Wetting the bed at night is common among toddlers, especially newly potty trained children. It can be frustrating and embarrassing for children and their parents. However, it becomes less frequent in preschool and kindergarten-aged children. Bedwetting in children aged five and older (also known as nocturnal enuresis) can be an involuntary release of urine during sleep.

What is nocturnal enuresis?

Nocturnal enuresis is nighttime urinary incontinence that occurs at least twice per week in children aged five years and older. It is not a serious condition, and most children outgrow it as they develop better bladder control over time. There are two types of nocturnal enuresis:

• Primary enuresis: Occurs in children who have never consistently stayed dry at night.

• Secondary enuresis: Occurs in children who have been dry for at least six months but then begin wetting the bed again.

Primary enuresis is more common in children. If your child experiences secondary enuresis, it should be evaluated by a pediatrician, as it could be a sign of a urinary tract infection, emotional factors like stress, or another underlying health condition.

Causes of bedwetting

Below are some common reasons why your child wets the bed in the middle of the night:

• Genetic predisposition

• Delayed bladder development

• Reduced bladder capacity (small bladder)

• Sleep disorder

• Overproduction of urine

• Constipation

• Urinary tract infection

• Diabetes

• Emotional stress or anxiety  

Emotional implications of bedwetting

Wetting the bed can lead to reduced self-esteem, social withdrawal, and difficulties in interpersonal relationships. Bedwetting may also impact school performance and cause significant distress for both the child and their family. It can cause issues with sleepovers and school overnights.

Strategies to reduce bedwetting during the night

• Encouraging your child to use the bathroom at regular, scheduled intervals.

• Limit fluid intake in the evening, especially a 1 to 2 hours before bedtime

• Use bedwetting alarms, like a phone alarm or watch alarm

• Addressing the underlying conditions that may contribute to bedwetting, like treating constipation or emotional stress

• Positive reinforcement to encourage progress

• Avoid punishments that lead to upset and embarrassing conversations  

When to consult a pediatrician

Consult your local or Summer Health pediatrician is recommended if your child is older than five years and regularly wets the bed, especially if:

• Your child has trouble staying dry, especially with daytime symptoms

• Bedwetting occurs suddenly after a long period of dryness

• Your child experiences painful urination

• There are signs of an underlying medical condition, such as a urinary tract infection or diabetes

If you have questions about your child's bathroom habits or if your child has trouble staying dry, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health.