COMMON CAUSES OF BEDWETTING

Written by Caroline Meyer

In rare instances bedwetting may be caused by underlying diseases, but in general, for most children there is no medical condition causing the bedwetting. Medical conditions related to bedwetting are only diagnosed in around 1% of bed wetters. This doesn’t mean that kids who regularly wet the bed are doing so on purpose or even that they have complete control over the situation. They are not doing it to be “naughty” or with malicious intent. Quite often bed wetting is simply a developmental issue. 

Bed wetting is split up in to 2 categories, primary and secondary bed wetting. In primary bed wetting, the child has been wetting the bed regularly since early childhood and there has not been a significant improvement for a period of time. Secondary bed wetting refers to bed wetting that starts again after there has been a significant period of time in which the child has not had a nightly accident. This is usually more than 6 months of dry nights before it starts again. 

Primary bed wetting is often due to the child not being able to hold the urine in for the entire night and not waking up when the bladder is full.  They often have bad toilet habits during the day and may hold their urine in for as long as possible before using the bathroom. This is noticeable in squirming, holding the groin area, crossing legs and other methods of straining not to wet themselves during the day. They may also produce larger amounts of urine in the evening. This usually results in continuous night-time accidents. 

Secondary bed wetting is more often related to an emotional or medical problem. They may also wet themselves during the day.  Possible causes include urinary tract infection which can cause irritation and pain during urination as well as more frequent urination and a stronger urge to relieve themselves. UTI’s in children may also point to anatomical abnormalities. Neurological problems may also affect urination control. Diabetes increases urine output as well. Abnormalities in the muscles, organs and nerves can cause incontinence, more frequent urination and an inability to control the urges. Stress at home, constant conflict, major changes in the home, starting school and various other emotional issues that cause anxiety in a child can also result in bed wetting. Children that are abused sexually or physically may also start bed wetting, even if they have not done so for a long time. 

It is unusual to note that many children who wet the bed past the expected age often have a parent that also had accidents past the usual age. Children who have had parents with a similar experience often outgrow the bed wetting at the same rate their parent did, albeit later than expected based on their peers. 

While primary bed wetting is seldom a cause for concern and most children outgrow this phase, secondary bed wetting should be investigated further in case there is a medical or psychological issue that may need to be attended to. 

Some tips to reduce primary bed wetting include:

• Reduce fluid intake before bedtime and take the child to the bathroom before they go sleep.
• Get up during the night to wake the child so they can use the bathroom until they get used to getting up on their own to use the bathroom. 
• Make sure there is some low lighting and easy access for the child to use the bathroom. 
• Reward them for staying dry.  

Don’t punish the child for accidents; focus on potential prevention in future. Punishing the child may actually prolong the problem by creating added anxiety. Save yourself time and hassle by using layers with waterproof covers to make night-time clean-ups quick and prevent mattresses getting soaked.  Have your child help with the clean-up but don’t make a big deal of it. Rest easy knowing that they will eventually outgrow this phase. This is true in almost all cases of extended bed wetting.  If you have concerns, contact your physician and schedule a check-up to make sure there are no physical problems causing the bed wetting.