The experts, including psychologists, sleep scientists, doctors, nurses, and others studying nocturnal enuresis, or nighttime bedwetting, have proposed all kinds of potential reasons to answer why kids wet the bed. And I know as parents we have considered and wondered about plenty of other possible causes.
So why do kids wet the bed? The cause of bedwetting can be simple or complex. Medical reasons are often straightforward. But most reasons that kids wet the bed include several causes all at play together, making the problem difficult to solve. In the end, bedwetting can become a habit for these children.
And the truth is, aside from an obvious reason like a urinary tract infection, according to the Mayo Clinic, no one knows for sure why kids wet the bed after about five years old.
If a child is wetting the bed because of a medical concern, then knowing why is vital. If the reason is not so clear, then knowing potential whys can help us emotionally and help us to solve it. When we can understand a problem, it’s easier to deal with it.
Here’s the most complete list of bedwetting causes that I could muster up. Read on and find help.
Causes of Bedwetting
1. Development
By the age of 5, 80-84% of children no longer wet the bed at night. Doctors say there’s no cause for concern if a child is wetting the bed as late as age 7, unless the child is bothered by it. If it’s causing the child stress, they say that it’s time to get help.
Everyone begins life wetting the bed. It’s normal. Of course, most of us grow out of it. It’s simple development. Some of us need a little encouragement, while others of us stop on our own. At any rate, if a child is 5 or younger and still wetting the bed, the likely cause is human development.
Sometimes, development is delayed. In this case, the reason kids wet the bed could be that they cannot recognize a full bladder because the nerves that control the bladder are slow to mature.
Possibly, the development of circadian rhythms that control urine production are delayed. Circadian rhythms are the body clock. At night, they tell the body to slow certain functions, including urine production. As any new parent knows, it takes time for us humans to get a regulated body clock, with days and nights in their proper order.
With each year of development, 15% of bedwetting cases resolve themselves. In other words, 15% of 4 year olds wetting the bed will stop by age 5. Of those still wetting the bed at age 5, 15% will stop by age 6, 15% of those still wetting at 6 will stop by age 7, and so on. So, yes, much of bedwetting is caused by development.
However, what about the kids who don’t stop on their own? With each passing year, they are less likely to stop bedwetting. What is the cause for those kids?
2. Genetics
Since development happens at a different rate for everyone, it makes sense that a parent who trained late will pass along that physical trait and have a child who trains late.
In fact, scientists have mapped some of the genes associated with nighttime bladder control. Researchers have linked genes on chromosomes 13 and 12 to enuresis. While the genes are linked, the actual effect on the function and symptoms of enuresis is unknown.
Many children who wet the bed have at least one parent or close relative who also had nocturnal enuresis as a child. Approximately one third of fathers and one fifth of mothers of children with enuresis were bedwetters as children.
Heredity is not the cause for everyone, but it can help some to not worry about late training. Genetics may play a part in answering why a child wets the bed, but the numbers show that there are plenty of children who wet the bed and have no close relatives who also did.
3. Afraid of The Dark
The bathroom may seem a step away to adults, but to some kids, getting there requires a run through the gauntlet. Monsters, spiders, and odd scrapes in the night lurk in the imaginations of many children.
It’s enough to keep them from venturing out of bed when their bladders are full. They decide that maybe they don’t have to go to the bathroom so badly after all and fall back asleep.
Their young, learning bladders may not be able to hold it until daylight.
It’s a simple fix. A well-placed night light or two will do the trick.
Most likely, if this is why a kid is wetting the bed, the child is on the younger side. And hopefully, the parents catch on quickly and bedwetting never becomes an ongoing problem.
4. Urinary Tract Infection (UTI)
UTIs are not common in children, but they can occur. A couple of known causes are flake form bubble baths and, for girls, wiping back to front after a bowel movement.
Urinary tract infections cause frequent and uncomfortable, if not painful urination. Staying dry at night can be a challenge.
A child who has always wet the bed likely does not have a UTI. Bedwetting from a UTI is likely bedwetting that started suddenly, after a period of dryness (secondary enuresis)
It is not expensive or invasive to have someone checked, and treatment is generally a simple course of antibiotics. Wouldn’t it be wonderful if that were all it took to cure a child’s bedwetting?
