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Johns Hopkins Health - Avoiding Accidents

Fall 2009
Issue No. 6

Avoiding Accidents

Date: September 24, 2009

girl sitting on bed, wet spot beside her

Bedwetting is embarrassing for kids and frustrating for parents—and it can lead to bigger problems. Here’s why you need to resolve it quickly

How common is nighttime bedwetting in kids?
Bedwetting that happens only at night—what we call primary nocturnal enuresis—is actually pretty uncommon, says pediatric urologist Ranjiv Mathews, M.D. What most parents and many pediatricians don’t realize is that the vast majority of children who are wetting the bed at night also are wetting themselves during the day. Daytime wetting is the real problem.

How does this happen?
It starts with children who aren’t using the bathroom during the day. They’re busy playing or they’re at school, and they’re holding their urine, maybe because a teacher won’t let them go. To avoid having to go to the bathroom, they’re not drinking enough during the day. Then, at the end of the day, they guzzle large amounts of fluid because they are thirsty, and that leads to the nighttime wetting.

Is this a physical or a psychological problem?
Both. The cycle of daytime and nighttime wetting creates a physical problem with the bladder muscle, which ultimately leads to a reduced bladder capacity. Over time, it can create significant bladder issues and even more extreme urological problems. The psychological and behavioral effects we see are related to school performance and self-esteem, for example. Kids may also begin acting out, become isolated and gain weight.

What can parents do?
Parents can start by putting their children on a bathroom schedule during the day, and making sure they drink a good amount of water and avoid sodas and sugary drinks. Some kids improve quickly with just these steps. When this doesn’t work or there’s resistance from children, doctors can help to identify the problem—to make sure it’s not something more serious—and to work with the children and their parents toward a solution.?

Learn more about bedwetting and other problems your child might be having at For appointments and consultations, call 877-546-1872.