by Jordana Allen
From around the age of five, bedwetting is classed as a medical condition called Nocturnal Enuresis. It can be frustrating, and it can knock a child’s confidence, but it’s not something they can control – so it’s really important they’re never shamed or told off. Most parents already know you can’t “train” a child to stay dry at night; it’s a developmental process that happens naturally. But the good news is there are things you can do to support it if it’s starting to bother them.
Step 1: Check for Constipation
More than half of children that wet the bed are affected by constipation. When your child sleeps and their muscles relax, a full bowel can press on the bladder and cause it to empty.
Your child might be constipated if:
- They poo less than every other day
- Their stool is small, hard, or pellet like (think “rabbit droppings”), rather than a formed, sausage shaped stool
A really easy way to keep track is using the ‘Happy Poop’ app. You can log each bowel movement and use the built in Bristol Stool Chart to record what the stool looked like. After a few weeks, you’ll have a clear picture of your child’s bowel habits – and the app even lets you export charts to share with health professionals. If things aren’t as regular as you thought, you’ll have solid evidence for a GP appointment and can get treatment started.
Step 2: Once Constipation is Well Managed, Focus on the Bladder
There are three main reasons a child may wet the bed – and your child may have one, two, or even all three.
1 – They’re Not Drinking Enough During the Day
This one surprises a lot of parents! Many restrict fluids, hoping it will reduce bedwetting – but it actually has the opposite effect. The bladder is a muscle, and like any muscle, it needs regular use to be able to hold a larger volume of urine. If it isn’t filled and emptied often enough during the day, it won’t manage well overnight.
General daily drink guidelines:
- Ages 4–8: 1000–1400 ml
- Ages 9–13:
- Girls: 1200–2100 ml
- Boys: 1400–2100 ml
Aim for 6–8 drinks spread throughout the day:
- 3 at home (breakfast, after school, dinner)
- 3 at school (mid-morning, lunch, mid-afternoon)
If they need to drink more because they’re playing sports or it’s a hot day, add one in on arrival to school and try to make sure they are a few hours apart. Make sure the last drink is at least an hour before bed. If your child struggles to remember to drink in the day, you can buy digital watches (check out the ERIC website linked below) that vibrate discreetly on their wrist at times set by you when it’s time for a drink. It takes around 3 months to retrain a bladder, so consistency is key and don’t expect results overnight.
2 – They’re Not Producing Enough Vasopressin
Vasopressin is a hormone we produce at night to tell our kidneys to make less urine. It also makes urine more concentrated (hence that strong morning wee!) Most children begin producing enough Vasopressin by age 4–5, but some take longer. If your child isn’t making enough, your GP or Children’s Continence Team may prescribe Desmopressin, a medication that mimics the hormone. A sign that they aren’t producing enough Vasopressin is if the wetting is within the first couple of hours of going to sleep, or if they are wetting a large amount 1-2 times a night.
Note: your child must be drinking well during the day to safely take Desmopressin.
3 – They Aren’t Waking to a Full Bladder (“Poor Arousability”)
Sometimes their brain does not register a full bladder enough to wake them up. In these cases, a bed alarm can be incredibly effective.
A bed alarm works by detecting wetness and sounding a loud alarm, waking your child. Over time, they begin recognising the sensation earlier, may stop mid-wee and head to the toilet, and eventually achieve dry nights. Once your child has 14 consecutive dry nights, the alarm can usually be stopped. It’s hard work at the start, but long term success rates are excellent.
Signs of poor arousability are that they are sleeping through the wetting or wetting later into the night.
The First Steps for Parents
If your child wets the bed, your starting plan should be:
- Reassure them you know it’s not their fault.
- Check for constipation (and treat it if present).
- Improve daytime drinking habits and bladder training.
- Don’t lift them for a ‘dream wee’ – they aren’t awake enough and you are actually teaching their brain to wee in their sleep.
If you’ve done all of this and your child is still wetting at night, that’s the perfect time to seek support from a health professional or your local Children’s Continence Team.
ERIC has some excellent information on Constipation, Bed wetting and anything else related to your child’s toileting. They also have a phone line you can call for advice if you prefer to speak to someone. https://eric.org.uk/
Bladder and Bowel UK also have some excellent resources about Desmopressin and Bed Alarms as well as a helpline and other resources for toilet training. https://www.bbuk.org.uk/children-young-people/
