Q. My 8-year-old daughter still wets the bed at night. She has started to become self-conscious of this. What can I do to help her?
A. Bed-wetting, or nocturnal enuresis, is common. Although most children develop daytime bladder control between ages 2 and 4, staying dry at night often occurs much later. In fact, 15-30 percent of 6-year-olds and 4 percent of 12-year-olds still wet the bed some of the time, according to the American Academy of Pediatrics.
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Common reasons for wetting the bed at night include:
• Sleeping too soundly to recognize the sensation of a full bladder.
• Small bladder capacity.
• Increased urine production.
• Family history of bed-wetting.
A child who has never fully developed nighttime bladder control has primary nocturnal enuresis. Secondary nocturnal enuresis occurs when a child who’s been dry at night for at least six months starts wetting the bed again. It’s more likely to have an underlying medical reason and should be evaluated.
Treatment for primary nocturnal enuresis includes decreasing a child’s overnight urine production and training a child to rouse in response to the sensation of a full bladder. Initial measures include limiting fluid intake before bed, avoiding caffeinated and carbonated beverages and waking her to urinate about 1-2 hours after she falls asleep.
If a child continues to wet the bed, a bed-wetting alarm is the next step. A bed-wetting alarm signals in response to urine, thereby prompting the child to wake and to go the bathroom. Bed-wetting alarms have a relatively high success rate when used for children who are at least 7 years old and have begun having occasional dry nights.
A medication called DDAVP is used in some cases. DDAVP works by decreasing urine production overnight. It does not cure bed-wetting. Because of potential side effects, its use is typically reserved for specific social situations, such as summer camp or sleepovers.
Nocturnal enuresis can sometimes be a sign of an underlying medical problem. If your child is experiencing any pain with urination, lower extremity weakness, blood in her urine, daytime accidents, increased thirst or fever, she should be seen by her physician. More information is available at aap.org.