{"id":7253,"date":"2019-12-27T09:00:16","date_gmt":"2019-12-27T14:00:16","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=7253"},"modified":"2021-03-15T13:22:37","modified_gmt":"2021-03-15T17:22:37","slug":"bedwetting-tips-treatment-medication","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/bedwetting-tips-treatment-medication\/","title":{"rendered":"Childhood bedwetting: How to help your child overcome it"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Bedwetting can be a stressful condition for kids and their families. There is the inconvenience of changing bedding and clothing, the cost of products like waterproof pads, the worry about if this is normal, and the feelings of embarrassment. Because it can be an uncomfortable subject to talk about, it is often not spoken of in social circles; however, bedwetting is actually quite common, and is often considered part of normal childhood development.<\/span><\/p>\n<h2><b>What is bedwetting?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Bedwetting\u2014which is medically referred to as nocturnal enuresis\u2014is involuntary urination during sleep in children after the age that they can reasonably be expected to stay dry throughout the night.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are <\/span><a href=\"https:\/\/www.mottchildren.org\/posts\/your-child\/bedwetting\"><span style=\"font-weight: 400;\">two types<\/span><\/a><span style=\"font-weight: 400;\"> of bedwetting: primary and secondary.<\/span><\/p>\n<p><b>Primary nocturnal enuresis<\/b><span style=\"font-weight: 400;\"> is when children have never had an extended period of time staying dry at night. Primary bedwetting is the most common type of bedwetting.<\/span><\/p>\n<p><b>Secondary nocturnal enuresis <\/b><span style=\"font-weight: 400;\">is if a child has previously stayed consistently dry overnight for at least a six month stretch and then begins wetting the bed again, this is considered secondary bedwetting. This type is less common, accounting for approximately 25% of bedwetting.<\/span><\/p>\n<h2><b>How common is bedwetting?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">\u201cBedwetting is extremely common,\u201d says Baltimore pediatrician <\/span><a href=\"https:\/\/mdmercy.com\/centers-of-excellence\/womens-health\/family-childbirth-and-childrens-center\/our-doctors\/pediatricians\/ashanti-w-woods-md?sc_lang=en\"><span style=\"font-weight: 400;\">Ashanti Woods<\/span><\/a><span style=\"font-weight: 400;\">, MD. \u201cIt is considered a normal part of childhood development.\u201d The number of children who experience regular bedwetting decreases with age. The <\/span><a href=\"https:\/\/www.chop.edu\/conditions-diseases\/bedwetting-nocturnal-enuresis\"><span style=\"font-weight: 400;\">approximate number of children<\/span><\/a><span style=\"font-weight: 400;\"> who have nocturnal enuresis is as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">5- to 6-year olds: 15% to 20%<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">8- to 10-year olds: 6% to 10%<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">11- to 13-year olds: 4% to 5%<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">14- to 16-year olds: 2% to 3%<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">17- to 18-year olds: 1% to 2%<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">While daytime wetting is <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/urologic-diseases\/bladder-control-problems-bedwetting-children\/definition-facts\"><span style=\"font-weight: 400;\">more common with girls<\/span><\/a><span style=\"font-weight: 400;\">, bedwetting is <\/span><a href=\"http:\/\/urology.ucla.edu\/body.cfm?id=478&amp;action=detail&amp;ref=16\"><span style=\"font-weight: 400;\">more common with boys<\/span><\/a><span style=\"font-weight: 400;\">. Boys make up approximately 75% of children who experience nocturnal enuresis.\u00a0<\/span><\/p>\n<h2><b>At what age is bedwetting considered a problem?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">\u201cBedwetting is thought to be abnormal if it persists beyond 6 years of age,\u201d says Dr. Woods, who also stresses that even after age six it is still quite common.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While bedwetting can be considered unproblematic until adolescence, it\u2019s a good idea to consult your family physician\u00a0 if your child is <\/span><a href=\"https:\/\/www.mottchildren.org\/posts\/your-child\/bedwetting\"><span style=\"font-weight: 400;\">still frequently wetting the bed by age 7 or 8<\/span><\/a><span style=\"font-weight: 400;\"> in order to rule out possible medical conditions, or if the bedwetting is causing psychological problems (such as low self-esteem) for your child or your family.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There does not appear to be a specific age in which bedwetting becomes concerning\u2014it varies from expert to expert, but most agree that barring another medical condition, whether or not to treat the bedwetting depends on how intrusive it is.