Five year old with a wet bed

Kelly asked if she should do anything about a 5 year old chlid who is still wetting the bed.

Night training will occur automatically, and there really isn’t anything parents can do that makes much difference. Think about it: the kiddo’s asleep, and isn’t really trying or not trying to do anything. Star charts, rewards, punishments, or “practice” are all very unlikely to make any difference.

Children wet the bed because they sleep very deeply, and while asleep cannot really pay attention to the signals from their bladder. The deepest sleepers tend to continue wetting the bed the longest. Often (but not always) one or both parents were also wetting the bed at the same age.

Many things have been tried:

  • Restricting fluids after dinner. This is a tough one to do—when kids are thirsty, they’re going to drink. One variation: rather than decrease evening drinking, try to encourage more morning drinks. That way Junior might be less thirsty before bed and less likely to go to sleep filled with water. At least one study from Europe showed that this exact stretegy did work, at least some of the time.
  • Potty pagers. These are gizmos that buzz or shreik when a sensor placed on the underwear gets wet. What most families who try these tell me is that the gizmo wakes everyone in the family up—everyone, that is, except the wet child!
  • Parental awakenings. The idea here is to wake up the child at a decent time, say 11:00 pm, before mom and dad go to bed, and make Junior use the bathroom. After several weeks of this, the child will start to wake himself up at that time. For this to work, you have to wake your child completely, and NOT carry him or her to the bathroom. In practice, this can be tough to do. Did I mention that these kids sleep very heavily?
  • Medicines. DDAVP is FDA approved to treat bedwetting starting at age 6. But a recent FDA warning pointed out that several kids had seizures using this medication. It should never be used at times when a child is getting dehydrated or when a child is drinking lots of extra fluids. Though DDAVP has been used safely by many children, the effectiveness disappears as soon as the medicine is stopped. I only suggest DDAVP for children who are a bit older, and who themselves are getting self-conscious about bedwetting.

Certainly, at age 5 I would recommend doing essentially nothing. You can have your child participate in the clean-up (either putting the pull-up in the trash, or stripping the bed), or maybe consider parental awakening. But really, it’s best for now to wait and see without focusing on this issue as a problem.

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8 Comments on “Five year old with a wet bed”

  1. Jack Says:

    Dr. Roy,

    We had very good luck with the pager or, as it’s otherwise known, the behavior modification device. Initially it did wake us up more than our son, but eventually his body learned to respond. Took about 3 months, but after that he’s been very dry. Another key thing is double voiding before bed. We still will have the occasional accident if he’s too tired at bed time for the double void. He will even volunteer when he gets up that he forgot to go a second time. But at this point things are pretty good. We also try to restrict anything with caffeine, more for the diuretic effects than it being a stimulant.

    Great blog,

    jack

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  2. Dr. Roy Says:

    Thanks Jack, and I’m glad your son is doing well! That’s a good point about caffeine, which can hide many soft drinks. Stay away from it if you’d like your child to stay dry.

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  3. Beth Olsson Says:

    Hi Dr. Roy

    I just found this blog – love it! Another time sucker when I’m at work.

    I’m especially glad to have found this as Jack (who will be 6 in December) still uses pull ups nightly and I’d say 5 nights out of 7 wakes up wet. I was beginning to worry, but after reading this, I think it’s just a matter of time. I know that I was a late to nighttime training as well (and my parents/doc did end up putting me on some kind of drug – who know what that was back in the 70’s).

    Thanks again,
    Beth

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  4. Jennifer Says:

    I’ve been hearing – just wait, no worries until 8, etc. I just can’t get past it and what it is doing to my son. He’s embarrassed that he wets the bed and knows that he does. I’ve found sites such as http://www.drybed.com and http://www.nobedwetting.com and wonder about treating the ‘deep sleep’. Not just for bed wetting, but to promote better sleep and better days being more alert from better sleep. What are the thoughts on treating ‘deep sleep’ vs ‘waiting to grow out of it’?

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  5. Dr. Roy Says:

    Jennifer, you’re the one who’s worrying me. A five year old, and you say “I can’t get past it and what it is doing to my son”?? Look at that statement. The issue isn’t that there is anything wrong with your son; it’s your response to his perfectly normal behavior that’s creating a problem. If he’s embarrassed, it’s because he senses that you are disappointed in him.

