Dr Catherine
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4-7 years

Hi N.G., managing children’s bedwetting can be incredibly tricky, partly because we often do not understand the underlying cause and partly because there are so many mixed messages out there about how best to proceed. It is often helpful to keep in mind nighttime wetting is mostly unconscious and therefore the kinds of techniques we used in training children during the day do not apply to the nighttime situation. Nighttime wetting at this age is considered to be perfectly normal, with about 15-20% of children continuing to wet at night up to the age of 7 years. It is not unusual for parents to comment on how soundly their child sleeps (even not waking when they wet); while deep sleeping is not a direct cause of bedwetting it certainly makes it more difficult for children to wake in response to a full bladder. The best approach to the treatment of children’s bedwetting is the conditioning alarm. Bedwetting alarms work by setting off an alarm when your son starts to wet, waking him up so that he gets up and goes to the toilet. Over a period of time this conditions the body into recognizing the signs of a full bladder, your son will eventually learn to wake on his own without the need for the alarm. The success of the alarm does depend on how motivated children are to become dry which is why doctors often don’t recommend their use with younger children. Do get him to empty his bladder fully just before going to bed, however with respect to nighttime waking - we know that lifting or taking children to the toilet during the night is really a form of management and does little in the way of helping children to stop wetting the bed, and can at times prolong the bedwetting process. Children continue to wet the bed at night until they either learn to wake or their bladder learns to hold onto the amount of urine their kidneys produce. Lifting at night means children do not get the chance to get used to the signals that the bladder sends to the brain telling them to wake-up and empty their bladder nor does the bladder have the opportunity to stretch and develop. The good news is that most children your sons age will outgrow bedwetting on their own, if however it starts to become a significant issue for either you or him then I would certainly recommend you speak with your GP about introducing more formal measures to help him to stop. Regards, Dr Cathrine