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Bedwetting can also <\/span><a href=\"https:\/\/www.webmd.com\/urinary-incontinence-oab\/bed-wetting-in-adults#1\"><span style=\"font-weight: 400;\">occur in adults<\/span><\/a><span style=\"font-weight: 400;\">. This is usually due to an underlying medical condition such as diabetes, problems with the ADH (antidiuretic) hormone, overactive bladder, blocked urethra, constipation, obstructive sleep apnea, pelvic organ prolapse, problems with the structure of the bladder or other urinary organs, enlarged prostate, urinary tract stones, or a urinary tract infection.\u00a0 It can also be caused by certain medications such as sleeping pills or antipsychotics like clozapine or risperidone.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Bedwetting in adults may be a symptom of more serious conditions like bladder cancer or prostate cancer, or diseases of the brain and spine like a seizure disorder, multiple sclerosis, or Parkinson\u2019s disease.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Treatment options for bedwetting in adults depend on the reason for the bedwetting.<\/span><\/p>\n<h2><b>What causes bedwetting?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">\u201cPediatricians still do not know an exact cause for bedwetting,\u201d says Dr. Woods. \u201cAn observation that has been made is that bedwetting tends to run in families.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is definitely a genetic component, according to Utah pediatrician <\/span><a href=\"https:\/\/healthcare.utah.edu\/fad\/mddetail.php?physicianID=u0548562\"><span style=\"font-weight: 400;\">Cindy Gellner<\/span><\/a><span style=\"font-weight: 400;\">, MD. \u201cScientists have even identified the genes for delayed nighttime bladder control,\u201d Dr. Gellner <\/span><a href=\"https:\/\/healthcare.utah.edu\/the-scope\/shows.php?shows=0_fzkrmew3\"><span style=\"font-weight: 400;\">said in an interview<\/span><\/a><span style=\"font-weight: 400;\"> for University of Utah Health. \u201c\u2026they&#8217;re on chromosomes 8, 12, and 13. That&#8217;s why we see this run in families so much.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other factors <\/span><a href=\"https:\/\/www.chop.edu\/conditions-diseases\/bedwetting-nocturnal-enuresis\"><span style=\"font-weight: 400;\">can include<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Children being deep sleepers, not waking up when the bladder is full\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Inadequate production of the sleep hormone vasopressin, which signals the body to make less urine at night.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">An immature or small bladder<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Occasionally, bedwetting can be caused by a bigger medical problem. \u201cSome medical conditions that physicians consider when bedwetting is prolonged include constipation, urinary tract infections,\u00a0diabetes, and stress,\u201d says Dr. Woods.\u00a0\u201cIn rare situations\u2026due to anatomical reasons, surgery may be indicated [like a] blockage\/narrowing that prevents a child from fully emptying his\/her bladder.\u201d<\/span><\/p>\n<h2><b>How can I stop bedwetting?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Bedwetting is usually outgrown, but <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/urologic-diseases\/bladder-control-problems-bedwetting-children\/treatment\"><span style=\"font-weight: 400;\">there are several things that can help<\/span><\/a><span style=\"font-weight: 400;\"> some kids.<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\"><b>Timed Voiding<\/b><span style=\"font-weight: 400;\">. Get children on a schedule of urinating every 2 to 3 hours during the day, whether or not they feel the urge. You can even get them a watch that vibrates at set times to remind them to go.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Double Voiding.<\/b><span style=\"font-weight: 400;\"> There are different techniques; most commonly the child would urinate, relax on the toilet for 20-30 seconds, and then urinate again.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Monitor Liquids.<\/b><span style=\"font-weight: 400;\"> Encourage more drinking during the day and less at the end of the day and evening (unless they are involved in sports and need additional hydration.) Avoid drinks with caffeine or bubbles, citrus juices, and sports drinks.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Motivational Therapy.<\/b><span style=\"font-weight: 400;\"> Be patient and encouraging. All methods work better when the whole family is on board. Try a reward system, not just for having a dry night, but for sticking with a routine. Never shame, reprimand, or punish a child for bedwetting\u2014they aren\u2019t doing it intentionally.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Get Children Involved.<\/b><span style=\"font-weight: 400;\"> Help them feel some control over the situation by coming up with a routine together. Let them help change bedding (but not as a punishment).