Bedwetting and Age

When Parents Should Seek Help

By C.J. Johnson

Up to seven million children in the United States wet the bed, according to the Children's Center for Bladder Control. Bedwetting is not considered abnormal, however, until a child reaches the age of 5. If the child is still wetting the bed at age 6, parents may then want to seek help.

"Children over the age of 6 who are engaged in sleepovers often want to be treated for social reasons, and I believe that is a good reason to start treatment," says Dr. James M. Cummings, a urologist practicing in St. Louis, Mo.

It may not be medically necessary to treat bedwetting also called enuresis after the age of 6, but Dr. Cummings says peer pressure plays a strong role in a child's behavior. "Six is around the age at which social forces seem to become more paramount in a child's life," says Dr. Cummings.

Because the medications currently prescribed for bedwetting have many side effects, urologists and pediatricians alike recommend a change in the child's routine. Experts say the safest form of therapy, which is also most effective, is altering habits to encourage dry beds.

Dean Cloward, a child psychologist practicing in Rigby, Idaho, offers a few suggestions. Parents can start with the basics by limiting fluids after dinnertime. This may be sufficient for some children, but even if it is not successful, it is a good idea to continue this routine when other treatment programs have begun. The child should also empty his bladder just prior to bedtime.

Waking the child at night and taking them into the bathroom to empty their bladder may help, but this should be done only if it does not disrupt sleep patterns for the parent and child. Cloward explains that often the child will wet at close to the same time each night. You might try waking your child just prior to that time and taking them to the bathroom. Often the child is too sound asleep to wake up to an alarm, and occasionally, the child is too asleep to even arouse to urinate, but it can work for some children.

"Other approaches can be designed, but should be created and initiated by a child psychologist," says Cloward. "This assures that other damaging effects of the enuresis do not impact the child and that the intervention helps, not hurts." For extreme cases, Cloward also suggests finding a child psychologist who specializes in nocturnal enuresis.

Cloward believes positive reinforcement can help children remain focused on staying dry, but may not work in every situation.

For some children, the ability to control their bladder will come with teaching. In these cases, reinforcement is the best means to intervene. Creating a chart that the child can add stickers to on each dry morning is a good start.

While you are working on bedwetting, it may be helpful to use disposable absorbent underpants. These undergarments, which resemble regular underwear, prevent the embarrassment of waking to damp sheets and eliminate frequent laundering. Saved from the shame of being wet can help kids' self-esteem.

Want to see more?

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• Oh Brother, I Wet the Bed
• Childhood Baby Blues: The Effects of a New Baby on Bedwetting
• Summer Camp or Bust: Your Bedwetting Child Can Do It!