Time To Take Action: World Bedwetting Day 2021

For World Bedwetting Day 2021 Bladder & Bowel UK are releasing a series of blogs to help increase understanding of a problem that is not often discussed, but causes stress and distress throughout the world to children, young people, and their families as well as some adults. Here, we discuss some treatment options for bedwetting.

Treatment for bedwetting

Bedwetting (enuresis) is a recognized as a medical condition in children who are at least five years old and have been toilet trained during the day for six months.  It has a number of different causes. These include not waking up to bladder signals, producing too much urine at night (because the child is not able to make enough vasopressin – a chemical messenger that tells the kidneys to make less urine during sleep), and problems affecting how much urine the bladder can hold. Other factors include constipation, what, when and how much your child drinks, and eating just before going to bed.

Why it is important to treat bedwetting

Children who wet the bed usually sleep through their bladder emptying. However, many of them do have disturbed or restless sleep, which can make them more tired than their peers during the day.  This can affect their behaviour and how they perform at school.  Some children who are wet at night are more anxious about having sleep overs or going on overnight trips with clubs or school.  Some children get upset about wetting the bed.

Things to try at home to help with bedwetting

Most primary aged children should be drinking about 1.5litres of water-based drinks a day.  They should have more than this if they are overweight, very active or if the weather or their environment is hot.  Secondary aged girls should be drinking about 1.5 – 2.5litres a day and boys should have about 2.5 – 3litres a day.

Fizzy drinks and drinks containing caffeine can irritate the bladder lining and so should be avoided.

Drinks and food, particularly those high in protein or salt, just before bed can increase the likelihood of wetting. These should be avoided in the last hour before bed.

Going to the toilet just before sleep and having a consistent bedtime routine can also help.  You can also have a trial for a few nights without disposable pull up pants or nappies, if these are used.

What if these things don’t help?

If you have tried or cannot manage the things mentioned above and the wetting continues, then talk to your child’s healthcare professional.  They should be able to offer an assessment and be able to discuss options for treatment of bedwetting.

The treatment chosen will depend partly on the outcome of the assessment and partly on what you and your child feels is likely to be the best option for you.

The first treatments offered are usually either an alarm or a medication called Desmopressin.

Alarms for bedwetting

Alarms are designed to make a noise and wake your child as soon as your child starts to wet. The child would then get up and go to the toilet before settling back to sleep. Alarms are most effective in children whose bladders are working well and who are able and willing to work with them.

The alarm can take several weeks to work. Signs that the alarm is likely to work include seeing at least one of the following in the first three to four weeks:

• Your child waking to the alarm
• Your child managing to pass some urine in the toilet when they wake
• The wet patches getting smaller
• Your child sleeping for longer before the alarm sounds

If there is no progress in the first three to four weeks, your child’s healthcare professional should be able to discuss options with you.

Desmopressin for bedwetting

Desmopressin is a medicine that can help with bedwetting. It is very like the vasopressin that most people produce to tell the kidneys to make less urine. It works by reducing the amount of urine the kidneys make during sleep.

Desmopressin is available on prescription from the age of five. It is usually given at bedtime or up to an hour before and can work very quickly.  It is a safe medicine to use, but children must not drink for an hour before they have it and for eight hours afterwards (they are usually asleep then).  There is more information on desmopressin in the Bladder & Bowel UK leaflet here.

What if the treatment does not Work?

While there are three main causes for bedwetting (not being able to wake to a full bladder, not being able to reduce the amount of urine made overnight, and the bladder not being able to hold onto the urine that is made) there are other factors that have an effect.  Therefore, one treatment on its own will usually be successful for about 60% of children.  40% of children will need to have more than one treatment for bedwetting to help them overcome it.

If your child is still wetting after trying one treatment, they may be offered a different treatment, either instead of the one they have already tried, or as well as that one.  It is important that you talk to your child’s healthcare professional about other options available if the first treatment has not worked. It is also important to know that a treatment that has not worked the first time you try it, may work later.

Where can I find more information?

Bladder & Bowel UK is a national charity. It provides information that is free to access, download and print about bladder and bowel conditions and management solutions for people of all ages on their website here. Information on bedwetting is available here.

There is also information on bedwetting on the Stop Bedwetting website. There is information about World Bedwetting Day available here.

Bladder & Bowel UK produce a free quarterly electronic newsletter for the public called Talk About. Talk About is full of interesting articles, suggestions and information for people affected by bladder and bowel conditions. To receive this fill in the form here and ask to be added to the mailing list.

You can contact the Bladder & Bowel UK confidential helpline by filling in the web form or phoning us on 0161 214 4591.

This World Bedwetting Day, Take Action. Contact your healthcare professional if bedwetting is a problem for you or your child.