Bed-wetting: How old is too old?

My 6-year-old son has a bed-wetting problem. He never has an accident during the day, but occasionally he has one at night. He is embarrassed about it, and I assure him that all kids wet the bed sometimes. I wonder, though, is 6 years old too old to still be wetting the bed? And if so, could it be indicative of a medical problem?

Although your son is at the upper end of the normal age range for nocturnal enuresis (the medical term for wetting the bed), it is more common than you may think. The fact that nighttime diapers (“pull-ups”) for older children are readily available in supermarkets is evidence that this is not an unusual issue. Approximately one in 10 6-year-olds have nighttime accidents, and usually they are not caused by any underlying health issue.

Often, bed-wetting is just a routine part of childhood development. The fact that your son does not have this problem during the day is a good sign that he will likely outgrow it soon. Sometimes, a child’s bladder may simply be too small to hold urine throughout the night, or the bladder’s nerves are too underdeveloped to wake him from sleep when the bladder is full. Childhood bed-wetting also tends to run in families — parents who were bed-wetters as children are more likely to have children who also have accidents at night.

This is not cause for you to bring your son to the pediatrician beyond his usual checkups. You can help your son manage bed-wetting by making sure he is urinating throughout the day, and limiting the amount of liquid he consumes in the two hours before bed. If he continues to wet the bed a year or two from now, you may want to consider having him do exercises to strengthen the muscle that controls the bladder. He could also use a bed-wetting alarm at night, which is a device that uses a moisture-sensitive pad that is inserted into the underwear and goes off at the first drops of urine. This will wake him up, so he can go to the bathroom.

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You may want to bring your son to a pediatrician, however, if the nighttime bed-wetting started again after six months or longer had passed without an incident. Although uncommon, bed-wetting can be symptomatic of another condition. If the bed-wetting is accompanied by a fever, abdominal pain, or blood in the urine, that may indicate a urinary tract infection. If bed-wetting is accompanied by increased thirst, hunger, fatigue, and weight loss, the cause may be type 1 (juvenile) diabetes. Type 1 diabetes is diagnosed when the body halts production of insulin, a hormone that allows the body to process glucose from carbohydrates. If you have witnessed any of these symptoms in addition to bed-wetting, a pediatrician can perform a urinalysis to see if there is anything unusual going on.

Your son’s bed-wetting is probably just a phase that will soon pass. Every child develops at his or her own pace, and there is no need for him to feel ashamed. With good bathroom and bedtime habits, he can look forward to nights without wetting the bed.