\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Bedwetting Alarms<\/b><span style=\"font-weight: 400;\">. These come with a moisture sensor that clips to the child\u2019s clothing or bedding. An alarm will sound as soon as the child begins to wet the bed. This method requires a commitment from both the child and the parent. At first, it\u2019s likely only the parent will wake up with the alarm, and they will need to wake the child and take them to the bathroom. Over time, many children learn to wake with the alarm and eventually to wake with the sensation of a full bladder. Some improvement can happen within a few weeks, but the alarm usually needs to be used for three to four months to be most effective. This method doesn\u2019t work for all kids, but when it does work it tends to have long-lasting success.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Medication<\/b><span style=\"font-weight: 400;\">. Medication is not a first resort, but can be helpful for some children. It is particularly helpful for special events such as a sleepover, traveling, or camp.<\/span><\/li>\n<\/ol>\n<h2><b>Are there medications that can help stop bedwetting?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">While not the first line of treatment, there are some medications that can help.<\/span><\/p>\n<h3><b>Desmopressin<\/b><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/desmopressin-acetate\"><span style=\"font-weight: 400;\">Desmopressin<\/span><\/a><span style=\"font-weight: 400;\"> (DDAVP) is used to <\/span><a href=\"https:\/\/www.webmd.com\/drugs\/2\/drug-12128\/desmopressin-oral\/details\"><span style=\"font-weight: 400;\">control the amount of urine<\/span><\/a><span style=\"font-weight: 400;\"> made by the kidneys. It is taken orally, and the dosage depends on the patient and the condition. It is often a physician\u2019s first choice of medication for bedwetting and it is effective in about <\/span><a href=\"https:\/\/www.chop.edu\/conditions-diseases\/bedwetting-nocturnal-enuresis\"><span style=\"font-weight: 400;\">50% of patients<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While safe to take over long periods of time, it <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/urologic-diseases\/bladder-control-problems-bedwetting-children\/treatment\"><span style=\"font-weight: 400;\">doesn\u2019t usually help with reducing bedwetting in the long run<\/span><\/a><span style=\"font-weight: 400;\">. Bedwetting often returns once the medication is stopped.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Desmopressin can be very helpful when used for special events such as a sleepover, a long flight, camp, etc.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A partial list of <\/span><a href=\"https:\/\/www.webmd.com\/drugs\/2\/drug-12128\/desmopressin-oral\/details\"><span style=\"font-weight: 400;\">potential side effects<\/span><\/a><span style=\"font-weight: 400;\"> incl<\/span><span style=\"font-weight: 400;\">ude headache,\u00a0nausea,\u00a0upset stomach, or flushing of the face. More serious side effects are rare but can occur. Seek medical help if there are signs of an allergic reaction.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This medicine may cause <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/desmopressin-acetate\"><span style=\"font-weight: 400;\">low levels of sodium<\/span><\/a><span style=\"font-weight: 400;\"> in the blood. Carefully follow the doctor&#8217;s instructions about how much liquid to drink each day. This is especially important for children. Children can also be at <\/span><a href=\"https:\/\/www.kidney.org\/patients\/bw\/BWmeds\"><span style=\"font-weight: 400;\">risk for seizures<\/span><\/a><span style=\"font-weight: 400;\"> due to water intoxication, making regulating fluid intake highly necessary.<\/span><\/p>\n<h3><b>Imipramine<\/b><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/imipramine-hcl\"><span style=\"font-weight: 400;\">Imipramine<\/span><\/a><span style=\"font-weight: 400;\"> is an antidepressant that is sometimes used to control bedwetting. Ten to 50% of patients <\/span><a href=\"https:\/\/www.kidney.org\/patients\/bw\/BWmeds\"><span style=\"font-weight: 400;\">report full dryness<\/span><\/a><span style=\"font-weight: 400;\">, and others report some improvement.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It isn\u2019t well understood how this drug works, but it is thought to work in one of several ways:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">By changing the child&#8217;s sleep and waking pattern;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">By affecting the time a child can hold urine in the bladder; or<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">By reducing the urine production.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Imipramine is more effective in older children, and not generally prescribed to children under age 6 to 7.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is usually taken 1 to 2 hours before bedtime, and dosage depends on the age of the child.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Side effects are uncommon, but can include irritability, insomnia, drowsiness, reduced appetite, and rarely, unpleasant personality changes. These side effects can be reversed by reducing or stopping imipramine.