Health Topics for Child Health and Development

UI Children's Hospital

UI Family Care Centers

Divisions Within the Department of Pediatrics

Iowa Registry for Congenital and Inherited Disorders

Bedwetting (Enuresis)

Bedwetting is an involuntary discharge of urine during the night. It is not deliberate or controllable. Developing bladder control is a process that normally takes several years. It varies in individual children. Bedwetting ranges from one wet episode a month to 7 or more times a week. More boys experience bedwetting than girls. Occasional or infrequent bedwetting is considered normal until about age 5 in girls and age 6 in boys.

Factors that contribute to bedwetting include:

• heredity
• delayed maturation of bladder function
• small bladder capacity
• stress, or rarely, more serious emotional problems
• constipation
• diabetes
• seizures and
• urinary tract infection

Bedwetting is usually due to normal immaturity of the nervous and urinary systems. Only 1 percent of bedwetting is caused by a serious underlying problem. Most children do not become fully toilet trained before 2 to 4 years of age. Up to age 6 bedwetting is usually due to nothing more than a small bladder. Generally the condition stops before the teenage years.

Bedwetting can place enormous emotional burdens on a child. A child's self-esteem can be devastated by parents who punish or embarrass the bedwetter, or when playmates make fun of them. Getting angry does not help and may worsen the situation. Restricting fluids, shaming, and rejections do not help the child gain bladder control. These techniques only serve to raise the child's anxiety level.

Bedwetting may be stopped without embarrassing the child or hurting the child's feelings. Avoid certain foods and beverages that may increase urine production, like chocolate, cocoa, tea, coffee, or sodas that contain caffeine. Limit the amount of any beverage consumed within 2 to 3 hours before bedtime.

Try these techniques:

• give regular reminders to urinate before going to bed
• encourage the child to get up to urinate during the night
• leave the bathroom light on
• teach the child to use an alarm that awakens him at the first sign of moisture in the bed
• praise the child for dry nights and respond gently with sympathy to wet nights
• establish a morning routine for wet pajamas and wet bedding and
• provide special nighttime underwear so the child can sleep away from home without fear of embarrassment

Medication is another treatment option, though bedwetting often returns when the drug is stopped. It is not advisable to give bedwetting drugs to preschoolers.

Contact your healthcare provider for more information if any of these symptoms occur with or without bedwetting:

• straining during urination
• feeling of burning on urination
• recurrent dribbling
• cloudy or pink urine
• blood stains or discharge on underpants
• unpleasant odor
• constant thirst
• abdominal pain, fever or
• sudden loss of bladder control after mastering toilet training

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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