Why Is My 4 Year Old Wetting the Bed Again

Bedwetting is a problem for many schoolhouse-age children and their families. The good news is that for many children the problem volition resolve itself over time, or can be fixed through fairly uncomplicated treatment.

Bedwetting (too called nocturnal enuresis) is very common. As the post-obit graph shows, virtually a 3rd of iv-year-olds wet the bed. By the time they are 6, only 1 in ten children wet the bed, and one in xx past historic period ten. Bedwetting tin sometimes go along into adolescence.

Pct of children who wet the bed at different ages

bed wetting graph

Well-nigh children take no lasting problems from bedwetting; notwithstanding, many will experience embarrassed or ashamed. It is important to reassure your child that they are not the just one who wets their bed. For younger children, there will well-nigh likely be many other bedwetters in the same class at school.

It is common for children to become dry out at nighttime for a while and and so to start wetting their bed again.

What causes bedwetting?

While not all causes of bedwetting are known, some of the possible factors are:

genetic trend (bedwetting tends to run in families; if one or both parents wet the bed when they were children, so it is quite probable their children will be bedwetters)
a smallish bladder capacity
the kid is a deep sleeper
the child's kidneys keep to produce a lot of urine at night (usually, people make less urine when they are asleep)
constipation (if constipation is causing your child to wet the bed, treating the constipation will assistance your child to stay dry at night. See our fact canvass Constipation)

In some rare cases, at that place may be a medical problem that is the cause of the child's bedwetting.

Bedwetting is not often a behavioural problem and children rarely do information technology for attention. It is far more probable that they take fiddling control or awareness when they are having accidents overnight.

When to run into a doctor

You may wish to run across a dr. about your child's bedwetting if:

your child is at least 7 years old (handling for bedwetting is non recommended before this age as treatment is less effective and many children become improve on their ain)
you lot or your kid are troubled or frustrated by the bedwetting
you punish, or are concerned that y'all might punish, your child for wetting the bed
your child wets or has bowel movements in their pants during the daytime

If your child has been dry at dark for vi months then begins to wet their bed once more, it is of import to see a medico for evaluation.

The doctor will consider your child's details and determine if there is a physical problem that needs to be addressed.

Treatment for bedwetting

Motivation

Well-nigh children don't need rewards to motivate them to have part in treatment – the prospect of a regular dry bed is normally enough.

It tin be helpful to continue a tape nautical chart of wet and dry nights. Your child should make the chart themselves and choose how to complete it. Some children like to put stars or stickers on for dry out nights, or to colour information technology in or draw pictures. Choose something that fits in with your child's interests, for example, football stickers. Charts used on their ain ordinarily have footling success, but in combination with other treatments they can exist very useful.

Drinking fluids

Information technology is important for your child to drink enough of fluids spread evenly throughout the day. Don't try to restrict the amount of fluid your child drinks in the evening, equally this volition not assist and can even filibuster the process of beingness dry at night. However, don't give drinks containing caffeine (coffee, tea, hot chocolate, caffeinated soft-drinks like cola etc.) late at night.

Bedwetting alarms

Bedwetting alarms are idea to be the nearly useful and successful first-footstep to treat bedwetting. Research has shown these alarms will assist 80 per cent of children to become dry, and almost children volition then stay dry. Children using alarms are less likely to relapse compared to children taking medication.

A child using a bedwetting alarm needs a supportive and helpful family as it may take half-dozen to eight weeks to work.

There are ii types of bedwetting alarms - Bell and Pad Alarm and Personal (body-worn) alarm. The bell and pad alarm can be hired through RCH Enuresis dispensary.

Bell and Pad Alarm Video

Personal Alarm Video

Bong and pad alert instructions

Bedwetting alarms are available for hire or tin be purchased. A safety mat is placed in the bed nether where the kid's bottom will be, and is connected by a wire to a box with a battery-powered alert bong. Others have a smaller sensor that attaches to a child's underwear. These systems operate at low voltage and at that place is no risk to your child.

