Bedwetting problem in children

It is the involuntary leakage of urine day or night in a toilet trained child who has reached the age of 2-4. It is a common problem in childhood. It is generally not cause for concern until 7 years of age. There may be underlying physiological or psychological problems. These need to be well identified and treated. Lifestyle changes, humidity alarms, bladder training, sometimes medication can be tried. Professional support may be required.

When should I take a child who wets the bed to the doctor?

Bedwetting problem in children can improve with some precautions you can take at home and lifestyle changes. In some cases, it may be necessary to investigate the presence of an underlying disease.

• If the child over the age of 7 continues to wet the bed,
• If the child, who did not have a problem for a period, later developed a problem of bedwetting,
• If it is accompanied by painful urination, excessive thirst, pink urine, hard stools, it may be useful to consult a pediatrician or pediatric urologist.

Why do children wet the bed?

Bedwetting in children is mostly a result of the bladder development process and decreases with age.



It is more common in boys.

Some diseases that can cause urinary incontinence in children include:

• Small bladder: The development of the bladder has not been completed, it may have remained small, and it may not have grown enough to hold the child’s urine.
• Nerves are underdeveloped: Bladder movements, whether it is full or empty, are perceived by the nerves. If the nerves are not mature enough, they cannot perceive the full bladder or perceive it late. The child does not wake up from sleep and slips under it. Rarely, urinary incontinence may occur due to structural disorders of the nervous system in the urinary tract.
• Hormonal Disorders: In case of insufficient production of anti-diuretic hormone, nocturnal urine production cannot be slowed down and the full bladder causes urinary leakage.
• Urinary tract infection: It is accompanied by symptoms such as fever, painful urination, and pink colored urine. Urine cannot be controlled and urine leaks occur.
• Diabetes Mellitus: There may be symptoms such as drinking a lot of water, thirsty quickly, incontinence at night, urinating profusely, fatigue, and weight loss.
• Sleep problems and sleep apnea: Snoring can manifest itself as daytime sleepiness, tonsil enlargement. Breathing is interrupted during sleep.
• Chronic constipation: In case of prolonged constipation, the muscles lose their function and urine cannot be retained.
• Stressand anxiety problems : Desire for attention due to family problems, changing home or school, new sibling joining the family or sibling jealousy, pressure during toilet training,
• Having a family history of urinary incontinence
• Extreme fatigue and eating habits: Drinking plenty of fluids before going to bed, caffeinated drinks such as cola,
• Structural problems in kidney and urinary tract,
• Emotional problems: Parents’ indifference or excessive attention, accidents or shocks,
• attention deficit and hyperactivity disorder

Which children are at risk for bedwetting?

Some situations may pose a risk for children to wet the bed. These:

• Gender: Boys are more at risk than girls.
• Stress and anxiety: Desire for attention due to family problems, changing home or school, new sibling joining the family or sibling jealousy, sleeping away from home, pressure during toilet training
• Family history: Bedwetting in parents or other siblings is a risk factor.
• Diseases: Diseases such as diabetes mellitus, attention deficit/hyperactivity disorder, developmental disorders pose a risk.

How do physicians diagnose children who wet the bed?

When a physician is consulted with the complaint of bedwetting, the physician diagnoses with anamnesis, examination and some laboratory findings.



Before the examination, the child’s urination, defecation, sleep, fluid intake habits, presence of a situation that may cause stress or anxiety, family history, other findings accompanying incontinence are questioned.

In the examination, findings are investigated in terms of infection or other diseases.

In terms of urinary tract infection, developmental disorders, and other systemic diseases, blood and urine tests and radiological analyzes are performed. For children who wet the bed during the day, uroflowmetry, cysteretrogram, ultrasonography, measurement of bladder wall thickness and measurement of residual urine after voiding may be required. If a neurological cause is suspected, X-ray and MRI can be done.

What can be done at home for children who wet their bed?

Calm down, this is common in children. Avoid putting pressure on the child, do not punish, do not scold, be supportive.

• Reduce the amount of fluid taken at certain times of the day and at night,
• Do not give water, especially 2 hours before bedtime,
• Keep away from caffeinated foods and drinks,
• Send it to the toilet before going to bed,
• Make it easier to access the toilet,
• Wake your child to urinate at night on a certain schedule,
• Keep away from fried foods, carbonated drinks, dyed candies,
• Urinate every two hours on average.
• Advise school-going children to pee every two breaks,
• Get into the habit of defecating regularly every day,
• Encourage the child to take responsibility for staying dry.

How to treat children who wet their bed?

Families of children who wet the bed are told by the physicians what they can do at home. For cases that do not improve despite these, humidity alarms can be used or drug therapy is given.

If there is constipation, urinary tract infection, or other underlying disease, treatment is applied for it. If necessary, counseling to cope with stress is provided with the support of a psychiatrist.

In children over the age of 8, devices that ring when the child wets the bed are used in alarm treatment. Treatment takes 2-3 months on average. A great deal of improvement is achieved.

The aim of drug therapy is to prevent involuntary bladder contraction and to enlarge the bladder. It takes an average of 1 year. Side effects of drugs such as dry mouth, blurred vision, facial flushing, body temperature shooting, irritability and decreased school performance are seen. Therefore, it is used as a last choice.