Despite how common it is, bed-wetting remains largely misunderstood and for many families, it’s a quiet source of stress, shame and frustration.
A South African study found that 16% of children aged between 5 and 10 wet the bed, with the condition occurring twice as often in boys than in girls.
Yet even with numbers like these, many parents are reluctant to seek help due to the social stigma attached. Dr Andrew Ferreirinha, a paediatrician at Mediclinic Kloof gives some advice.
Understanding bed-wetting
First off, bed-wetting is not something children do on purpose – it is unintentional and usually happens because:
- their brain and bladder are still learning to communicate during sleep;
- they are deep sleepers who don’t wake up when their bladder is full.
The condition is medically divided in two main categories:
- Monosymptomatic enuresis, which refers to nighttime bed-wetting only
- Non-monosymptomatic enuresis, which includes both night and daytime symptoms. Daytime wetting is less common and more likely to be linked to underlying medical issues, which should be investigated by a doctor.
It can also be classified as primary (the child has never had a prolonged dry period) or secondary (bed-wetting returns after at least six months of dryness).
Why does it happen?
There are many possible reasons for bed-wetting, including delayed bladder maturity, sleep disturbances, and hormonal imbalances.
Other contributing factors include stress, constipation, urinary tract infections (UTIs), anatomical abnormalities, and – more rarely – neurological conditions that interfere with the signalling between the brain and bladder. You, as the parent, also have a part to play from a genetic point of view, as your child has a 50% chance of bed-wetting if one of the parents did the same when they were growing up, and an almost 75% chance if both parents had the condition.
The psychological toll
As bed-wetting is poorly understood and socially taboo, it often has psychological consequences that go beyond the physical. Children may feel embarrassed or ashamed, leading to low self-esteem, anxiety and even social withdrawal – particularly if they avoid sleepovers or camps out of fear.
Is there a cure?
Most children eventually outgrow bed-wetting, but there are several management options to help the process along – starting with a visit to a healthcare professional to rule out underlying health issues.
Additional non-pharmacological methods can also include:
- Scheduled toilet breaks during the day and before bed.
- Avoiding caffeine, fizzy drinks and colourants.
- Creating a comfortable and child-appropriate toilet environment.
- Encouraging children to use school toilets when needed.
- Avoiding lifting or waking the child at night.
- Not removing nappies until dry nights are consistent.
Some cases, however, may also benefit from the use of medication. The most common is desmopressin (DDAVP), a synthetic version of the antidiuretic hormone that reduces urine production overnight. For children with an overactive bladder, anticholinergic medications may also be considered, although these are not used as first-line treatment.
