More about Bedwetting
Bladder conrol
If a child wets themselves: what parents should know
Most children become dry at night by around the age of five. However, if an older child still wets the bed at night (enuresis) or has daytime urinary accidents (urinary incontinence), parents are understandably often concerned. It is important to know that both are more common than many people think – and in many cases, there are good treatment options.
Facts that can be reassuring
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About 10% of children still wet the bed at the age of 7
(boys about twice as often as girls) -
About 2–3% of 7-year-old children have daytime accidents
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Bedwetting can run in families
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Daytime incontinence can have different causes
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It becomes less common with age – however, 1–2% of teenagers still wet the bed at night
(during the day: 0.5–1%)
Causes: usually nothing “serious”
If children still wet themselves after the age of 5, this is only rarely a sign of a disease of the kidneys, bladder, or another physical cause. Often, control over bladder emptying simply develops more slowly than in other children. Bedwetting is also often partly genetic.
Relapses can happen – and are not “intentional”
Sometimes a child starts wetting again after months or even years of being dry. This can, for example, be related to stress or changes such as:
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Moving house or changing schools
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Loss of a family member
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Birth of a sibling
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Stress, fears, or insecurity
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Conflicts (for example with other children or at school)
Important: children do not wet the bed on purpose. In most cases, they feel very uncomfortable about it themselves. Help your child with encouragement and the feeling: “We can do this together.”
Daytime incontinence: please have it properly assessed
Daytime incontinence has different forms and causes. Accompanying physical factors (such as urinary tract infections) are more common here than with bedwetting. That is why a careful examination by a paediatrician is especially important.
When should you see a doctor?
An appointment with a paediatrician can be very helpful in identifying possible causes and finding the right support. If needed, your child may also be referred to specialists.
If there are also signs of emotional or psychological strain (for example ADHD, persistent sadness, strong insecurity, or noticeable changes in eating or sleeping), an assessment by a child and adolescent psychiatrist may be useful. There, solutions are worked out together with the child and the parents.
Causes of bedwetting (enuresis)
How bladder control develops
Bladder function develops gradually in children – especially during the first four years of life:
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In the 1st year of life, babies still empty their bladder involuntarily. However, they are often dry between voids.
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Between 1 and 2 years, children increasingly notice that they need to go – and can sometimes already communicate this.
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Between 2 and 4 years, many children learn to consciously control the bladder sphincter.
Even if a child is dry during the day, bedwetting at night may continue for some time. Many children do not become reliably dry at night until around the age of 5. Important: toilet training usually does not directly influence bedwetting.
Bedwetting often runs in families
Bedwetting can be inherited. As a rough guide:
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If one parent was affected as a child, there is about a 40% chance that the child will also wet the bed.
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If both parents were affected, the risk increases to about 75%.
Common causes: maturation, sleep, and urine production
Most often, bedwetting is linked to delayed maturation of bladder control in the brain. Several factors may play a role:
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Some children produce relatively large amounts of urine at night because the day-night rhythm of certain hormones is not yet fully mature.
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Many children sleep very deeply and do not notice the urge to urinate in time.
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In addition, bladder emptying during sleep may not yet be sufficiently “inhibited” – this too is usually developmental.
Psychosocial triggers and contributing factors
Stress can also trigger bedwetting or make relapses more likely – for example:
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Birth of a sibling
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Separation of the parents
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Death in the family
Other factors that may occur more frequently alongside bedwetting include attention problems/hyperactivity, difficulties with social behaviour, or intellectual disabilities. Some children also have bowel problems (for example constipation).
What exactly does “enuresis” mean?
Enuresis refers to any wetting during sleep. It affects about:
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10% of 7-year-old children
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1–2% of teenagers
Specialists also distinguish whether bedwetting occurs with or without bladder dysfunction. In most cases, children wet the bed at night without having a bladder dysfunction.
Primary and secondary enuresis
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Primary enuresis: The child has never been dry at night for a longer period of time.
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Secondary enuresis: The child has been dry for at least 6 months and then starts wetting again.
Sometimes there are also daytime symptoms, such as frequent urgency, “holding on” and postponing toilet visits, or difficulty emptying the bladder. In that case, a medical assessment is especially advisable.
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