Adolescent Psychiatrist Questions Bedwetting

Can I do anything to stop my child from wetting the bed?

My son is 8 years old, and has been wetting the bed at night for a few months now. It started very suddenly, so I am not sure what caused it. What can I do for him?

11 Answers

Thank you for your question at FATD. This is a general answer, and it is not meant to be a medical consult, or establish "patient-doctor" relationship. Typically, the way I start investigating new onset bed wetting, is first of all take a good medical and psychiatric history, including any possibility of abuse or traumatizing event or simply a change of routine in the child's life. In addition, I try to rule out any physical causes of the bed wetting including but not limited to high blood sugar, or urinary track infection, in collaboration with the child's pediatrician. When trauma, and physical causes have been ruled out then we focus on possible psychiatric diagnoses which can contribute to bed wetting, including attention deficit hyperactivity disorder.
I hope this helps, again thank you for your question.


Melina Spyridaki-Dodd, M.D.
New onset bedwetting can be from numerous causes - a urinary tract infection, a trauma, a medical illness, toxins, medications. He should be evaluated at a minimum by his Pediatrician to rule out obvious medical causes
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Educate him about the need to limit fluids, consider getting him up after he has gone to be when you go to bed to have him pee again. Consider if he has been stressed in some way that has caused regression and work through that if there has been something. Sometimes sensitivities to OJ, milk, corn, tomatoes, cinnamon, cocoa, chocolate, peanuts, peppers, or artificial dyes/preservatives can cause enuresis. It is also important to conform through a UA (urinanalysis) with PCP that this is not cause d by a urinary tract infection - if it is a UTI then referral to urologist would be routine as UTIs in boys are often cause d by previously unknown anomalies and require attention. Best Wishes!!
First, have him evaluated by his primary doctor. I would check a urine analysis (UA) for infection or other abnormalities. A physical exam helps check for any physical problem.

Is he urinating more than usual during the day? Diabetes causes increased thirst, hunger, & urine output.

If the above are not a problem, I would have him start “bladder exercises” while he is urinating during the day: Go - Stop - Go - Stop - etc. Do this every time he urinates & for the entire stream. This helps set up a reflex so he will eventually do this even during sleep.

Stretch the size of the bladder by measuring the maximum volume he can hold — I recommend peeing into a small Coke bottle & mark this initially & weekly. Boys find this interesting and are usually very cooperative.

Success is usually gradual. First aim for 1-2 dry nights a week (for 2 weeks). Then, 2-3 dry nights a week. Etc. If the goal is met, offer some small reward. No punishment or humiliation otherwise- just encouragement.

8yo? He can quietly strip his bed & take it to the washroom if he wets the bed. Nothing is said.

Some children respond to a homeopathic medicine = Causticum— 5 pellets dissolved under the tongue (not chewed or swallowed) before bedtime. You might find 15C or 30C (dilution) in a store that has homeopathic medicine.

I will refrain from talking about prescription medicines initially (like Imipramine).

Hope this helps!

There are many reasons a child can have nocturnal enuresis (nighttime bedwetting). These reasons can be medical and/or psychiatric. Depending upon the cause, there are medications and behavioral techniques that can help with this.

Thank you,

Joshua Paul Werblin, M.D.
Bed wetting that persists to 8 years old (primary enuresis) is not uncommon, but it sounds like he was dry for years, then suddenly developed the symptom, which is a whole different kettle of fish, with multiple possible etiologies. First, you need to consider physical issues, such as a urinary tract infection, so have him evaluated by your pediatrician. New onset enuresis is also a warning flag for emotional distress. Something may be bothering him, even simply a change, in his environment at school, home or playground. If there are no physical explanations, having him talk to a mental health professional who works with children might reveal how you can help.
If children regress with their toilet training, it can be physiological or psychological. First thing is to get him evaluated by a pediatrician to exclude focal causes. Also, it has to be monitored if he is doing it only at night or has accidents during the day.
Psychologically, it can signify trauma. And it has to be assessed by a psychologist or psychiatrist. Trauma for children can be very insignificant in adults eyes, but something as small as seeing a dead bird on the street can cause psychological trauma in children.

I hope he will get better soon. All the best.
May want to check out for constipation cause that can cause bed wetting or any urinary tract infection. If that is not the case then recommend seeing a psychologist if any anxiety/stress.
Bedwetting that starts, or continues, after age 7 may be a sign of either urinary, other medical, or psychiatric problems. A pediatrician should first evaluate for urinary or other medical problems. If those are absent, behavioral treatment and/or medication can be used. Behavioral treatment consists of 1) pre-bedtime water restriction, and 2) an alarm (sound + vibration) triggered by a moisture sensory - traditionally referred to as the "pad and bell" method. This is highly effective; cost varies. Medication makes the kidneys produce less urine overnight. Some causes of bedwetting may instead improve with psychotherapy.

NB: This does not constitute medical advice, please see the disclaimer in my Expert Blog for details.
So your son had been toilet trained and suddenly started wetting the bed. This usually raises concern. The first thing I would recommend doing is taking him to his pediatrician or your primary care physician. A face to face interview and a thorough assessment and physical exam are essential to direct treatment. There may also be need for laboratory and psychological work up, but start with your primary care provider.
1. Assess if the child is anxious about something (a situation, person, etc.).

2. Establish a cut-off time that the child is able to drink liquids.

3. A bell and pad is effective.