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Importantly, <\/span><b>an overdose can cause death<\/b><span style=\"font-weight: 400;\"> in children, and there have been reports of accidental overdoses. Imipramine <\/span><b>must<\/b><span style=\"font-weight: 400;\"> be kept out of reach of children and sealed in a childproof container or with a childproof cap.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As with desmopressin, bedwetting tends to reoccur once Imipramine is stopped.<\/span><\/p>\n<h3><b>Oxybutynin and Hyoscyamine<\/b><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/oxybutynin-chloride\"><span style=\"font-weight: 400;\">Oxybutynin<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/hyoscyamine-sulfate\"><span style=\"font-weight: 400;\">Hyoscyamine<\/span><\/a><span style=\"font-weight: 400;\"> are anticholinergics used to treat urinary and bladder problems.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">They are not generally helpful to kids who have nighttime wetting only when used on their own, but an anticholinergic <\/span><a href=\"https:\/\/www.kidney.org\/patients\/bw\/BWmeds\"><span style=\"font-weight: 400;\">can be used in combination with desmopressin<\/span><\/a><span style=\"font-weight: 400;\"> to help some kids with bedwetting, particularly kids who have reduced function bladder capacity.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">.Dosage for these medications varies based on age and weight. Common side effects include dry mouth and facial flushing. An overdose may result in blurring of vision and hallucinations.\u00a0<\/span><\/p>\n<h3><b>Tolterodine\u00a0<\/b><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/tolterodine-tartrate\"><span style=\"font-weight: 400;\">Tolterodine<\/span><\/a><span style=\"font-weight: 400;\"> is another anticholinergic that has fewer reported side effects and is more specific for its action on the bladder. It is not approved for children under 12.<\/span><\/p>\n<h2><b>How to manage ongoing bedwetting<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">While you are waiting for treatment to work or for your child to outgrow bedwetting, there are <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/urologic-diseases\/bladder-control-problems-bedwetting-children\/treatment\"><span style=\"font-weight: 400;\">some things you can do<\/span><\/a><span style=\"font-weight: 400;\"> to make sleep time more manageable and enjoyable.<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\"><b>Absorbent or Waterproof Products.<\/b><span style=\"font-weight: 400;\"> Reusable or disposable absorbent underwear can be useful for sleeping away from home. At home, disposable or reusable pads or mattress protectors help protect bedding.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Easy Nighttime Transitions.<\/b><span style=\"font-weight: 400;\"> Lay out spare clothes for your child to change into if they wake up wet at night. Consider layering sheets with waterproof pads to make it easy for children to remove wet bedding during the night and in the morning.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Bathing.<\/b><span style=\"font-weight: 400;\"> Make sure your child showers or bathes daily to remove the smell of urine.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Respect Privacy.<\/b><span style=\"font-weight: 400;\"> If your child prefers to change on their own, allow them to. Don\u2019t discuss their bedwetting around other people unless at a doctor\u2019s visit.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Offer Encouragement.<\/b><span style=\"font-weight: 400;\"> Talk to your child and let him know that bedwetting isn\u2019t his fault and that you know he isn\u2019t doing it on purpose. Tell him how common it is, and that it\u2019s likely some of his friends wet the bed now or did at some point as well. Reassure him that he isn\u2019t in trouble and that it will get better. If any adult family members in your family wet the bed as children, ask them to speak to your child about their experiences in a comforting manner. (Respect privacy and ask your child\u2019s permission before doing so.)<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Bedwetting is tough, but it\u2019s important to remember that it\u2019s common, often treatable, and usually outgrown. If other medical conditions and constipation have been ruled out, then it\u2019s mostly a waiting game. Have patience, be kind, and you\u2019ll all get through it.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bedwetting can be a stressful condition for kids and their families. There is the inconvenience of changing bedding and clothing, the cost of products like waterproof pads, the worry about if this is normal, and the feelings of embarrassment. Because it can be an uncomfortable subject to talk about, it is often not spoken of [&hellip;]<\/p>\n","protected":false},"author":65,"featured_media":7617,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[3564],"coauthors":[8622],"class_list":["post-7253","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-children","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Childhood bedwetting: How to help your child overcome it<\/title>\n<meta name=\"description\" content=\"Bedwetting is common in 5- to 6-year-olds. 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