5. Constipation
Kids get constipated. It could be from diet, too little water, or holding stool too long. When someone is constipated, there is extra pressure on the bladder. It is much more difficult to hold urine in this case.
A study has linked constipation to bedwetting. Like all the reasons why a kid wets the bed, constipation may be a cause, but it does not answer it for everyone.
To combat constipation, one help is counter intuitive when your goal is to end bedwetting. That is, increase the child’s water intake, though I might suggest the increase in fluids should be concentrated in the morning rather than later in the day. Diet changes are also suggested. More intensive treatment under the direction of a doctor may include laxatives or enemas.
Diagnosis and treatment require a trip to the doctor’s office.
6. Weak Muscles
It has been suggested that weak sphincter muscles contribute to bedwetting because the child does not have the strength to hold a full bladder. On the other hand, some claim that weak muscles have nothing to do with bedwetting.
I do wonder about weak muscles contributing to bedwetting, especially as I have seen some of my kids dribble a bit even during the day. Some daytime wetness is not uncommon in kids who wet the bed at later ages.
A child can easily learn to tighten his or her sphincter muscles for intervals throughout the day to strengthen the sphincter. There is no harm done and actually this exercise contributes to overall bowel and bladder health, whether or not someone wets the bed.
7. Hormones
The anti-diuretic hormone (ADH) regulates urine production. When we sleep, it causes a decrease in our urine production. Some studies have shown that some kids release less of this hormone when they’re asleep.
There are synthetic drugs that mimic the hormone. When children are on the drugs, bedwetting decreases, but it resumes when the drug is no longer taken.
Drugs can work as a short-term solution. Some physicians prescribe them so that kids can go to sleepovers, camping trips, and other events without concern for wetting the bed. However, drugs are not a sufficient long-term solution. There is the expense to consider, and more importantly, the side effects.
Even if hormones are the cause of bedwetting, isn’t it possible that a child could still get dry, even if it means getting up more often at night? I believe the answer is yes.
A child with a hormone issue can certainly be trained to keep dry at night. It might be more work, but I believe it is possible. Nonetheless, if this is a concern for a family, they should consult their doctor.
8. Deep Sleep
As a cited cause of bedwetting, deep sleep is gaining in popularity. There are plenty of stories of bedwetters sleeping through alarms while the rest of the family in different rooms throughout the house is woken by the sound.
My own sons who struggled with bedwetting are very deep sleepers and continue to miss alarm clocks. However, they are both now dry every night.
Deep sleep may be a contributing factor in bedwetting, but it does not answer everything.
9. Sleep Disorders
Sleep apnea and sleepwalking have both been associated with bedwetting. More study is needed to get some conclusive numbers. Nonetheless, some have noted that some children who wet the bed snore or sleepwalk. Of course, so do children who do not wet the bed.
When researching, I have found plenty of stories of children who sleepwalk into another family member’s room and pee on that person’s bed, or next to it. Of course, I have found these stories for children who are not normally bedwetters and for children who wet the bed. Peeing while sleepwalking appears to be its own issue rather than an actual cause of kids wetting the bed.
10. Poor Toilet Training
This includes children who were potty trained too young or too forcefully. It also includes children who were potty trained, but with poor habits that did not allow for the brain to fully key into a full bladder. Perhaps daytime accidents or dribbles were never fully dealt with, and even accepted.
Potty training is not an easy endeavor. Usually, in spite of all the parents’ foibles (I speak from hard-earned experience), it all ends smoothly. But sometimes it doesn’t.
Poor toilet training is not a cause that has undergone any extensive research. The cited examples are anecdotal, or stories. In fact, many medical experts will say that how a child was potty trained has nothing to do with bedwetting. Perhaps they’re right. But honestly, I’ve seen too much. And most parents I’ve talked to will say the same. They – and I – can see a connection between potty training and bedwetting.
This cause is actually not one of the hardest to fix. If children are wetting the bed because they weren’t toilet trained well, then retraining the right way will take care of it.
11. Diabetes
Bedwetting can be one of the first signs of diabetes. Diabetes causes excessive thirst and excessive urine.
If a child has always wet the bed (primary enuresis), then this is not likely a cause. However, if a child has secondary enuresis, meaning dry for a season, then starting to wet the bed, diabetes can be the culprit. Note that there are usually other signs of diabetes besides or in addition to wetting the bed.
