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Because bed-wetting is so common, doctors often need to reassure both parents and kids. Here are five things they'd like you to know.
1. Bed-wetting is normal and involuntary
Most parents don't chat about bed-wetting in playgroups or school pick-up lines. But it's normal and very common – the American Academy of Pediatrics says 5 million kids in the United States wet the bed. At age 7, 1 in 10 kids can't stay dry at night.
Not only is bed-wetting widespread, it's also entirely involuntary. A child who wets the bed isn't being lazy or defiant. It has to do with growth and development, not control or the lack of it.
Before your child can stay dry all night, his brain, muscles, and bladder need to mature. They have to be able to work together to produce less urine at night and to send and receive signals that are strong enough to wake him up to use the bathroom.
2. Daytime and nighttime dryness are separate milestones
Got your little one potty-trained during the day? Wonderful! But staying dry during the day and doing so at night are actually distinct developmental achievements.
If your child is successfully wearing big-kid underwear and using the potty all day, but waking up wet on a regular basis at night, you haven't failed at your toilet-training efforts. She just needs more time to reach that other stay-dry milestone.
For many kids, the time gap between day and nighttime dryness is so close that it seems like the same achievement. But it can take months – and even years – longer to stay dry at night.
3. Bed-wetting is rarely caused by a medical problem
If your child has been wetting the bed regularly since being out of diapers during the day, there's probably no medical cause for concern. But be on the lookout for changes in your child's typical pattern.
If after a long stretch of dry nights your child suddenly begins to wet the bed or has other symptoms, such as a fever or pain when urinating, check in with the doctor. Physical problems, most commonly constipation or a urinary tract infection, might be the culprit, or it may just be a temporary setback.
4. Don't punish, and be careful with rewards
Star or sticker charts for dry sheets might seem like a good idea. But because your child can't control whether or not she wets the bed, rewarding her for staying dry one night won't help her succeed the next night. It might even stress her out.
If your child likes the idea, you can reward her for things she can control, such as going to the bathroom before bed, helping you change sheets, or responding to a bed-wetting alarm if you've got one. These actions can help your child feel less helpless and more in control of the situation.
The opposite – punishment or blame for a wet bed – just makes the situation worse.
5. There's no miracle cure
These strategies can help with bed-wetting. But usually the only "cure" for bed-wetting is time.
Bed-wetting alarms: Alarms can be effective. They require a serious commitment from both you and your child, and they don't work for all kids.
Prescription drugs: There are prescription drugs that can reduce urine production, but they don't shorten the time it takes for kids to achieve nighttime dryness. They're usually not recommended until age 7, and even then, only for short-term situations such as sleepaway camp.
Adequate fluids: It's a myth that restricting fluids at night stops bed-wetting. Keeping your child hydrated throughout the day – including in the evening – is important for lots of health reasons. Among other benefits, it helps prevent constipation and urinary tract infections, common causes of bed-wetting.
Nighttime bathroom visits: Waking up your child and walking him to the bathroom to use the toilet won’t help him stay dry at night sooner, but it might reduce the number of wet sheets you have to change. Just decide if it's worth it to wake your deep sleeper – and disrupt your own sleep.