Not-so-dry nights: How to manage bedwetting in school-aged children

Once you’ve toilet trained your child through the day, you could be fooled into thinking that the hardest part of the process is over! But it can take young children a lot longer to stay dry through the night; in fact, you may still be facing wet sheets as they start school.

Bedwetting in five to six year-old children is quite common, as Heba Shaheed can attest. A physiotherapist who specialises in women’s health and children’s pelvic health, she says, “Up to the age of five, that is kind of normal but after the age of five, there are about 20 percent of children that will experience bedwetting.”

Common causes of bedwetting

The most important part of tackling bedwetting is to identify why it’s happening in the first place.

“Is it a bladder problem? Is it a muscle or pelvic floor problem? Is it a kidney problem? What is it?” Heba questions. A common reason for bedwetting in children is that their bladder can’t hold the volume of urine the kidneys produce when they’re asleep. “During the night your bladder doesn’t actually hold much urine, but the kidneys are making lots … but there’s nothing to hold it, so then [kids] just have those accidents.”

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Surprisingly, the bowels can often be a large factor in bedwetting too.

“A lot of children, up to 25 percent of kids, can get quite constipated. When you’re constipated, there’s this blockage in your bowel and that puts pressure on the bladder … then it fills even [less] because of this pressure from the bowel,” Heba explains.

“It could also be a nerve problem. So that connection from your brain, down to your kidneys, down to your bladder and down to your pelvic floor; it’s not working very well. Children are still developing, and ideally by the age of five that system should have been developed but unfortunately, in one in five children, it’s not completely developed.”

Rest assured though, there are plenty of techniques and strategies you can try to help address these root causes.

Bedwetting treatments to try

Not all children will wet the bed every night. If the bedwetting is infrequent, once every five nights or less, it could be related to something they drank before bed. A good way to manage this is to check when and what they drink. “Usually in the three hours before bed, we advise that they don’t have any fluids,” Heba says. Or if you suspect bowel issues, it’s about fixing that in the hope of lessening the bedwetting.

Also consider their emotional state at the time, Heba recommends. “Maybe they’re scared about going to school the next day.”

When to seek professional help

If you’re experiencing more frequent bedwetting with your child, you can get help from a paediatric pelvic health physiotherapist. They can help identify the root cause with you and your child, then help find solutions.

“We sometimes have night-time alarm systems. It’s almost like a bladder drill program. They wake up and go and empty their bladder to retrain their brain and their bladder to wake up and go and wee, rather than emptying in the bed,” Heba says.

Ultimately, staying dry throughout the night may happen naturally as your child matures – but you can certainly fast-track the journey to dry sheets by working to discover the reason why your child is wetting the bed, and having a supportive team around you to help your child.