How to manage bedwetting in children?

Bedwetting, or nocturnal enuresis, is more common than you might think. In most children, these little accidents gradually disappear before the age of 5. But in some, it can persist a little longer. It's not a medical problem, but that doesn't stop it from being distressing for parents and embarrassing or shameful for children. In this article, we explain what can cause bedwetting and what to do to manage this phase of your child's life.

What is bedwetting or nocturnal enuresis?

The term "enuresis" refers to involuntary and unconscious urination (the act of urinating). This can occur during the day (diurnal enuresis) or, more commonly, at night. In the latter case, it is called nocturnal enuresis or, more commonly, bedwetting. You can probably picture this scene: your child looking sheepish, pajamas and bed sheets wet in the morning upon waking. While it's never fun, it doesn't mean your efforts to potty train them have been in vain or that your child has a problem: although unpleasant, it's a perfectly normal phenomenon. Fortunately, there are many ways to limit or prevent these little nighttime accidents, the best approach being to be patient and understanding (it's not your child's fault) and to implement solutions.

Did you know that bedwetting is more common than you think?

• Bedwetting, sometimes called nocturnal enuresis, or simply enuresis, is a common problem in children. It occurs in approximately 30% of children between the ages of 4 and 8. It is estimated that it affects around 750,000 children in France.

So why don't we talk about it more often?

• Although it's an experience shared by many families, the taboo surrounding bedwetting persists. In fact, according to one study, nearly four out of five parents (79%) in the UK believe there's a taboo surrounding bedwetting.

It is interesting to note that more than one in ten parents (13%) whose child wets the bed do not feel comfortable talking to anyone about it, and only half (47%) would seek advice from someone (friends, family or health professional).

Half (49%) of parents of children aged 5 to 7 who wet the bed feel helpless. 51% of them also say they are worried or stressed about their child's bedwetting.

According to a study, two-thirds of parents surveyed in the UK said their child felt upset (61%) or embarrassed (60%) about wetting the bed.

It's time to break the taboo surrounding bedwetting! By talking more openly…

• With disposable and absorbent underwear , we want to help break the taboo of bedwetting, because we know that the majority of parents (85%) would like people to talk more openly about bedwetting and that two-thirds (64%) of parents say there is not enough information available about bedwetting.

The causes of bedwetting (nocturnal enuresis)

• The mechanisms of nocturnal enuresis (bedwetting) are not fully understood. It seems that children need time to learn to control their bladder at night, that is, to control their nervous system and muscles and unconsciously suppress the urge to urinate associated with a full bladder. This is not at all a voluntary phenomenon on the part of your child, but rather something unconscious and uncontrolled.

Your child may wet the bed for several reasons, including:

• He is a deep sleeper and has difficulty waking up even when his bladder is full.
• He has a small bladder or one that is not yet developed enough to hold urine all night.
• He may not have learned to hold it in and release it yet (communication between brain and bladder is not perfect).
• He produces too much urine at night because of a deficiency in antidiuretic hormone, whose role is to slow down this production.
• He may be constipated, which creates pressure on the bladder and can cause nocturnal enuresis.
• He is too tired.
• He is suffering from a medical problem such as diabetes or a urinary tract infection.
• He is disturbed by an upheaval in his life, for example the arrival of a new baby in the family, a move, or a divorce.
• There is a family history of bedwetting.
• He has sleep apnea (he stops breathing while he sleeps), which can increase the risk of bedwetting.
• He is hyperactive with attention deficit, which increases the risk of bedwetting.
• Your child may wet the bed for many reasons, including a not fully mature bladder, an inability to hold it, sleeping too deeply, producing too much urine at night, constipation that compresses the bladder, emotional disturbances, or a medical problem.

What to do when your child wets the bed?

