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Bedwetting
It is often extremely upsetting for children who wet the bed, and many people,
both professionals and family members do not always appreciate the impact it
can have on children’s lives, on their confidence, and ability to take part in
sleepovers and school trips like their friends. It can also be very stressful for
their parents, both to cope with the extra washing and also to support their
child.


Bedwetting is more common than most people realise. It affects up to half a
million children and teenagers in the UK every night but, because no one talks
about it, most people think they’re alone.


Studies have shown that 1 in 6 five year olds, 1 in 7 seven year olds, 1 in 11
nine year olds and 1 in 50 teenagers are affected by bedwetting and the
problem is more common in boys than girls, especially in the younger age
groups.




Why do children wet the bed?

It is not unusual for children under the age of five to still be wet at night, or to
have occasional wetting accidents in the day. We don’t fully understand why
some children take longer than others to master the art of staying dry, but we
know it is not linked to poor toilet training or laziness on the child’s part. It does
tend to go in families, and there is a hereditary factor.


There are three other main reasons why bedwetting occurs. None of these are
within the child’s conscious control, and bedwetting occurs during sleep so
they are not aware it is happening and they do not wet on purpose.

A lack of the right levels of the natural hormone vasopressin which causes the
kidneys to concentrate urine production at night has been shown to cause
bedwetting. This means that rather than a reduced amount of urine being
produced overnight, the kidneys produce daytime amounts of urine and the
bladder cannot hold it.

Indications that night time vasopressin is lacking include large, wet patches of
urine in the night and wetting soon after sleep, in the early part of the night.
Medication to replace the inadequate hormone can be prescribed, and this is
usually very helpful and has few complications. It can enable children to take
part in sleepovers and other activities.

Another reason is an overactive bladder. The muscles of an overactive
bladder contract before the bladder is full and this signals that it needs to
empty urgently. Signs of an overactive bladder will sometimes be apparent
during the day with the child needing to go to the toilet often and very urgently
and they may have damp pants during the day. At night the child will often
have small wet patches in the bed and wake up after wetting. Medication can
be prescribed to relax the strong signals from the bladder.

And the third and final reason why bedwetting occurs is that the child doesn’t
receive the signal sent from the bladder to the brain which tells them to wake
up to empty the bladder. Bedwetting alarms can be useful for this and they
have a good success rate but need the child to be motivated and want to use
one, and have good support from their carers. Alarms help a child to learn to
hold their wee at night, and so can help with a permanent cure as the child
learns the skill.


Other factors, such as constipation and urinary tract infections are known to
affect the bladder and should always be checked by your GP or health
professional;, especially if the child wets during the day beyond the age of five,
or has discomfort when they wee.


For the one in seven children who wet the bed beyond the age of seven, a full
assessment of the problem will help identify any possible physical factors and
the school nurse or GP should be able to direct you to a specialist continence
clinic or service.


How to manage bedwetting

The best time to consider interventions for bedwetting is when the child is
ready and expressing a desire to become dry. A full assessment at a
bedwetting clinic will determine which intervention is best for each child and
their family; not all areas have easily accessible clinics and there may be a
waiting list. It is important to be able to offer regular support and
encouragement for most children, and if possible a choice of type of alarm or
medication to try. With treatment, most children can become dry at night. If
there is no bedwetting service in your local area you may wish to contact your
GP to discuss medication or purchase a bedwetting alarm (a good range of
alarms are available to purchase from ERIC www.ericshop.org.uk).
It’s important to ensure a child drinks regularly through the day (6-8 glasses of
water based fluid); this helps ensure the bladder fills to its full capacity and
over time can help the bladder hold more urine before it needs emptying at
night.




ERIC’s top tips

There are many things parents can do to help children manage or overcome
bedwetting.


    Try to stay patient and calm so your child does not become anxious. A
     positive approach will help to reassure your child that they will succeed.

    Make sure that your child drinks 6-8 water-based drinks throughout the
     whole day. Cutting back on drinks does not help.

    Experiment to see if any drinks, such as fizzy or flavoured drinks, tea,
     coffee and chocolate drinks increase the problem and avoid these
     accordingly.

    Ensure your child does not put off going to the toilet in the day and
     encourage a visit to the toilet last thing before settling down to sleep.

    Leave a soft light on to guide the way to the toilet at night and clear any
     obstacles from the route.

    Use bedding protection such as bed mats and duvet protectors (available
     from ERIC). Absorbent pants are also useful for under-fives and for
     holidays, but these are best dispensed with once your child is ready to
     tackle the bedwetting.

Plan ahead if you will be staying away from home. ERIC’s ‘Nights Away – No
Worries’ leaflet contains information to help manage bedwetting when staying
away from home and is available online. There are also products that can help
such as sleeping bag liners available from ERIC.


