Advice and resources : Bedwetting

Overview

Nocturnal enuresis, more commonly known as bedwetting, affects approximately half a million children and teenagers in the UK. Some people can find bedwetting an embarrassing subject to talk about and this can delay the child, young person or family from seeking help.

Bedwetting can have a big impact on a child’s self-esteem and on their family life, but there are many things that can be done to improve the condition.

What you might see

Children learn not to wet the bed at varying ages; no two children are exactly the same. It’s usual for a child to stop wetting the bed by the time they are 5 years old, so from 5 onwards you can seek support from your School Nursing team or GP in addressing this problem.

Recommended toilet training should include:

• Getting your child toilet trained during the day before you start leaving their nappy/pull-ups off at night. It’s usual for most children to be reliably dry during the day between the ages of 3 and 4
• If your child's nappy is dry or only slightly damp when your child wakes for a few mornings in a row, they might be ready for night-time toilet training
• Ask your child to use the potty/toilet last thing before they go to bed and make sure it's close by so they can use it if they need to wee in the night. There are bound to be a few accidents so a waterproof sheet to protect your child's mattress is a good idea

It’s important to praise your child for success; if things aren't going well, stick with nappies/pull-ups at night for a while longer and try again in a few months.

• School Nursing Service

How you can help

Before your child sees a health professional, encourage them to get into good bladder and bowel habits:

• Make sure they poo regularly (at least four times a week) and treat any underlying constipation; this might need you to increase the amount of fibre they take in their diet – options include more fruit and vegetables per day and a high fibre cereal for breakfast
• Assess and treat daytime bladder problems first, wetting accidents or urgency for example; children can commonly ignore signals from the brain alerting them to use the toilet if they’re engrossed in playing games/watching TV
• Encourage them to drink plenty during the day - six to eight glasses of water-based fluid - but only give them a small drink before bed, if necessary; ideally, stop them drinking an hour before bedtime
• Encourage them to fully empty their bladder before they go to sleep, it can be helpful to use the toilet as part of their bed-time routine but use the toilet again just before settling to sleep to ensure their bladder is fully emptied
• Make it easier for your child to access the toilet during the night, e.g. move to the bottom bunk from the top if they share a room; having a night light and a bucket might help if they wake in the night for a wee
• It can be very frustrating for a child to not receive a reward for a dry bed when it’s something they can’t control and this can reduce motivation; instead, reward your child for drinking well during the day or for helping change wet bedding rather than for keeping their bed dry, which is beyond their conscious control
• Think positively. Get them to repeat the phrase "I can be dry!" as they get into bed; motivation is key to the child achieving dryness, support and praise from you and other members of the family can make a big difference to how quickly this can happen

When to ask for help

If you’ve consistently used all the advice given here and your child is still wetting the bed, contact your local School Nursing service for further advice and support.

Please note that services might vary in the different localities in Berkshire due to local commissioning arrangements.

• School Nursing Service

Helpful resources

• ERIC - Children's bladder and bowel charity
• NHS Choices - bedwetting