You can’t help but be extra proud when you get potty training down pat with your child. No more bringing diapers and changing wet or soiled nappies on the go! It’s also financially liberating to be done with diapers as well. So, it can be frustrating when, after weeks or months of bliss with your potty-trained toddler, he starts to wet the bed again.
Bed-wetting is a normal part of a child’s development. According to HealthyChildren.org, a parent resource backed by the American Academy of Pediatrics (AAP), most children are toilet trained between age 2 and 4, but some may not be able to stay dry throughout the night until they are older.
The medical term for bed-wetting is nocturnal enuresis, according to the U.S. National Sleep Foundation. It is most common within six months to a year after toilet training, and it is expected to pass.
Doctors don’t know for sure what causes bed-wetting and typically categorizes it as a result of the body’s immaturity. Your child’s bladder may be small or not yet developed enough to hold urine for a full night, or he has not yet learned how to hold and empty urine well. The AAP explains it as a still-developing communication between the bladder and the brain. Most kids who wet themselves eventually resolve itself as they learn to control their bladder.
The reasons typically associated with bed-wetting are as follows:
Your child may be in deep sleep that he doesn’t wake up when his body sends signals that he needs to empty his bladder.
Your child’s body is not getting enough of a hormone that decreases urine flow at night to limit trips to the bathroom.
Your family has a history of bed-wetting. Many kids who had problems with bed-wetting have at least one parent or relative who had similar incidents as a child, the AAP explains. If both parents wet the bed when they were young, it’s more likely their child will do, too.
Your child has been feeling under the weather, overly tired, or having difficulty adjusting to significant life changes or stress going on at home or in school
Your child is constipated. Full bowels can put pressure on the bladder and lead to problems with holding and emptying urine well. This could also be an adverse effect of issues with potty training or a long history of constipation that went unrecognized and untreated.
Your child may have underlying medical problems, such as urinary tract infection (UTI), obstruction of the urinary tract, among others.
“The age at which children become able to control their bladders during sleep is variable. Bladder control is a complex process that involves coordinated action of the muscles, nerves, spinal cord, and brain,” explains the U.S. National Sleep Foundation. There are many things you can do to guide your child on bladder control and prevent bed-wetting.
1. Don’t make a big deal if your child wets the bed.
Treat it like any potty training incident. “Never be angry with or punish your child because he or she is not doing it deliberately,” Dr. Susan Bolante-Kapalungan, M.D., told Smart Parenting. Reassure your child that wetting the bed is something that happens typically to kids, and it’s not his fault!
2. Protect the bed.
Place a plastic sheet to protect his bed mattress from getting wet and keep bacteria that can cause skin infections from thriving. It can also help keep urine odor at bay. You can also try bed-wetting alarms (available in online stores such as Lazada and Shoppee). It’s a contraption that you strap onto your child and lets you know if he's wet the bed and lets you change the sheets urgently.
3. Check your kid’s bedtime routine.
Make sure your child doesn’t drink a lot of liquids at least two hours before bedtime. Let him empty his bladder before settling into bed. Some parents opt to gently rouse their child in the middle of the night to pee.
4. Let your child help clean up.
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Learning and helping how to change sheets can motivate your child to be more responsible and better at controlling his bladder. But don’t make your child feel like he’s being punished for bed-wetting. Instruct him to wake up and go to the bathroom to pee when he feels any dampness on his bed.
While it’s typical for 4- to 6-year-olds to still wet the bed once in a month, keep a lookout for other symptoms that may indicate other problems. The doctor may check for signs of a UTI, constipation, bladder problems, diabetes, or severe stress. Alert your child’s pediatrician if your child’s bed-wetting is accompanied by the following symptoms:
Your child has been potty trained for six months to a year and then suddenly begins to wet the bed again.
Your child is aged 7 years old or older and still wets the bed once to thrice monthly.
Your child starts bed-wetting during the daytime as well.
You notice some changes in how often or how much your child urinates daily, either going to the bathroom more often due to an irritated bladder or holding off peeing because it hurts.
Your child’s genital area has some redness or rashes.
After urinating, your child experiences dribbles (when a little urine leaks after he is supposedly done peeing)
Your child complains of a painful or burning sensation while peeing or is straining while urinating.
Your child has poor bowel control, or he pees a little (a.k.a. incontinence) while coughing, running, or heavy lifting objects.
You notice that your child urine has an unusual odor, color (cloudy or pink) or his underwear has bloodstains on it.
You child exhibits other possible signs of infection such as fever, swelling, or vomiting.
Your child is having issues with gait or walking.
Your child displays a sudden change in personality or mood.
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Your child’s pediatrician may refer your child to a urologist to determine any other underlying factors that contribute to his bed-wetting incidents. In some cases, the urologist may prescribe medication to kids who are above 7 years old when different strategies fail. These medication work by helping the bladder hold more urine or by lessening the production of urine at night. The doctor may also instruct you to help your child do bladder training exercises to help him hold his pee a little longer.