children and bedwetting

by Diane K. Newman, RNC, MSN, CRNP, FAAN

Overview & Prevalence of Bedwetting

Bedwetting (voiding while asleep) is a condition that affects 5-7 million children over the age of six. Often parents are too uncomfortable or embarrassed to discuss their child's bedwetting as they feel it may reflect on them as a parent. Also, children are ashamed or embarrassed by the problem and are fearful that friends will learn about it.

Children who wet the bed rank bedwetting as the third most stressful life event after parents' divorce and fighting. It is important for parents and children to understand that bedwetting resolves at a rate of 15 percent per year, so most children will outgrow it.

Statistics show that twenty percent of four-year-olds still wet the bed, but ten to fifteen percent of these children stop bed-wetting each year and as many as one to three percent of eighteen-year-olds still wet their bed. Studies show a strong family history of bed-wetting is predictive and risk increases five to seven times for a child with one parent that experienced bed-wetting in childhood.

Bedwetting (referred to as nocturnal enuresis) is defined as the involuntary passage of urine in a child age five or older in the absence of other medical conditions such as congenital defects or conditions of the nervous (brain and spinal cord) and urinary tract systems (kidneys & bladder). Ten percent of all children over age four, mostly boys, experience bedwetting, which is the most common bladder disorder seen in young people. In addition, approximately 750,000 children with such handicaps and birth defects as spina bifida or tethered cord syndrome experience ongoing bladder control problems. At least one percent of school children may have abnormal voiding habits and all forms of childhood wetting, other than bedwetting, should be categorized as bladder incontinence.

Only five to ten percent of children who suffer from enuresis are found to have a physical abnormality. Only one to three percent of adolescents over age sixteen are troubled by nocturnal enuresis. Controversy surrounds the various treatment options and most health care professionals (doctors and nurses) feel that parents should postpone medical action, at least until puberty, since most children outgrow the problem by then.

Social Consequences

Bedwetting causes social limitations for a child, especially about sleepovers with friends. Children commonly fear having their bed-wetting discovered by others and they sense being different from other children. In fact, children who bed-wet are more likely to report being bullied by other children. Parents often become frustrated and aggravated over the constant need to change bed linens and both children and parents may develop a sense of failure, which can be very painful for the child. As with incontinence in adults, bed-wetting in children is surrounded with myths and misinformation. Furthermore, health care providers seem to underestimate the impact of bedwetting on both children and families and tend to fail to assess children for it.

References

1. Berry, AK. Helping Children with Nocturnal Enuresis. AJN. 2006;106(8):58-65.

Last updated August 2006