If your family is losing sleep over wet sheets, and you are exhausted by it all, you’re not alone. And you don’t need to figure it all out by yourself! Millions of children wet the bed, and the reason why isn’t always a simple answer because it could be happening for more than one reason. The most important thing to remember is that it’s not your child’s fault. Any type of wetting disorder can be the source of a lot of distress for families. The key to figuring out when to be concerned is to pay attention to when it is happening and communicate with your child’s pediatrician. They can help you understand what’s normal versus a cause for concern.

Wetting disorders can run in the family so if a parent had trouble with urinary incontinence after age 5, it is more likely that their children will as well.

Wetting accidents for children age 5 or younger are fairly common, but it is important to pay attention to make sure it is not more than a passing phase. If a child is having daily struggles or continues to have accidents after age 5, especially with UTIs, don’t delay in seeking medical advice.

“Children with daytime and nighttime wetting accidents along with constipation should get checked as soon as possible,” said Timothy Bukowski, MD, pediatric urologist, WakeMed Physician Practices. “Wetting can definitely be the symptom of seemingly unrelated health issues and left unaddressed for too long can develop into serious illness. Approximately 10 percent of kids have some type of wetting issue, and 15 percent of 7-year-olds have nighttime wetting issues,” said Dr. Bukowski. “That number decreases by about 15 percent a year until age 15, so it is not believed to have anything to do with puberty.”

Bedwetting is not typically treated until age 7, but that doesn’t mean it shouldn’t be looked into to rule out related health conditions. Many times young children aren’t concerned with their wetting issues, but it tends to become much more of a concern when older kids start to stay overnight at camps or the homes of friends and family.

Children vary so much in how they grow and develop, and some simply don’t mature as fast as others when it comes to bladder control. Parents should never make their child feel bad about wetting accidents, and it is important not to compare one child to another when it comes to daytime or nighttime accidents.

Oops Moments!

Daytime wetting issues are less concerning and more likely to go away on their own. Most of the time, a little patience, guidance and reassurance from parents will go a long way in a child’s developmental years. However, an overactive bladder or other health concerns could be contributing to daytime wetting issues so it’s good to keep an eye on things and talk to your family’s pediatrician.

“During the day, a child feels a pressure when they need to urinate, and over time the brain is trained to turn off the bladder until they have a place to go,” said Dr. Bukowski. “However, the brain isn’t necessarily going to do that when a child is sleeping.”

Deep Sleepers

Many bedwetting issues are considered to be associated with a sleep issue. A child might have a bladder capacity issue or wet the bed due to stress or a traumatic event, but Dr. Bukowski said those cases are not as common.

“More than likely children with nighttime wetting issues are also sound sleepers,” said Dr. Bukowski. “Until they start waking up when their body signals it’s time to go, the accidents continue.”

In addition to the confusion and frustration many families experience with bedwetting, the ongoing cost of pull-ups and even new mattresses can really start to add up. Most families try a number of things with sleep routines to troubleshoot, but many times they aren’t able to find a rhyme or reason.

Seeking Solutions

A referral to a urologist can be helpful in ruling out causes, alleviating concerns and navigating next steps for possible bedwetting solutions.

“The first thing we do is make sure the child doesn’t have a physical problem that would lead to bedwetting,” said Dr. Bukowski. “Concerns would include anything anatomical or spinal that could require surgery.”

Urinary tract infections (UTIs) are also a concern that parents should be aware of and watch for any signs or symptoms. If a child’s bedwetting is due to an overactive bladder, they might respond well to medication. A pediatric urologist will likely prescribe something to try for a short period of time and assess if it is helping reduce or stop the nighttime accidents.

Bedwetting alarms are another option that helps some kids wake up when they start to go so their brain begins to recognize the sensation, but Dr. Bukowski explained they won’t do much good if the child sleeps through the alarm sound. Instead, many times the rest of the family is awakened and annoyed.

“In the future, it is possible there will be wearable devices that help track and predict nighttime bedwetting,” said Dr. Bukowski.

Foods to Watch

The following foods can irritate the bladder and might contributed to nighttime wetting at any age. Talk to your pediatrician and check with a dietitian before
starting any type of elimination diet for your child or yourself.

• Sugary foods
• Acidic foods (citrus fruits)
• Carbonated beverages (even diet or caffeine-free)
• Tomato-based foods
• Dairy products
• Tea and coffee (including decaffeinated and some herbal)

Troubleshooting Tips

• Adjustments to a child’s diet to avoid foods that can irritate the bladder
• Decreasing the amount of fluid after dinner. Make sure they drink a liter of water (approximately 4 cups) throughout the day.
• Try to get kids to bed at same time every day.

Waking Kids Up to Go?

Some parents try waking their child up late at night when they go to bed, but Dr. Bukowski warns this has varying success and doesn’t necessarily train them to wake up more easily when their body needs to urinate. Regardless, some families find this at least helps prevent some accidents and gives the rest of the family a better night of sleep.

How Often Should Children Go?

Parents often wonder what’s a normal frequency of urination for kids. Dr. Bukowski provided these basic guidelines to help families notice when something might be wrong.

• Newborns – Every Hour
• At 6 months – Every Three Hours
• Potty Trained – Five Times a Day

To help keep young children on track, Dr. Bukowski recommends parents encourage the following schedule for going to the bathroom.

• When They Wake Up
• Mid-Morning
• Lunchtime
• Afternoon/Afterschool
• Before Bed

Pediatric Therapy for Bladder & Bowel Issues

Pelvic floor dysfunction is very common among children. It’s also very treatable. WakeMed Outpatient Rehabilitation physical therapists offer services for:

• Urinary incontinence
• Urinary frequency/urgency
• Urinary retention
• Painful urination or with bowel movements
• Fecal frequency/urgency
• Encopresis (bowel incontinence)
• Constipation

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WakeMed Physician Referral Services Available

Services are available by physician referral at WakeMed’s new practice at 505 Oberlin Road as well as locations in North Raleigh and Cary. Please call 919-350-7000 for information or to schedule an appointment for your child (or you)! Pelvic health therapies are available for adults at these locations, too.