Is Your Kid a Bed-Wetter? Don’t Worry, It’s Normal

Most kids are potty-trained between ages 2 and 4. But about 20 percent of 5-year-olds and 10 percent of 7-year-olds still wet the bed at night. Why?

There’s not a single cause for bed-wetting, a complex set of issues on which experts don’t agree. For some kids, it may be “dysfunctional voiding,” where the bladder doesn’t fully empty. Constipation also can irritate the bladder. Mostly, bed-wetting seems due to sleep pattern issues, where hormones that normally slow the kidneys at night are not released, so the child continues to make as much urine at night as throughout the day.

Slowing the Parade

Our bladders are designed to hold about three to four hours’ worth of urine; most of us go to the bathroom five to six times a day. But what about that eight hours or so during the night when most folks don’t use the bathroom? The bladder is a muscular sac that holds urine until it is released to the urethra — this process slows way down when you’re sleeping, and the bladder can hold more. While you sleep, your brain sends out hormones to slow your kidneys along with your heart, intestines and everything else — you’re basically hibernating.

Some kids who wet the bed are very heavy sleepers who don't release enough hormones to slow the kidneys down. When their bladder is full, they don't wake up, they wet the bed — otherwise their bladders would explode. So bed-wetting is actually not considered an abnormal occurrence.

Taking Away the Shame

Bed-wetting tends to run in families, and boys are more likely to wet the bed than girls. If one parent was a bed-wetter, there’s a higher likelihood their kids will wet the bed. Yet even though bed-wetting is considered a normal, involuntary response with a genetic link, even very young children often feel shame. And parents who want to be supportive can still get frustrated with frequent clean-ups and nighttime interruptions when a child wakes up in a wet bed.

One way to address the guilt is to explain to your child that this is normal for them — don’t compare them to siblings or cousins who don’t wet the bed. If keeping your kid in diapers or pull-ups longer gives them more confidence and you more peace of mind, that’s OK, too. Let your child help with the clean-up — that will also demonstrate that this is normal. Don’t make it a punishment.

Occasional bed-wetting is actually considered normal all the way up to age 15, by which point almost everyone outgrows this problem. For kids who continue to wet beyond 15, there may be other anatomical issues going on that need to be evaluated. While it’s very rare for kids to be wetting the bed by the time they graduate high school, for those who do, college — and roommates — is a big worry. The good news is there are medications to manage this in young adults that aren’t appropriate for children under 10.

Relax, It’s OK

Many parents of bed-wetters want their children evaluated early because they’re concerned something is wrong. One of the most important things doctors can offer these families is reassurance that bed-wetting is normal.

Ultrasounds and X-rays can be used to check for anatomical abnormalities, but one of the best things parents can do until kids outgrow it on their own is be alert to anything that makes the bladder more irritated, like a child holding his pee for longer than normal because he’s too busy playing. If you can eliminate those daytime issues and constipation, about half of all kids will improve or stop wetting entirely.