by The American Academy Of Child & Adolescent Psychiatry
Most children begin to stay dry
at night around three years of age. When a child has a problem
with bedwetting (enuresis) after that age, parents may become
Physicians stress that enuresis
is not a disease, but a symptom, and a fairly common one. Occasional
accidents may occur, particularly when the child is ill.
Here are some facts parents
should know about bedwetting:
- Approximately 15 percent of
children wet the bed after the age of three.
- Many more boys than girls wet
- Bedwetting runs in families.
- Usually bedwetting stops by
- Most bedwetters do not have
Persistent bedwetting beyond
the age of three or four rarely signals a kidney or bladder problem.
Bedwetting may sometimes be related
to a sleep disorder. In most cases, it is due to the development
of the child's bladder control being slower than normal. Bedwetting
may also be the result of the child's tensions and emotions that
There are a variety of emotional
reasons for bedwetting. For example, when a young child begins
bedwetting after several months or years of dryness during the
night, this may reflect new fears of insecurities. This may follow
changes or events which make the child feel insecure: moving
to a new environment, losing a family member or loved one, or
especially the arrival of a new baby or child in the home. Sometimes
bedwetting occurs after a period of dryness because the child's
original toilet training was too stressful.
Parents should remember that
children rarely wet on purpose, and usually feel ashamed about
the incident. Rather than make the child feel naughty or ashamed,
parents need to encourage the child and show faith that he or
she will soon be able to enjoy staying dry at night. A pediatrician's
advice is often very helpful.
Parents may help children
who wet the bed by:
- Limiting liquids before bedtime
- Encouraging the child to go
to the bathroom before bedtime
- Praising the child on dry mornings
- Avoiding punishments
- Waking the child during the
night to empty their bladder
In rare instances, the problem
of bedwetting cannot be resolved by the parents, the family physician
or the pediatrician. Sometimes the child may also show symptoms
of emotional problems--such as persistent sadness or irritability,
or a change in eating or sleeping habits. In these cases, parents
may want to talk with a child and adolescent psychiatrist, who
will evaluate physical and emotional problems that may be causing
the bedwetting, and will work with the child and parents to resolve
these problems. Treatment for bedwetting in children includes
behavioral conditioning devices (pad/buzzer) and/or medications.
Examples of medications used include anti-diuretic hormone nasal
spray and the anti-depressant medication imipramine.
Copyright © 1997 by the
American Academy of Child & Adolescent Psychiatry.