4 Year-old Wetting Bed at Night Again

Bedwetting is a problem for many schoolhouse-age children and their families. The good news is that for many children the trouble will resolve itself over fourth dimension, or can be fixed through adequately simple handling.

Bedwetting (also chosen nocturnal enuresis) is very common. As the following graph shows, almost a third of four-year-olds wet the bed. Past the fourth dimension they are six, simply one in 10 children wet the bed, and ane in 20 by age x. Bedwetting can sometimes keep into adolescence.

Percentage of children who wet the bed at different ages

bed wetting graph

Most children have no lasting issues from bedwetting; however, many volition experience embarrassed or ashamed. It is important to reassure your child that they are not the merely i who wets their bed. For younger children, there will most likely be many other bedwetters in the same course at school.

It is common for children to get dry at nighttime for a while and so to first wetting their bed again.

What causes bedwetting?

While not all causes of bedwetting are known, some of the possible factors are:

genetic trend (bedwetting tends to run in families; if 1 or both parents wet the bed when they were children, and so it is quite probable their children will be bedwetters)
a smallish bladder capacity
the kid is a deep sleeper
the kid's kidneys proceed to produce a lot of urine at dark (usually, people make less urine when they are asleep)
constipation (if constipation is causing your child to wet the bed, treating the constipation volition help your child to stay dry at night. Come across our fact sheet Constipation)

In some rare cases, there may be a medical trouble that is the cause of the child's bedwetting.

Bedwetting is not often a behavioural problem and children rarely do it for attention. It is far more probable that they accept fiddling control or awareness when they are having accidents overnight.

When to see a doctor

You may wish to see a medico well-nigh your child's bedwetting if:

your child is at least seven years old (handling for bedwetting is not recommended before this age every bit treatment is less constructive and many children get meliorate on their own)
y'all or your child are troubled or frustrated by the bedwetting
yous punish, or are concerned that yous might punish, your kid for wetting the bed
your kid wets or has bowel movements in their pants during the daytime

If your child has been dry at night for six months then begins to wet their bed over again, it is of import to see a dr. for evaluation.

The doctor will consider your child's details and determine if there is a concrete trouble that needs to exist addressed.

Treatment for bedwetting

Motivation

Most children don't need rewards to motivate them to have part in treatment – the prospect of a regular dry bed is usually enough.

It can be helpful to proceed a record nautical chart of wet and dry nights. Your child should brand the chart themselves and choose how to complete it. Some children like to put stars or stickers on for dry nights, or to colour it in or draw pictures. Choose something that fits in with your child's interests, for instance, football stickers. Charts used on their own usually accept little success, but in combination with other treatments they can be very useful.

Drinking fluids

It is of import for your child to drink enough of fluids spread evenly throughout the solar day. Don't try to restrict the amount of fluid your child drinks in the evening, every bit this will not aid and tin can fifty-fifty delay the process of being dry out at night. All the same, don't requite drinks containing caffeine (coffee, tea, hot chocolate, caffeinated soft-drinks like cola etc.) late at dark.

Bedwetting alarms

Bedwetting alarms are idea to be the well-nigh useful and successful first-pace to treat bedwetting. Inquiry has shown these alarms will assistance 80 per cent of children to go dry, and most children will then stay dry. Children using alarms are less probable to relapse compared to children taking medication.

A child using a bedwetting alert needs a supportive and helpful family equally it may take six to eight weeks to piece of work.

There are 2 types of bedwetting alarms - Bong and Pad Alarm and Personal (body-worn) alarm. The bell and pad alarm tin be hired through RCH Enuresis clinic.

Bong and Pad Warning Video

Personal Alarm Video

Bell and pad alarm instructions

Bedwetting alarms are bachelor for hire or can be purchased. A rubber mat is placed in the bed under where the child's bottom will be, and is connected past a wire to a box with a battery-powered warning bell. Others accept a smaller sensor that attaches to a child's underwear. These systems operate at low voltage and there is no risk to your child.