    Those web sites will be all too happy to take your money. He’s going to outgrow this, and I’m sure someone will be happy to take both the credit and your credit card number.

    Deep sleep is a wonderful thing. Let your son enjoy it.

    Was I too harsh? I think I was channeling Dr Phil!

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  6. jenn Says:

    My 5 yr old son wets the bed 5 out of 7 nights its really hard my other children 3 and 9 make fun of him I know it hurts his feelings but I really do not know what to try next its nice to know that i am not the only mom with this problem anyone with sugestions

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  7. Lyle Danuloff, Ph.D. Says:

    Dear Dr. Roy,
    I read your response to a parents concern regarding continuing to wet the bed at five years old.

    Every consultation we conduct begins with a thorough understanding of that child, teenager, or adults history including the following: history in the family, daytime issues of wetting or frequencies, symptoms from deep sleep. We do not regard bedwetting at any age as perfectly normal behavior. I wonder if you are willing to guarantee that the five year old child in will outgrow bedwetting?

    According to the American Pediatric Association, less than 1% of bedwetting is caused from a physical problem. Discussing bedwetting with a medical doctor typically leads to two responses; Wait or try a drug. Neither addresses the core of the problem.

    I work with the Enuresis Treatment Center, which deals only with bedwetting cases. We have treated thousands of children, teenagers, and adult bedwetters, tracking all related symptoms. Our extensive research validates bedwetting as a problem caused by abnormally deep sleep, which doesn’t allow for the bedwetter’s brain and bladder to connect so they can effectively respond to each other.

    In 99% of all bedwetting cases, (based upon our research of tens of thousands of documented cases) the root cause is sleeping so deeply. It is an inherited deep-sleep disorder that results in bedwetting and more importantly…a fragmented, non-restorative, sleep.

    This compromised sleep can also result in daytime symptoms; difficulty awakening, fatigue, memory difficulty, irritability, difficulty concentrating. These symptoms can increase as a bedwetter reaches adulthood.

    There is No guaranteed that someone will outgrow bedwetting, in fact after the age of seven, it is less likely. 1 in 50 teenagers, as well as 3.2 million reported cases of adults still wet the bed. More importantly, if someone were to outgrow this problem, they are then left with a sleep disorder, along with possible challenging symptoms that can no longer be treated.

    Proper treatment is never simple. If drugs are prescribed or considered to be at all effective, consider that once the drugs are discontinued, the bedwetting will likely resume. Drugs may serve as a temporary fix for a complicated problem, and drugs clearly produce side effects, some as yet unknown.

    Many medical professionals misinform patients when they blame a small bladder as the cause of bedwetting. It is actually a RESULT of the bedwetting. Moreover, restricting fluids causes further underdevelopment of the bladder, as well as dehydration.

    Psychological counseling has not been proven to end bedwetting. Neither has hypnosis, chiropractic care or homeopathic remedies.

    For 35 years, the Enuresis Treatment Center, a respected private clinic in Michigan, has been ending bedwetting for children, teenagers, and adults who thought there was no hope. Our research and experience has validated that bedwetting can be treated without drugs or invasive surgery.

    The internet offers a great deal of information about bedwetting, unfortunately most of it is offered from sources that do not specialize in bedwetting treatment. When researching treatment programs, we suggest parents, or an adult seeking help, ask for references and check staff credentials. This will give better insight as to success and lasting results of a bedwetting treatment program. Please visit their website for more information. http://www.nobedwetting.com

    Sincerely,
    Lyle Danuloff, Ph.D.
    http://www.nobedwetting.com

    Like

  8. Lauren Says:

    I’ve found that drinking Milk, Juice and pretty much anything besides water will trigger accidents. I suppose it has something to do with how fast your body digest them verses water. After 5pm its water only and after 7 nothing except a sip before bed. Works like a charm 🙂 Also I will sometimes woke up my children on either a regular basis if necessary a few hours after bed time or just on nights I foresaw an accident happening. Crying before bed, being off schedule or interference with Nap time almost always affected potty training so these are things to look for. I found with my BF’s daughter that even though she didn’t like naps at 4/5 if she didn’t get one she would sleep so heavily she couldn’t wake to potty so don’t ditch the naps yet 🙂

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