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Why Kids Wet the Bed & How to Help Them Through It

Bed wetting, or enuresis, is fairly common. According to the American Family Physician about five to seven million wet the bed (with boys tending to do it more) —  but that doesn’t make it less stressful for the parent or embarrassing for the child. So to better understand why kids wet the bed and how to help them, SheKnows spoke with some family doctors and experts for the best advice for handling it.

Why does bedwetting occur?

According to  Dr. Matthew Ruderman, Ph.D., a licensed clinical psychologist at Providence Saint John’s Child and Family Development Center, there are two types of enuresis.

“Primary enuresis is when the child has never been persistently dry at night (since a young age),” he tells SheKnows. “This is often associated with a family history of the problem, a developmental delay, or physiological issues, although psychological factors may play a role.”

For example, a child’s bladder may be too small to hold the amount of urine they are producing, the muscles that contract the bladder may be stronger than the muscles that hold urine in, a hormonal imbalance may exist, or there might be a bladder and/or urinary tract infection.

Secondary enuresis is a recurrence of bedwetting after a year or more of bladder control and no previous nighttime accidents.

“This is more likely to be associated with emotional distress, such as depression, anxiety, attention-deficit hyperactivity disorder, trauma, and/or abuse,” says Dr. Ruderman.

In the case of the latter, Dr. Fran Walfish, family and relationship psychotherapist, and author, The Self-Aware Parent, tells SheKnows she has often treated kids who are dealing with anxiety.

“Many children who hold high levels of anxiety during the daytime often ‘let go’ and relax during sleep and [wet the bed],” she says. “In some instances, I have treated a number of young boys up to even age 8 years-old who still have urinary accidents.  There is belief among some professionals that this may go along with certain children who have ADHD –  These kids do not want to stop and interrupt the activity they are involved in so they hold their urine too long.”

If your child is wetting the bed, both Drs. Ruderman and Walfish suggest families should consult with their pediatrician. In addition, they recommend some strategies that parents can do to help manage their kid’s bedwetting.

Never shame

Whatever the cause might be of your child’s bed wetting, Dr. Walfish says it’s imperative that “parents do not make a big fuss, criticize or punish your child over bedwetting.”

Instead, Dr. Ruderman says to “stay supportive, make sure the child knows that bedwetting is not their fault and avoid blame and punishment.”

Ensure your child have adequate fluid intake throughout the day

“This helps increase bladder capacity and allows children to recognize the feeling of a full bladder and needing to use the restroom,” says Ruderman. “Children who do not drink throughout the day may overload on liquids after school and in the evening, increasing the risk of bedwetting at night.” Additionally, caffeine should be avoided before bed because it is a diuretic.

Have them wear an alarm

“I have recommended a pulsating buzzer that the child wears on his pajama bottoms,” says Dr. Walfish, noting the device has been successful with many of her patients. “It acts like the old-fashioned pagers. It buzzes at the first drop of moisture teaching the child to wake up and pee in the toilet versus in his pajamas.”

Use a reward system

Children receive stickers and later reinforcement for completing behaviors, such as emptying their bladder before bedtime and drinking fluids throughout the day, suggests Dr. Ruderman, adding that “reinforcement should be used for sticking to routine, not necessarily for having a dry night.”

Let your kid help out with the clean-up

“Have your child participate in self-cleaning so that you are not doing all the hard work,” suggests Dr. Walfish. “Make him self-reliant.  He can strip the bed of wet linens and help put clean fresh sheets on the bed.  He can also use wipes to clean himself and put new pajamas on. This will motivate him to use the toilet because it’s less work.”

Use medication only as a last resort

“Sometimes doctors treat enuresis with medication, although this is not usually the first course of action because no medicine has been proved to cure bedwetting permanently,” says Dr. Ruderman. “Furthermore, bedwetting often continues when the medication is stopped.” He suggests psychotherapy, specifically if the bed wetting is linked to psychological factors such as anxiety, trauma, abuse, and attention-deficit/hyperactivity disorder.

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