12. ADHD
ADHD does not actually cause bedwetting. However, it’s been accused of doing so because bedwetting is slightly more common in children who have ADHD.
No one is sure why. Researchers suggest that the link between bedwetting and ADHD has to do with either brain development or the ability to pay attention to a full bladder.
At any rate, though it’s not a cause, children with ADHD may be more likely to wet the bed.
13. Medication That Affects Sleep
Certain prescription medications have incontinence as a side effect. Even some over the counter medications, like antihistamines, have been linked to bedwetting.
Generally, when medications are the culprit, the person bedwetting is an adult. Children aren’t taking the same number or kinds of prescriptions as adults.
Even so, if a child has started wetting the bed around the time a round of medication has been started, it’s worth looking into a possible link.
14. Dandelions
Yes, dandelions. The pretty – or invasive, depending on your opinion – yellow flowers are diuretics. Diuretics cause the body to pass more urine.
In folk medicine, it has been said that children who handle dandelions can end up wetting the bed.
Dandelions are the one flower that I tell my children to pick all they want. I actually let the flowers grow so that my little ones have something to pick other than my tulips and petunias. I might wonder if dandelions were the cause of bedwetting in my home except for the fact that all my children handled them, and still do. Only two of my kids wet the bed, and they’re both dry now, and still picking dandelions.
Nonetheless, dandelions have been accused of causing bedwetting, so they deserve a place on this list. And maybe for someone out there, there is a link.
15. Caffeine
Caffeine increases urine production, having a very mild diuretic effect. Because of this, some have suggested that it causes bedwetting.
Most experts agree that limiting caffeine later in the day is a good idea, but no one can say that it actually causes kids to wet the bed. It’s just one more possibility in the list that answers Why do kids wet the bed?
16. Small Bladder
If a child has a small bladder, then he or she will need to pee more often. Holding it in the night may be particularly difficult.
A family may never know if a small bladder is an issue. While the bladder could be checked with a doctor, the problem of bedwetting could be addressed with good training for waking up at night to go to the bathroom.
17. Stress
Stories abound of children experiencing major emotional trauma and subsequently wetting the bed. Moving, a new baby, a death in the family, divorce, and problems at school are just a few stressors that can trigger bedwetting. In this case, stress being the cause of the bedwetting is obvious. Presumably, after such a storm of life passes, the bedwetting corrects itself, but not always.
Also, stress can come in less obvious ways, as it did in my home. (You can read more about me here and my family’s full bedwetting battle in my book.)
When one of my sons started to have dampness, we handled it poorly. I know it caused him major stress, and I believe that it perpetuated his wetting the bed. There was no major trauma, but stress definitely played a part in his bedwetting. I had hoped the bedwetting would stop after a short, stress-free time of his using disposable training pants. But, it didn’t. Even after the stressor was removed, the bedwetting continued.
Each case has to be examined individually, but I think it is safe to assume that plenty of children endure great amounts of stress for varied reasons. Children in these circumstances could use some positive support and practical help. I know that was the case for at least one of my children.
18. Attitude
Of all the possible reasons why a child is bedwetting, attitude is the one I have heard and seen suggested by parents more than any other. It’s also the one I have heard debunked by experts more than any other.
The parents say things like, “My child wets the bed on purpose.” Or, “My child has a bad attitude.” Other times, the parent might not come right out with the term attitude, but rather state a variation of, “My child isn’t trying hard enough.” Or, “My child doesn’t even care.” Still, there is the more negative, “My child is manipulating me.” And I confess, I have certainly felt these frustrations and spoken them in my heart.
The doctors and child care professionals tend to say, “Your child isn’t doing it on purpose.” And, “Your child isn’t lazy.” And, “Your child is doing the best he or she can and needs your support.”
I believe both the frustrated parents and the well-meaning professionals are right. Every child and every situation is different. Attitude, which could be anything from rebellion to attention-seeking to control issues and beyond, can very well be a cause of bedwetting, but I think it’s very, very few children who fall into this category.
I talk much more in depth about attitude in my article, My Child is Wetting The Bed On Purpose!
I’ll just say that of all the children I’ve worked with and spoken with, their desire is to stay dry. They may look like they have a bad attitude because of how discouraged they feel, but when they voice their feelings, it’s clear that they want to be dry as much as their parents want them to be dry.
