Bed-wetting- Age 5
Five-year-olds typically stay dry all night, with only occasional nighttime mishaps. Some children, though, continue to wet the bed at night; the condition affects 10 to 13 percent of children over the age of 5. Boys — especially those with a family history of bed-wetting — are more commonly afflicted with this problem.
In order for your child to stay dry all night, her brain must be able to keep a full bladder from emptying while she’s sleeping or a signal from her bladder must be strong enough to wake her up to use the toilet. Some children take longer to get to this point than others.
What you can do
Try not to make a big deal about sporadic accidents. If your child consistently wets the bed at night, downplay these mishaps, too, and make sure she understands that they are not her fault. Don’t punish her or make fun of her; she really can’t help it, and you’ll only make her feel more ashamed. You should also make sure her siblings know that teasing about this condition is an absolute no-no. Staying dry all night is a developmental skill that almost all children achieve in time, whether by sleeping through the night without wetting or by getting up to use the bathroom.
While you’re waiting for your child to outgrow bed-wetting, ensure that her mattress is adequately protected by a plastic sheet and urge her to get up as soon as she realizes she’s damp. If she does wet herself, change both her bedding and her pajamas as soon as possible, so her skin won’t get irritated and she’ll get used to sleeping in dry pj’s. You can also encourage her to wear extra-thick cloth or disposable training pants, though children this age may resist doing something they consider babyish or embarrassing. (It may help to tell reluctant kids that even adults sometimes wear such things.) For some children, particularly kids who’ve been dry for a long time and begin wetting again, a switch back to training pants may not be a good idea. Let your child’s temperament be your guide here.
You might also try a calendar or chart system noting her successes (dry nights) while never reprimanding her for wet ones. “Seeing the number of dry nights increase week by week is usually a positive motivating factor that parents can build on with their praise,” says Daniel Kessler, a developmental-behavioral pediatrician in Phoenix, Ariz.
Some parents find that waking a child to pee — if she’s been asleep for an hour or more — can put an end to the problem. You can also try to figure out what time of night she tends to wet the bed and set an alarm to go off 30 minutes beforehand. By making it her responsibility to get up to use the toilet, you may help her gain some control over the situation.
Others have found that bladder-stretching exercises do the trick. Talk with your pediatrician to see if your child should try this approach. Here’s how one exercise works: Encourage a child who feels the urge to go during the day to hold her urine for the 10 seconds or so it takes for the bladder contractions to stop. Then, when the impulse to pee returns, she should try to postpone responding again and again, until she simply has to go.
What to watch out for
If your child “dribbles” urine constantly, strains while she pees, or complains of burning or pain when she goes, she may have an infection or other health problem. If that’s the case, call her pediatrician as soon as possible. You should also talk with her doctor if her urine is cloudy or pink, or if she has redness or a rash in her genital area. These guidelines apply to both girls and boys.
If a child starts wetting the bed after a long dry period (three months or more), there may also be an underlying emotional cause. Talk with her doctor about any emotional factors you think might play a part, such as starting a new school, changes in the family (such as separation or divorce), or physical abuse.
What’s ahead
If your pediatrician suspects a urinary tract infection (UTI), he’ll take a sample of your child’s urine to check for the condition. If your child has an infection, the doctor will prescribe antibiotics to clear it up. If the UTI is to blame for the bed-wetting, your child’s problem should go away. Infection, however, isn’t usually the culprit.
If infection or slow development of the full-bladder response isn’t the cause, and your efforts to deal with the dilemma don’t seem to help, your child’s doctor may recommend additional tests (including X-rays of the bladder or kidneys) to check for abnormalities. If a problem is found, your physician will probably refer you to a pediatric urologist. Again, this is rarely the issue.
If no physical cause for your child’s predicament can be found, and her bed-wetting is considered a significant disruption in your family, her pediatrician may suggest some other strategies to try at home, such as a bed-wetting alarm. These alarms work by attaching sensors to your child’s underpants or mattress. At the first sign of wetness, the alarm sounds, waking your child and eventually conditioning her to recognize when her bladder is full, even during sleep. The alarms are fairly effective, and most kids who are helped by them improve in four to six months.
If an alarm doesn’t seem to help, your doctor may prescribe medicines, usually in pill or nasal-spray form, as a last resort. Imipramine is often the first choice, and approximately half of children respond to it. Kessler advises parents to discuss the pros and cons of these medicines, including side effects and potential dangers, with their pediatrician.
Only a very small percentage of bed-wetters don’t outgrow the problem or respond to any treatment. These kids, however, almost always have the condition under control by adolescence.
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