Bedwetting: how can I help my child, and when should we get help?
When a child older than five wets the bed at night, it is called bedwetting, or enuresis. It is very common and not harmful to the body, but it can knock a child's self-confidence (1177). It is not your child's fault, so never scold or punish (1177, NHS). It goes away for most children, on its own or with treatment (1177). Contact your health centre or the school health team if your child is 6–7 or older, asks for help, or starts wetting the bed after being dry (1177). A bedwetting alarm helps most children within two to three months (1177).
| Question | What applies | Source |
|---|---|---|
| How common is it? | One of the most common health problems at age 6–7. About 5–10 percent of children in the first years of school wet the bed | 1177, Rikshandboken |
| Is it my child's fault? | No. It is something the child cannot control. It also has nothing to do with how or when they stopped using nappies | 1177 |
| Does it run in families? | Often. More than half of children who wet the bed have one or two parents who did too | Rikshandboken, 1177 |
| Should we cut down on drinks in the evening? | There is no evidence that it helps, although some families feel it does. Give enough water during the day and avoid caffeine such as cola, tea and coffee | 1177, NHS |
| Does waking my child at night help? | It can mean a dry bed that night, but it does not help them stop wetting in the long run. If you do it, only once a night | 1177, NHS |
| When is treatment offered? | Usually from age 6, and younger if the child is unhappy about it and wants help | 1177 |
| Which treatment works best long term? | The bedwetting alarm. Most children are helped within two to three months if it is used every night | 1177 |
Why it happens
Bedwetting usually comes from a combination of things the child has inherited (1177):
- Too much urine at night: the body does not make enough of the hormone vasopressin at night, so the bladder fills up before morning.
- An overactive bladder: the bladder squeezes before it is full. These children often need to pee often during the day too.
- Being hard to wake: the child does not wake up when the bladder is full. This is true for very many children who wet the bed.
Constipation and urinary tract infections can also cause bedwetting, especially if it starts after a child has been dry. Diabetes or kidney disease is a very rare cause, and then the child is usually very thirsty and needs to drink at night as well (1177). 1177 says it is very unusual for worries or other psychological problems to be the cause, although the NHS lists stress at home or at school as one possible reason. Either way, bedwetting can make a child feel worse about themselves (1177).
What helps at home
- Make it clear it is not their fault. Do not scold or punish: it does not help and can make bedwetting worse (1177, NHS).
- Toilet routines: let your child pee just before bed (1177). The NHS suggests going to the toilet regularly, around 4 to 7 times a day.
- Drinks: give enough water during the day, and avoid drinks with caffeine such as cola, tea and coffee, as they can make children pee more (NHS).
- Be ready for the night: use waterproof covers on the mattress and duvet (NHS), and have clean pyjamas and dry sheets ready so changing in the middle of the night is easier (1177). A night light can make it easier for your child to get up and go to the toilet (Rikshandboken).
- Praise what they can do: agree on rewards for things your child can control, such as a sticker for using the toilet before bed (NHS).
- Sheet protectors from healthcare: a district nurse or a urotherapist can prescribe aids such as sheet protectors for children over five who have been diagnosed with bedwetting. What you can get varies between regions (1177).
What to say to your child
Older children can find bedwetting embarrassing and worry that friends will tease them, and the older the child, the bigger the risk of shame and lower self-confidence (1177). 1177 suggests telling your child things like:
- You cannot help that you wet the bed, and you do not need to be ashamed.
- There is nothing wrong with you.
- You are not alone: there are probably one or two other children in your class with the same problem, even if you do not know who they are.
- There is good help for getting rid of it.
It is important that bedwetting does not stop your child from doing things. For sleepovers or camps, night pants can be a temporary solution if your child wants that, or you can send extra sheets or a spare sleeping bag. Prepare your child and the adult in charge (1177).
Alarm and medicine
Treatment works best when your child wants it. Do not nag a child who does not want help yet, as that can make it more shameful; talk to understand why instead (1177). The two main treatments are (1177):
- Bedwetting alarm: a small sensor in the underwear sends a signal to an alarm clock when the child starts to pee. Over time the child learns to recognise a full bladder. Use it every night for at least two months; most children are helped within two to three months, and it has no side effects. Many children do not wake to the alarm at first, so a parent needs to sleep nearby and help. Start during a calm period, and if the alarm frightens your child, stop and try again in about six months.
- Medicine (desmopressin): a prescription tablet that melts under the tongue and reduces how much urine is made at night. It is taken 30–60 minutes before bed, and afterwards the child should drink no more than a small glass. It can be used regularly or just for sleepovers, but bedwetting often comes back when the child stops. Drinking a lot in the hours before taking it can cause a rare but serious side effect (water intoxication), so follow the instructions you are given.
The alarm is usually tried first because it more often makes the bedwetting go away for good. If neither treatment helps, your child should be referred to a paediatrician (1177).
Try this week
- Put clean pyjamas, a towel and a dry sheet by the bed, so a night-time change takes two minutes and no one needs to fuss.
- Choose a calm moment and tell your child: "It is not your fault, lots of children have this, and there is good help."
- Check the day: enough water, no cola or tea in the evening, and a toilet visit right before bed.
When to get help
Contact your health centre or the school health team if your child wets the bed and is 6–7 years or older, asks for help themselves, or starts wetting the bed after being dry (1177). The NHS gives a similar time frame: being dry for more than 6 months before it started again. Seek care even if your child does not want to if they also need to drink at night, have to strain to pee, or feel sick and are losing weight, although this is unusual (1177). Call 1177 for medical advice or help finding the right clinic. Outside Sweden, contact your doctor or school nurse (NHS). See also how much sleep children need.
This guide is general information, not medical advice for your child.