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Bedwetting occurs most nights in 15% of five-year-olds and is still a problem for 3% of all 15 year-olds. There are around 750,000 children and young people in the UK who regularly experience problems with continence - that’s 1 in 12 children. Wet beds or wet or soiled pants during the day are a daily occurrence for some families to cope with. The frustration and extra work involved in managing this can put a strain on family life.
However, because it’s a taboo subject, the real figures for older children could be much higher. It’s significant that night-time ‘nappies’ are widely available in sizes to fit children up to 15 years old. There are many different strategies recommended to help parents deal with their child’s bedwetting. Some work for some families, not for others and there seems to be no definitive cure. Wet beds aren’t just an inconvenience. When an older child is still wetting at night it rules out fun experiences like school trips, sleepovers and can lead to embarrassment and fears about bullying.
Potty training is the first step to full continence and the journey along this well trodden path will be different for every child - some start early, some later, for some it’s easy but for others it’s a challenge. By offering simple, practical strategies ERIC can help parent’s overcome any obstacles they face. A frequent question from parents is ‘How do I know when to start potty training?’ A child should be showing some signs that they are ready to start. These signs include managing to stay dry for 1½ - 2 hours, predictable bowel movements, and showing an interest in their own weeing and pooing.
The usual continence pattern for a child is to gain bowel control at night; bladder control in the day and then bowel control in the day, and finally bladder control at night. When it’s time to say goodbye to nappies at night children feel so proud of themselves and their parents are delighted. But for some children night time dryness isn’t so easy to gain and parents can wonder whether it’s their fault or assume their child is just being lazy. Bedwetting occurs during sleep and for reasons outside of a child’s control – some children produce too much urine at night and may not receive the message that their bladder is full – a child who wets at night is not lazy.
Bedwetting is common in pre school children and most families begin to look for ways to resolve bedwetting when their child expresses a desire to stop. The age that this occurs varies but it is usually from 5 onwards.
No pull-up pants or nappies - These ensure your child no longer feels wet when they urinate, delaying them learning to be dry.
No ‘lifting’ - Don’t wake your child just as you are going to bed to ‘encourage’ them to have one last wee, she says. This actively trains your child to wee – half-asleep - in the night.
No reward systems – The most helpful way to get your child motivated and successful is to focus on the ‘goal’ itself – ‘dry beds forever’ and the benefits that will bring – sleepovers, holidays and so on - rather than the ‘prize’ – which can actually distract your child and make it harder for them to succeed.
Drink water - Don’t restrict fluids but stick to plain water where possible. Some children are more likely to have a wet bed after drinking sugary, fizzy or caffeinated drinks.
ERIC (Education and Resources for Improving Child Continence) do not discourage ‘lifting’ (picking your child up during the night and taking him or her to the toilet), but say that it will not help your child to learn when they have a full bladder and wake up or hold on. If you want to ‘lift’, ERIC recommends:
There’s general agreement that caffeinated drinks, particularly towards bedtime, can make the problem worse. Some organisations recommend enuresis alarms to help your child wake up when they need the toilet. These can sometimes be obtained free from your local enuresis clinic or obtained from the ERIC website. Medication can be prescribed for short term use, such as for short breaks, sleepovers or school trips. Contact your GP for advice or information.
If a child has problems wetting during the day it can be caused by constipation as the full bowel can put pressure on the bladder or a urinary tract infection (UTI) both can give a feeling of always needing to wee. Another cause of daytime wetting is an overactive bladder - the muscles of the bladder contract instead of relaxing whilst filling causing a sudden and urgent need to empty before the bladder is full - resulting in wet pants before a child has managed to get to the toilet. Parents often think their child is leaving it too late to go to the toilet, whereas the child usually has very little time to get to the toilet and a bit of leakage occurs whilst they are trying to get there.
Constipation often results in leakage and soiled pants. For some children, a painful poo experience can lead to anxiety about having a poo and can make them reluctant to poo causing them to try to hold on to their poo to avoid more pain. Parents often question their parenting skills when their child is constipated – they wonder whether their child’s diet is the cause or that they haven’t potty trained their child properly. Constipation often occurs for no known reason, but a visit to the doctor for medicine to clear the blockage and help things run smoothly again, drinking well and a good daily toilet routine will resolve constipation for most children.
ERIC can help parents understand what is happening when their child is having difficulties with wetting or soiling and offers information, support and lots of tips to overcome the problems. The ERIC Helpline is available weekdays on 0845 370 8008 (10am-4pm). A range of free to download leaflets is available on the ERIC website, where parents can also find a wide range of products such as bed alarms and bed protection to purchase to help with the everyday problems of a child who has wetting or soiling problems.
Helen says her daughter, Emma, seven, has just stopped wetting the bed:
“It was a slow process but we cut out drinks after dinner and never used pull-ups. We did, however, use bed mats. Most importantly, we never told her off for wetting the bed as it wasn't her fault. Now she is dry, we continue to limit drinks in the evening and make sure she pops to the loo again when she’s finished reading in bed.”
“My son, Sam, six, was wet every night until recently. After asking my health visitor for advice, I decided to stop using pull ups to see how we got on. For the first two weeks I was washing his bedding every morning and he was still wet every night and showing no signs of improvement at all. Then, he had a dry night, then another! I think he saw the pull ups as a security thing and without them, the consequences of a wet bed and pyjamas were a rude wake-up call!”
“I wet the bed as a child and was determined to help my children cope with it. I remember missing out on school trips away from home and, was bullied about it. The problem is there’s so much conflicting advice out there. My method was to put on night-time pull-up pants for a week if they wet the bed. Then I would take them off to see how they got on. If they wet the bed again then the night time pull up pants would go back on. I didn’t 'lift' the child out for a wee in the night as I did not want to disturb their sleep. The one time I did do this, my daughter got upset, refused to do a wee and then did one once they were back in bed! For all three I used a reward system (star charts, treats, days out etc) with good results. When they cottoned on to it, the wet beds became dry beds!”