How to treat bedwetting: which solutions really work?
Bedwetting is uncommon in children age 5 and over. The cause of bedwetting is almost always the child’s brain not yet linking the feeling of a full bladder with waking. For children and their families, solving bedwetting brings many benefits. But which ways to treat bedwetting really work?
Why do some people recommend methods that don’t work?
If you mention bedwetting to friends or family, or ask a question online, you may get all sorts of advice. Many of these methods don’t really work, but why do some parents think they do?
About 3 in 20 children age 5 and over stop bedwetting each year without help. If parents of these children are using a method to try to help the child at this time, they’ll often think this method caused their child to stop bedwetting.
To understand what really works, doctors look at scientific trials. Trials rule out chance by:
- including large numbers of children.
- dividing children randomly into two groups: one given the treatment and one given no treatment, or a fake treatment called a ‘placebo’.
By comparing the treatment group with the no-treatment group, it becomes clear if the method really works, and how well.
Here’s what scientific trials say about the common ways parents try to help children stop wetting the bed.
Alternative and complementary therapies
What are they? Alternative or complementary therapies include acupuncture, visiting a chiropractor, cranial osteopathy, homeopathy, hypnotherapy, reflexology and more. They are also called natural remedies or natural therapies.
Do these therapies work? It’s not clear. Some studies find some alternative therapies help bedwetting1, but improvements are small compared with some other methods.
Alternative and complementary therapies usually do no harm, but there are always risks when a therapy manipulates the body, pierces skin or involves consuming anything, like herbal pills. Keep in mind that in many countries, these therapies are not tested for safety and some therapists may not have full training.
One thing we can learn from these therapies is that it helps to give your child and their bedwetting problem positive attention. Alternative therapists often recommend other things we know work, like making sure your child is drinking enough.
If you’re keen to avoid medication for your child, one method has been shown to be much more effective than alternative therapies.
What is this? A bedwetting alarm (or enuresis alarm) uses a moisture sensor linked to an alarm to wake a child when they wet. Over time – weeks to months – children learn to wake before the alarm by noticing the feeling they’ve had just before the alarm has gone off: a full bladder.
There are a few types of bedwetting alarm:
- moisture-sensing bed pad wired to an alarm or bell
- small moisture sensor placed in underwear, wired to an alarm
- small moisture sensor placed in underwear, with a wireless alarm
- moisture-sensing bed pads that vibrate rather than make a sound.
Do bedwetting alarms work? Yes. Bedwetting alarms are the most effective way to help children stop wetting the bed. When used as directed with night toilet training, up to 9 in 10 children stop bed wetting. One study found children were 13 times more likely to stop wetting the bed with an alarm2.
When choosing an alarm, keep in mind:
- plastic-coated moisture sensors are best to avoid skin reactions.
- moisture-sensing bed pads are slower to detect wetness. For this reason, they’re mostly used for children who can’t or won’t wear a moisture sensor.
- vibrating alarms have not been studied. It’s not known if they work.
Read about the DRI Sleeper Solution to find out how to use our bedwetting alarms.
Ignoring the problem
What is this? Some parents have been told to ignore bedwetting in children age 5 and over, and just use night diapers (nappies). The theory is, children of this age ‘grow out’ of bedwetting.
Does ignoring bedwetting work? Not very well. From age 5, only 3 in 20 children ‘grow out’ of bedwetting each year3. It really means they’ve taught themselves to notice a full bladder and wake. This the same as when using a bedwetting alarm, but much slower.
Wearing diapers at night may make it harder for a child to learn not to wet the bed. Many diapers are now so absorbent that children don’t feel wet when they pee. The feeling of being wet helps the child’s brain link the earlier ‘full-bladder feeling’ with waking.
What is it? Lifting means choosing times in the night to carry a child to the toilet without waking them.
Does Lifting work? No. Studies have found Lifting doesn’t help children stop bedwetting4. That’s because children stop bedwetting by learning to wake at the right time. Taking a child to the toilet without waking them, like ignoring the problem and using nappies, may even slow down their learning.
Medication (tablets or pills)
What is this? Doctors may prescribe medicines for some children to help reduce bedwetting, such as desmopressin, oxybutynin or an antidepressant called imipramine. Medications are usually prescribed only for short-term use or in special cases, like when a child has an overactive bladder.
Does medication work? Medication can help short-term, but only helps long-term if used with a bedwetting alarm. If used without an alarm, most children start wetting the bed again when they stop taking the medicine5.
Night toilet training
What is this? Night toilet training includes a range of ways to help your child know they can stop bedwetting, develop skills and build confidence. For example:
- keeping a diary of when your child wets the bed
- phasing out diapers (nappies)
- regular routines around sleep, including relaxing and peeing before bed
- reward programs, like star charts, leading to rewards for dry nights
- having a good attitude around the bedwetting: staying calm and treating it as normal.
Does night toilet training work? Using night toilet training with a bedwetting alarm gives the best chance of success. Night toilet training is also a great place to start if your child isn’t yet ready for an alarm.
What is this? Some parents have been told if their child drinks less during the day they’ll wet the bed less often.
Does restricting drinking work? No6. Children should drink enough liquid, ideally water, during the day to make their bladder stronger. Aim for 250 mL (8 fluid oz) of water six times a day. Use waking, coming home, and meals and snacks as reasons for a glass of water.
Avoid drinks with sugar or caffeine (for example, chocolate milk, some juices, sodas, energy drinks, iced tea). Because these dry the body, they don’t make your child’s bladder stronger.
Treating medical problems related to bedwetting
What is this? Rarely, medical problems are part of the reason a child wets the bed. They include:
- sleep apnea (or sleep apnoea): short periods of not breathing when asleep
- bladder infection (UTI or urinary tract infection): they’ll probably be peeing a lot during the day if they have a bladder infection
- low ADH (anti-diuretic hormone) levels: it’s the hormone that stops the body producing as much urine at night as in the day.
Does treating medical problems work? Yes, in part. Take your child to a doctor if you think they might have any condition making their bedwetting worse. If the bedwetting keeps going after the condition has been treated, use a bedwetting alarm.
- 1Alternative treatments for the management of bedwetting, 2010
- 2Nocturnal enuresis case reviews, Western Journal of Medicine, 2001
- 3Pediatric bedwetting, US National Association for Continence
- 4Lifting and waking in the management of bedwetting, 2010
- 5Nocturnal enuresis case reviews, Western Journal of Medicine, 2001
- 6Fluid and diet restriction for the management of bedwetting, 2010