel serving as editorial consultant for Young and Healthy. He also is assistant director of Community Pediatrics at Cincinnati Children’s.
