Most children stop wetting the bed as they get older, but in the meantime there are a number of treatments you can try.
These treatments may help keep your child dry until they grow out of the problem.
The treatment for your child depends on a number of things, such as:
Depending on your childs symptoms and how well they respond to treatment, the person in charge of their care will be their GP or a paediatrician (doctor who specialises in treating children).
Alternatively, many clinical commissioning groups (CCGs) run bedwetting clinics, also known as enuresis clinics, which your GP can refer you to.
There's no single approach to treating bedwetting that works for everybody, but in most cases the recommended plan is to first try a combination of measures yourself.
If these don't work, a bedwetting alarm is often used. If the alarmis unsuccessful or unsuitable, medicationmay be recommended.
The various treatments for bedwetting are outlined below. You can also read a summary of the pros and cons of the treatments for bedwetting , allowing you to compare your treatment options.
The below measuresmay prevent, or at least reduce, episodes of bedwetting.
Drinking too much or too little can contribute tobedwetting. Ensuring your child gets the right amount of fluid each day is often recommended.
Although the amount of fluid your child needs can vary depending on things like how physically active they areand their diet, there are some general recommendations for daily fluid intake. These are:
However, its important to remember that these are just guidelines and many children don't drink this much.
As well as the quantity, timing is also important. Most of the recommended fluid intake should be consumed during the day, with only about a fifth during the evening.
Also, encourage your child to avoid drinks that contain caffeine, such as cola, tea, coffee or hot chocolate, because these increase the need to urinate during the night.
Encourage your child to go to the toilet regularly during the day. Most healthy children urinate between four and seven times a day. You should also make sure your child urinates before going to bed and has easy access to a toilet.
Many parents find reward schemes helpful in managing bedwetting. This is because motivating your child can help bedwetting treatments be more effective.
However, it's important to emphasise that these are only effective when they promote positive behaviour rather than punishing negative behaviour.
Bedwetting is something your child can't control, so rewards shouldn't be based on whether they wet the bed or not. Instead, you may want to give rewards for:
It's important not topunish your child or withdraw previously agreed treats if they wet the bed. Punishing a child is often counterproductive as it places them under greater stress and anxiety, which could contribute to bedwetting.
If you have tried using a reward scheme to improve your childs bedwetting and it hasn't been effective, there's little point continuing it as it's unlikely to be helpful.
If the above measures don't help, a bedwetting alarm is usually the next step.
A bedwetting alarm consists of a small sensor and an alarm. The sensor is attached to your childs underwear and the alarm is worn on the pyjamas. If the sensor starts to get wet, it sets off the alarm. Vibrating alarms are also available for children who have impaired hearing.
Bedwetting alarms are not prescribed on the NHS, but you may be able to borrow one from your local clinical commissioning group (CCG). Otherwise, they're available to buy. For example, an organisation called Education and Resources for Improving Childhood Continence (ERIC) sells alarmsfor around 40 to 140, depending on the type of alarm.
Over time, the alarm should help your child to recognisewhen they need to peeand wake up to go to the toilet.
Reward systems to promote good behaviour may help, such as getting up when the alarm sounds and remembering to reset the alarm. It also helps to make it as easy as possible for your child to go to thetoilet during the night, such as using night lights.
The alarm will usually be used for at least four weeks. If there are signs of improvement by this point, the treatment will continue. If there's no sign of improvement, treatment is usually withdrawn as it's unlikely to work for your child.
The aim of the alarm is achieve at least two weeks of uninterrupted dry nights. If there's some improvement after three months,but no sign of this goal being achievable, alternative treatments are usually recommended (see below).
Bedwetting alarms require commitment from both children and parents. There may be some situations where they're not suitable. For example, if:
Some children and their parents may also not like the idea of using an alarm to signify when the child has wet the bed.
If a bedwetting alarm doesn't help or isn't suitable, treatment with medication is usually recommended. The three main medicines used are described below.
Desmopressin is a synthetic (man-made) version of the hormone that regulates the production of urine, called vasopressin. Ithelps toreduce the amount of urine produced by the kidneys.
Desmopressin can be used:
Desmopressin should be taken just before your child goes tobed.
The medication reduces the amount of urine your child produces and makes it harder for their body to deal with excess fluid. Therefore, it's important they don't drink from an hour before taking desmopressin, until eight hours after. If your child drinks too much fluid during this time, it could cause a fluid overload, leading to unpleasant symptoms such as headache and sickness.
If your child isn't completely dry after one to two weeks of taking desmopressin, inform your GP becausethe dosage may need to be increased.
Your childs treatment should be reviewed after four weeks. If the bedwetting has improved, it's usually recommended that treatment continues for another three months, although your doctor may advisetaking desmopressin earlier each night (1-2 hours before bedtime). If there is continuing improvement during this time, the course may continue.
If bedwetting stops while taking desmopressin, the medication is reduced gradually to see if your child can staydry without taking it.
Ifdesmopressin or a bedwetting alarm doesn't work, you will be referred to a specialist.
Another option is to use a combination of desmopressin and an additional medication known as an anticholinergic. An anticholinergic called oxybutynin can beused to treat bedwetting.
Oxybutynin works by relaxing the muscles of the bladder, whichcan help improveits capacity and reduce the urge to pass urine during the night.
Side effects of oxybutynin include feeling sick, dry mouth, headache, Constipation or diarrhoea . These should improve after a few days once your childs body gets used to the medication. If they persist or get worse, contact the doctorin charge of your childs care for advice.
If the abovetreatments don't work, a prescribed medication called imipramine may be recommended.
Imipramine also relaxes the muscles of the bladder, increasing its capacity and reducing the urge to urinate.
Side effects of imipramine include dizziness, dry mouth, headache, and increased appetite. These should improve once your childs body gets used to the medication. It's important that your child doesn't suddenly stop taking imipramine because it can lead to withdrawal symptoms such as feeling and being sick, anxiety and difficulties sleeping ( insomnia ).
Treatment shouldbe reviewed after three months. Once it's felt your child no longer needs to take imipramine, the dosage can be gradually reduced before the medication isstopped completely.
It can be easy for experts to advise parents to remain calm and supportive if their child is bedwetting, but in reality it can be a difficult condition to live with.
While it'simportant never to blame or punish your child, it's also perfectly normal to feel frustrated.
You should tell your GP if you feel you need support, particularly if you're finding it difficult to cope.
You may also find it useful to talk to other parents who have been affected by bedwetting. Education and Resources for Improving Childhood Continence (ERIC) has a message board for parents .
Theadvice below may help you and your child cope better with bedwetting:
Bedwetting can be worrying and frustrating, but it's common for children to accidentally wet the bed during the night. The problem usually resolves in time.
Bedwetting is usually only regarded as a medical issue when it occurs in children who are five years old or older and who wet the bed at least twice a week.
Bedwetting is not your child's fault and there's often no obvious reason why it happens. In many cases, the problem runs in families.
It's likely your GP will ask you or your child about their bedwetting in order to check for any underlying cause and help determine the most effective treatment.
Although most children will stop wetting the bed as they get older, there are a number of treatments that can be tried.