A child may wet the bed at night for several reasons.  The most obvious is that the child is not waking when the bladder is full and needs to be emptied.

The bladder may need to be emptied more often at night due to the kidneys’ production of more urine than a normal bladder can tolerate.  A child may also have a smaller than average bladder or one that works harder than other children’s, however, these explanations are less common.

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Research has shown that the majority of bed wetters have a low production of a hormone called vasopressin, also called ADH, which stands for “antidiuretic hormone” (antidiuretic means “a substance, which depresses the secretion of urine”).  Vasopressin reduces the production of urine at night so that the urine becomes more concentrated.  This is why urine is darker in the morning.  If a child does not produce enough vasopressin, their urine is light and abundant, and the bladder becomes overfilled during sleep.  Therefore the child needs to empty their bladder.

Recent research has shown that approximately one third of all children who wet the bed at night do it because they have a more active bladder than their peers.  Although they produce less urine during sleep, the bladder needs to be emptied.

How to overcome bedwetting?

Bedwetting can be a heavy burden for both child  and parents.  Lack of treatment can result in the child developing self esteem issues and lack of treatment can result in psychological and social problems later in life.  Since, in most cases, bedwetting is caused by a lack of vasopressin, medical treatment can compensate for the lack of this hormone.  Once started on treatment, a child will often see the effect within two weeks.

If treatment is successful, a course will usually be given for three months, after which a week’s break is taken in order to assess whether treatment is still necessary.  If, as a result of stopping, the child is still not dry through the whole night, continued treatment is recommended for a while longer.

The medicine is to be taken just before the child goes down for the night.  Since it inhibits the production of urine at night, the child should not drink anything for an hour before sleep and eight hours after they have taken medicine.  This is usually not a problem if the child sleeps through the night already.

The majority of children who try this type of medical treatment usually experience rapid improvement.  Of these children around 60% are completely dry within a treatment period of 3-6 months, while the rest will see the problem reduced to a far more acceptable level.

Research among children who wet the bed at night shows that active treatment should start early; ideally by 6 years of age, when the child desperately wants to be dry at night.  The earlier the treatment is given, the less risk of future problems with a child’s self-esteem.  It is therefore essential that a treatment is sought as soon as it becomes clear that there is a problem.  The “wait and see” approach for this issue, is usually unsuccessful and can lead to long term issues..

Success also depends largely on whether the child wants the treatment to work and is motivated to see good results.  Many children will try to ignore the problem without accepting it as an issue and will do everything they can to keep it secret.  It is therefore important to make the child ready for treatment.  Among other things, it’s important to remove any feeling of guilt from the child – first by explaining the real reason they are experiencing this (lack of this hormone) and partly by stressing that the child is not alone with his problem.  Statistically, two or three other children in their school class also suffer with the same problem.  Seek further advice from your doctor to discuss options.

Do you have a bed wetter? How do you deal with it in your home? What advice can you offer other parents?