Bedwetting

Also called Nocturnal enuresis

Involuntary wetting at night. Common, not the child's fault, and punishing it does nothing except harm.

What it is

Around 1 in 12 children aged seven still wet the bed, and a small number continue into their teens.

Three things cause it, usually in combination: the kidneys producing too much urine at night, a bladder that holds less than it should, and a brain that does not wake to a full bladder. None of these is under the child's control.

It runs strongly in families. If both parents wet the bed as children, the odds are high.

Secondary bedwetting, where a dry child starts wetting again, is different and always needs a cause looked for: a urinary tract infection, constipation, diabetes, or emotional distress including abuse.

Signs you might notice

Wetting during sleep beyond the age of five, with no daytime symptoms in the common form.

Daytime urgency, frequency or wetting as well, which suggests an overactive bladder and changes the approach.

Constipation, which is present in a large proportion and is the most commonly missed treatable cause. A full bowel presses on the bladder.

Snoring and disturbed sleep, which may mean sleep apnoea.

Excessive thirst and passing large volumes, which needs diabetes excluded.

How it can affect day-to-day life

The emotional cost lands entirely on the child. Sleepovers, school trips and camps become impossible, and the shame is substantial.

Punishment, star charts for dry nights, and lifting a child to the toilet at night are all common and all counterproductive. You cannot reward somebody for something they do not control.

Parental exhaustion and washing are real burdens, and the frustration is understandable, which is exactly why families need support rather than judgement.

Supporting someone well

Treat constipation first. This alone resolves a meaningful proportion, and it is checked far too rarely.

Drink well during the day. Restricting fluid does not help and reduces bladder capacity further.

Do not punish, do not shame, and do not reward dry nights. Reward the things the child controls, like helping change the sheets.

Use waterproof bedding and keep it matter-of-fact.

Ask for an enuresis alarm, which has the best long-term evidence and works by teaching the brain to wake.

Ask about desmopressin for sleepovers and school trips specifically. Being able to go is worth a great deal to a child.

Investigate any child who was dry and has started wetting again.

Where to get help

A GP or school nurse can refer to a children's continence service. These exist in most areas.

ERIC, the children's bowel and bladder charity, run a helpline on 0808 169 9949 and are excellent.

Secondary bedwetting always needs assessment.