Resources
ERIC is the only national children’s charity dedicated to supporting children,
young people and their families. ERIC offers practical ideas, information and
resources to help manage or overcome the difficulties associated with
bedwetting. For more information visit www.eric.org.uk

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Bedwetting

  • 1. Bedwetting It is often extremely upsetting for children who wet the bed, and many people, both professionals and family members do not always appreciate the impact it can have on children’s lives, on their confidence, and ability to take part in sleepovers and school trips like their friends. It can also be very stressful for their parents, both to cope with the extra washing and also to support their child. Bedwetting is more common than most people realise. It affects up to half a million children and teenagers in the UK every night but, because no one talks about it, most people think they’re alone. Studies have shown that 1 in 6 five year olds, 1 in 7 seven year olds, 1 in 11 nine year olds and 1 in 50 teenagers are affected by bedwetting and the problem is more common in boys than girls, especially in the younger age groups. Why do children wet the bed? It is not unusual for children under the age of five to still be wet at night, or to have occasional wetting accidents in the day. We don’t fully understand why
  • 2. some children take longer than others to master the art of staying dry, but we know it is not linked to poor toilet training or laziness on the child’s part. It does tend to go in families, and there is a hereditary factor. There are three other main reasons why bedwetting occurs. None of these are within the child’s conscious control, and bedwetting occurs during sleep so they are not aware it is happening and they do not wet on purpose. A lack of the right levels of the natural hormone vasopressin which causes the kidneys to concentrate urine production at night has been shown to cause bedwetting. This means that rather than a reduced amount of urine being produced overnight, the kidneys produce daytime amounts of urine and the bladder cannot hold it. Indications that night time vasopressin is lacking include large, wet patches of urine in the night and wetting soon after sleep, in the early part of the night. Medication to replace the inadequate hormone can be prescribed, and this is usually very helpful and has few complications. It can enable children to take part in sleepovers and other activities. Another reason is an overactive bladder. The muscles of an overactive bladder contract before the bladder is full and this signals that it needs to empty urgently. Signs of an overactive bladder will sometimes be apparent during the day with the child needing to go to the toilet often and very urgently and they may have damp pants during the day. At night the child will often have small wet patches in the bed and wake up after wetting. Medication can be prescribed to relax the strong signals from the bladder. And the third and final reason why bedwetting occurs is that the child doesn’t receive the signal sent from the bladder to the brain which tells them to wake
  • 3. up to empty the bladder. Bedwetting alarms can be useful for this and they have a good success rate but need the child to be motivated and want to use one, and have good support from their carers. Alarms help a child to learn to hold their wee at night, and so can help with a permanent cure as the child learns the skill. Other factors, such as constipation and urinary tract infections are known to affect the bladder and should always be checked by your GP or health professional;, especially if the child wets during the day beyond the age of five, or has discomfort when they wee. For the one in seven children who wet the bed beyond the age of seven, a full assessment of the problem will help identify any possible physical factors and the school nurse or GP should be able to direct you to a specialist continence clinic or service. How to manage bedwetting The best time to consider interventions for bedwetting is when the child is ready and expressing a desire to become dry. A full assessment at a bedwetting clinic will determine which intervention is best for each child and their family; not all areas have easily accessible clinics and there may be a waiting list. It is important to be able to offer regular support and encouragement for most children, and if possible a choice of type of alarm or medication to try. With treatment, most children can become dry at night. If there is no bedwetting service in your local area you may wish to contact your GP to discuss medication or purchase a bedwetting alarm (a good range of alarms are available to purchase from ERIC www.ericshop.org.uk).
  • 4. It’s important to ensure a child drinks regularly through the day (6-8 glasses of water based fluid); this helps ensure the bladder fills to its full capacity and over time can help the bladder hold more urine before it needs emptying at night. ERIC’s top tips There are many things parents can do to help children manage or overcome bedwetting.  Try to stay patient and calm so your child does not become anxious. A positive approach will help to reassure your child that they will succeed.  Make sure that your child drinks 6-8 water-based drinks throughout the whole day. Cutting back on drinks does not help.  Experiment to see if any drinks, such as fizzy or flavoured drinks, tea, coffee and chocolate drinks increase the problem and avoid these accordingly.  Ensure your child does not put off going to the toilet in the day and encourage a visit to the toilet last thing before settling down to sleep.  Leave a soft light on to guide the way to the toilet at night and clear any obstacles from the route.  Use bedding protection such as bed mats and duvet protectors (available from ERIC). Absorbent pants are also useful for under-fives and for holidays, but these are best dispensed with once your child is ready to tackle the bedwetting. Plan ahead if you will be staying away from home. ERIC’s ‘Nights Away – No Worries’ leaflet contains information to help manage bedwetting when staying
  • 5. away from home and is available online. There are also products that can help such as sleeping bag liners available from ERIC. Resources ERIC is the only national children’s charity dedicated to supporting children, young people and their families. ERIC offers practical ideas, information and resources to help manage or overcome the difficulties associated with bedwetting. For more information visit www.eric.org.uk