If using a mat, it should exist placed on the bed on top of the lesser sail and should be covered with a slice of thin material (eastward.yard. an old sheet that has been cutting upward) simply large enough to embrace the mat and long enough to tuck in on either side of the bed.
The wires should exist plugged into the box, which should then be placed as far away from the bed as the wire will allow.
When going to bed, your child should switch on the alarm and get into bed. Information technology is all-time if they simply wear a pyjama peak and underpants, rather than pyjama trousers or a long nightdress.
When your child wets the bed, a loud alert will sound. Your child should go out of bed as quickly as possible, turn off the alarm and go to the toilet to cease emptying their bladder. Then your kid should dry the mat using the piece of material, put a new piece of textile over the mat, plow the alarm back on and get back into bed. You may have to help your child with some of this, at to the lowest degree for the kickoff few nights and specially if they are a very deep sleeper.
Practise the whole routine a few times with your child. You tin can utilise a glass of salty h2o, instead of urine, to set the alert off. Remind your child what the routine is equally your kid gets fix for bed for the starting time few nights.
If your child is a deep sleeper, you lot may have to wake them up for the first few nights when the alert sounds. Most deep sleepers will go used to waking to the sound of the alert. Your task is only to wake your child – they must exercise the balance themselves.
Inside a week or two your child should start to take some dry out nights. This may happen because they wake upward and get to the toilet before wetting the bed, or because they learn to concord on all night.
If your child has seven dry nights in a row, endeavor giving some actress fluid to potable in the evening. This is called 'overlearning'.
If your child has xiv dry nights in a row, try leaving the mat on the bed only without the alarm switched on and see what happens. If dry nights continue, try leaving the mat off the bed all together.

Medications

Most children with bedwetting do non need to take medication, but there are some occasions when it can exist useful. Your doctor can propose you if this treatment is suitable for your child.

DDAVP (also chosen Minirin) is a medicine that helps a child's torso brand less urine at nighttime. It will reduce the likelihood of your kid's bladder overfilling during sleep.

DDAVP is usually reserved for children who have not go dry after using a bedwetting alarm – sometimes the ii treatments are and then given together. Some children use the medication for sleepovers or school camps.

Information technology is prophylactic to uses DDAVP, provided you never exceed the recommended dose, and you avert excessive fluid intake in the evening subsequently dinner. Be careful to follow the instructions provided with the medication.

DDAVP can work quickly. Some children volition be dry out after the first night. Many doctors recommend using DDAVP for 3 months, followed by a tapering off flow to determine if your child tin can stay dry out without medication. Some children will resume bedwetting when the drug is withdrawn. If your kid becomes moisture again, your doctor may inquire y'all to restart DDAVP and endeavour to cease it again every few months to see whether your kid still needs it to stay dry out.

General tips

Regardless of which treatment you will be using with your child, there are some general strategies that are useful throughout the treatment procedure.

Information technology is very important to be patient and to encourage your child. Punishing or making fun of your child for wetting the bed will merely make the situation worse – make certain siblings understand this equally well.
Your child needs to be very involved in the treatment plan if it is to work. Be very positive on the practiced nights, and attempt not to be negative on the bad ones.
If you are putting your kid in a nappy or pull-up at night to salve on laundry, information technology is unlikely that they volition get dry while this continues. Nappies or pull-ups cannot be worn while using a bedwetting alarm.
You might like to apply some class of protection for the bed while waiting for your kid to stop wetting. A diversity of pads and covers are available to protect the bed and pillow, and there are underwear pads that can be used for sure occasions (e.m. school camps, holidays, sleepovers).

Key points to think

Bedwetting is very common
Most children take no lasting problems from bedwetting
Family members of children who wet the bed need to exist supportive and not critical
Bedwetting alarms are considered the most successful first step to care for bedwetting. Medication is an pick if alarms take not helped

For more data

See your GP
Bell and Pad Alarm Video - From wet to dry, lets requite information technology a try
Personal Alarm Video - From wet to dry, lets give information technology a effort
Dr Margie: How can you assist your child with their bed wetting?
Bedwetting alarms tin can be hired from The Royal Children's Hospital. Yous will demand a referral from your GP to access these
Run across The Continence Foundation of Australia website for advice on bedwetting and to find providers of products such as bed protectors and pads or underwear
David's Hole-and-corner Soccer Goals is a book for children who wet the bed, which is designed to exist easily read alone by children age seven and in a higher place. Search online or ask your local book shop

Common questions our doctors are asked

When will my child grow out of bedwetting?

All children develop at dissimilar rates, and some children may moisture their bed occasionally until the age of seven or eight. If this is happening regularly, see your GP. If your child is over vi years old and bedwetting is causing issues for them (or for yous), take them to the GP, peculiarly if they were previously dry overnight.

My child has school campsite coming upwardly. How can I stop him bedwetting at camp?

Y'all could showtime using a bedwetting alarm for two months earlier camp to help your child stop bedwetting – it may take half-dozen to eight weeks to piece of work for your child. If that doesn't piece of work, your GP may exist able to prescribe DDAVP for your child to use on schoolhouse camp. If you don't wish to utilise medication, you may like to try underwear pads for camp.

Developed by The Regal Children's Hospital General Medicine section. We acknowledge the input of RCH consumers and carers.

Reviewed July 2020.

Kids Wellness Info is supported by The Purple Children'south Infirmary Foundation. To donate, visit world wide web.rchfoundation.org.au.

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Source: https://www.rch.org.au/kidsinfo/fact_sheets/Bedwetting/