If using a mat, it should be placed on the bed on height of the lesser canvas and should be covered with a slice of thin material (e.g. an quondam sheet that has been cut upwards) just big enough to cover the mat and long enough to tuck in on either side of the bed.
The wires should be plugged into the box, which should and so exist placed every bit far away from the bed as the wire will allow.
When going to bed, your child should switch on the alarm and go into bed. It is best if they only wear a pyjama top and underpants, rather than pyjama trousers or a long nightdress.
When your child wets the bed, a loud warning volition sound. Your child should get out of bed every bit quickly as possible, turn off the warning and go to the toilet to finish emptying their bladder. Then your child should dry out the mat using the piece of material, put a new piece of fabric over the mat, plough the warning back on and go back into bed. Yous may take to help your child with some of this, at to the lowest degree for the first few nights and peculiarly if they are a very deep sleeper.
Do the whole routine a few times with your child. You lot can apply a glass of salty water, instead of urine, to set the alarm off. Remind your kid what the routine is equally your child gets ready for bed for the start few nights.
If your child is a deep sleeper, you may accept to wake them upwards for the first few nights when the alarm sounds. Most deep sleepers will become used to waking to the sound of the alarm. Your job is only to wake your child – they must do the residue themselves.
Inside a week or two your child should outset to have some dry nights. This may happen because they wake upward and go to the toilet before wetting the bed, or considering they learn to concur on all night.
If your child has seven dry nights in a row, try giving some extra fluid to drink in the evening. This is called 'overlearning'.
If your kid has 14 dry nights in a row, attempt leaving the mat on the bed but without the warning switched on and see what happens. If dry nights continue, effort leaving the mat off the bed all together.

Medications

Almost children with bedwetting do not need to take medication, but there are some occasions when it can be useful. Your doctor tin advise y'all if this treatment is suitable for your child.

DDAVP (also called Minirin) is a medicine that helps a kid'due south body make less urine at nighttime. Information technology will reduce the likelihood of your child'due south float overfilling during slumber.

DDAVP is usually reserved for children who have not go dry out after using a bedwetting alarm – sometimes the two treatments are and then given together. Some children use the medication for sleepovers or school camps.

It is safety to uses DDAVP, provided you never exceed the recommended dose, and you avoid excessive fluid intake in the evening after dinner. Be careful to follow the instructions provided with the medication.

DDAVP can work apace. Some children volition exist dry after the showtime nighttime. Many doctors recommend using DDAVP for three months, followed by a tapering off menses to determine if your child can stay dry without medication. Some children volition resume bedwetting when the drug is withdrawn. If your kid becomes wet again, your physician may ask y'all to restart DDAVP and try to finish it over again every few months to run into whether your kid all the same needs it to stay dry.

General tips

Regardless of which treatment you will be using with your child, at that place are some general strategies that are useful throughout the handling procedure.

It is very of import to be patient and to encourage your kid. Punishing or making fun of your child for wetting the bed will but make the situation worse – brand sure siblings understand this as well.
Your child needs to be very involved in the treatment plan if it is to piece of work. Be very positive on the good nights, and attempt not to exist negative on the bad ones.
If you are putting your kid in a nappy or pull-up at nighttime to relieve on laundry, information technology is unlikely that they volition become dry while this continues. Nappies or pull-ups cannot be worn while using a bedwetting alarm.
You might similar to utilise some course of protection for the bed while waiting for your child to stop wetting. A variety of pads and covers are available to protect the bed and pillow, and there are underwear pads that tin can exist used for certain occasions (east.g. school camps, holidays, sleepovers).

Key points to remember

Bedwetting is very common
Most children have no lasting problems from bedwetting
Family members of children who moisture the bed need to exist supportive and non critical
Bedwetting alarms are considered the virtually successful first pace to treat bedwetting. Medication is an choice if alarms have non helped

For more data

Meet your GP
Bell and Pad Alarm Video - From moisture to dry, lets give it a try
Personal Alarm Video - From wet to dry, lets give it a attempt
Dr Margie: How tin you help your child with their bed wetting?
Bedwetting alarms can exist hired from The Imperial Children's Infirmary. You will need a referral from your GP to access these
See The Continence Foundation of Australia website for communication on bedwetting and to find providers of products such as bed protectors and pads or underwear
David's Secret Soccer Goals is a book for children who moisture the bed, which is designed to be easily read lone by children age seven and above. Search online or ask your local volume shop

Mutual questions our doctors are asked

When will my child abound out of bedwetting?

All children develop at different rates, and some children may wet their bed occasionally until the age of seven or eight. If this is happening regularly, encounter your GP. If your kid is over half-dozen years old and bedwetting is causing issues for them (or for you), take them to the GP, particularly if they were previously dry out overnight.

My child has school army camp coming upwards. How can I stop him bedwetting at camp?

You lot could start using a bedwetting alarm for ii months before camp to help your child terminate bedwetting – it may take six to 8 weeks to work for your child. If that doesn't work, your GP may exist able to prescribe DDAVP for your child to utilize on school camp. If yous don't wish to use medication, you may similar to endeavour underwear pads for camp.

Adult by The Majestic Children's Hospital General Medicine section. We acknowledge the input of RCH consumers and carers.

Reviewed July 2020.

Kids Health Info is supported past The Royal Children's Infirmary Foundation. To donate, visit www.rchfoundation.org.au.

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Source: https://www.rch.org.au/kidsinfo/fact_sheets/Bedwetting/