• Reassure and support your child
• Remember, this isn't your child's fault. Children develop at different paces and need your support when they're upset. Reassure your child and help them through this difficult time.
• Keep an eye on his routine
• Pay attention to your child's toilet habits. You can encourage your child to avoid large amounts of liquid before bedtime (without dehydrating them, of course) and make sure they drink earlier in the day. Another tip is to encourage your child to go to the toilet 20 minutes before bedtime, and then again just before falling asleep.
• Make him responsible by requiring him to take care of his bed in case of an accident.
  
• Don't be afraid to talk to your child, understand what they're feeling, and how you can support them. Reassure them that you're there to help. Also, make sure the path to the toilet is easy and well-lit. You can use a potty in the bedroom if that's easier.
• Be prepared: Changing sheets, duvet covers, and bedding during the night can be frustrating. You can prepare for accidents with nighttime protective underwear, which reassures both children and parents and gives them confidence. While nighttime underwear isn't a magic solution to your child's bedwetting, it's very practical because you don't have to worry about washing the sheets every morning.
• You can always talk to a healthcare professional you trust, such as your general practitioner or pediatrician. They will be able to reassure you and give you personalized advice on how best to support your child going through a phase of bedwetting.

To manage bedwetting effectively, it's important not to scold your child or shame them for this nighttime occurrence. Remain calm and help them understand that it's an accident, that all children wet the bed, and that it will stop as they grow up.

Consult your healthcare professional if you notice any changes in the amount or color of your child's urine, if they continue to urinate even after finishing, if they experience pain or burning when urinating, etc. Also consult if they have redness in their genital area, difficulty controlling their bowel movements, mood changes, or involuntary bedwetting and daytime urination.

Talk to your healthcare professional about it

If your child is over 5 years old and continues to experience bedwetting despite following the advice in this article, consult your healthcare professional. They can ask you questions about the bedwetting to determine if it's related to stress, a family history of bedwetting, drinking too much water or eating salty foods, or if your child's urine shows any abnormalities.

Medical tests related to bedwetting (nocturnal enuresis)

In some cases, your healthcare provider may need to run some tests to identify the cause of the bedwetting. If they suspect a urinary tract infection, they may order urine tests and prescribe antibiotics. They may also order an X-ray of the bladder or kidneys if they suspect developmental problems.

Treatment for bedwetting or nocturnal enuresis

Your healthcare provider will likely advise you to simply limit your child's fluid intake in the two hours before bedtime, or something similar. If your child is constipated, specific treatment may be necessary.

• Bedwetting Alarms or Detectors: If you feel like you've tried everything but your child still wets the bed at night, here's a solution worth trying: a bedwetting alarm. This usually consists of an alarm attached to the mattress or mattress protector and a sensor placed in the child's underwear. As soon as the alarm detects that the underwear or sheets are wet, it wakes your child, who, upon waking, regains control of their bladder and prevents themselves from urinating. However, it's possible that your child may not hear the alarm, and the risk of bedwetting may not disappear completely. Nevertheless, the method seems to be quite successful in helping children wake up and go to the toilet when they need to urinate in the middle of the night.
• Medications: Some medications can also be useful in slightly older children, but their effectiveness varies.

If your child continues to wet the bed after age 5, talk to your healthcare provider. This doesn't necessarily mean your child has a problem, but some tests may still be necessary to rule out any medical issues. Your healthcare provider may also advise you on using a bedwetting alarm or medication, if needed.

Bedwetting happens to just about everyone , including you yourself when you were that age! It's very common for children between the ages of 2 and 4 to experience bedwetting (both daytime and nighttime) while they're potty training. For most children, this disappears around age 5, but it persists in a minority. There are many factors that can cause a child to wet the bed: a small bladder, stress, or even a medical problem. If your child wets the bed, don't scold them, but rather be understanding: after all, it's not their fault.

Cover the mattress with a waterproof mattress protector to prevent future accidents, encourage your child to use the toilet before bed, and limit their fluid intake for an hour or two before bedtime. If you are concerned about your child wetting the bed, consult your healthcare professional. They can perform tests to rule out any medical issues or prescribe treatment or a device to help manage bedwetting.

Be patient: the problem will disappear on its own after a while.