19. Cognition and Habit
Cognition refers to how our brains learn, how we process information, and how we use that knowledge. A habit forms when all that cognition takes hold and becomes automatic. There are also things that we do automatically that are not necessarily habits, but we’ve learned them thoroughly, like riding a bike.
What does all this have to do with why kids wet the bed? We know that all children have been wet at night for the first few years of their lives at least. That’s normal development. At a certain age, which varies from child to child, the physical body develops and the brain becomes cognizant, or aware of the fact that the release of the bladder is controllable. Toddlers will often voice that they are wet immediately after filling their diapers. Around this time, we begin potty training and teaching our children about dryness. Here we see cognition working against what has been automatic.
The next logical step is to teach about staying dry at night. Some kids get it so easily, but others really struggle. For some kids, somewhere along the way, the conscious cognition did not come together.
In the case of one of my sons, we did not teach very proactively or consciously. Over time, I believe his bedwetting simply became a habit. We never adequately countered what had been automatic for his brain in his first years of life and his brain never sufficiently made all the cognitive connections.
If we had taught with more intention, would he never have struggled with bedwetting? I will never know. What I do know is that eventually, as he and I consciously worked through My Bedwetting Victory, his brain received ample retraining and he is now 100% dry.
I also believe that he is not a special case. He had a hard time with potty training in the first place. For whatever reason, bladder control was a weak spot for him, just like some kids have trouble with math or reading. He eventually learned, but it took longer and more work in the cognition department.
For my other son, habit is the main factor we battled. I think stress started his early trouble, but then we removed the stress – for years. If stress was the cause, why didn’t the bedwetting stop? By the time we removed the stress, his brain had already begun to make some undesirable subconscious connections.
Over those quiet years, without some healthy retraining, those connections became habit. When he was older and we tried all the suggested methods to stop bedwetting, none of them were strong enough to combat a powerful habit. No matter how much he wanted to be dry, the cognitions in his brain needed some very powerful adjustments fueled by conscious thought.
My son is a good illustration for plenty of struggling bedwetters out there. While there is an initial cause other than habit, it is habit that keeps the bedwetting going. Retraining the brain is the answer.
What if I don’t know why my child is wetting the bed?
This is a pretty big list of possible answers to our question, Why Do Kids Wet the Bed? Even so, I’m sure there are plenty of reasons that are not suggested in the literature and that we will never know.
Knowing why may be of some help, especially if it’s a medical reason like a UTI or diabetes. But the truth is, there are probably a lot of whys all working together and intertwined. Families may discern some reasons and miss others. Even doctors can’t nail down the reason that kids wet the bed.
If a family does not know the exact reason for why a child is wetting the bed, it’s okay. A solution can still be found. That’s what parents want and that’s what kids want.
You can read more about My Bedwetting Victory here. And you can find my complete article on bedwetting solutions here.
References
- Material in this article is adapted from My Bedwetting Victory, by Jeannie Roy
- Children’s National Health System, “Pediatric Urinary Incontinence or Enuresis (bedwetting)”, https://childrensnational.org/choose-childrens/conditions-and-treatments/urology/urinary-incontinence-enuresis-bedwetting
- Fritz, Gregory MD and Randy Rockney MD, “Practice Parameter for the Assessment and Treatment of Children and Adolescents With Enuresis”, Journal of the American Academy of Child and Adolescent Psychiatry, Dec. 2004, https://www.jaacap.org/article/S0890-8567(09)61391-5/pdf
- Harvard Health Publishing, “Medications that can cause urinary incontinence”, Dec 2014, https://www.health.harvard.edu/bladder-and-bowel/medications-that-can-cause-urinary-incontinence
- Mayo Clinic Staff, “Bed-Wetting”, https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
- Rattue, Grace, “Bedwetting Linked to Constipation”, Medical News Today, Feb 2012, https://www.medicalnewstoday.com/articles/241113.php
- Reynoso Paredes, MD, Potenciano. “Case Based Pediatrics For Medical Students and Residents”. Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, 2002.
- Roy, Jeannie, My Bedwetting Victory, 2014, 2019
- Wikipedia, “Nocturnal Enuresis”, https://en.wikipedia.org/wiki/Nocturnal_enuresis
