How to combat the hidden costs of bedwetting in childhood

Davina Richardson RGN/RSCN BSC (Hons)

Specialist Nurse, Bladder and Bowel UK

Bedwetting affects between 5% and 10% of children at age seven and about 1 to 2% of adolescents. Yet, it remains largely hidden due to embarrassment and general misunderstanding about the causes.

Many affected families do not realise that bedwetting is a recognised medical condition from the age of five, and unfortunately myths remain from previous generations when there was little scientific evidence about what causes bedwetting.  

Various causes of bedwetting in childhood 

While stress and psychological factors can affect bedwetting, they rarely cause it. Bedwetting does not happen because of naughtiness or laziness in the child or because of anything they or their family have done wrong.    

Bedwetting in childhood may be due to the kidneys producing more urine during sleep than the bladder can hold. When this happens, there are not usually any bladder problems presenting during the day to warn you. However, some children will experience issues during the day, having to rush to the toilet more than the expected five to seven times a day or having bladder leakage. There can also be an associated underlying constipation.

When you are asleep, the brain will usually receive a signal from the bladder that it is full and needs emptying — at which point you would wake up and go to the toilet. However, when these issues are associated with an inability to wake during this signalling, wetting during sleep is the inevitable consequence. Unfortunately, for some children, the bladder is just not working as well as it should at storing urine.

How bedwetting affects children and parents 

It is widely recognised that the condition may cause embarrassment and distress to children and their families. Social opportunities may be restricted due to the difficulties of sleeping away from home.  

Approximately 30% of 1,006 parents, responding to a Bladder & Bowel UK survey undertaken for World Bedwetting Week in 2022, reported that their child had missed out on overnight trips away from home; and 36% were worried about going on holiday due to the bedwetting, with many opting to take their own waterproof mattress cover — and over half taking additional clothes.  

Treatment for bedwetting can mitigate many of the psychological, social and financial costs.

Financial and sleep consequences of bedwetting  

There are several potential associated costs to bedwetting. Over a third of parents in the survey expressed concern about the financial implications of having to purchase additional pyjamas, underwear and bedding.  

There are also the associated expenses of additional detergents, water and electricity for the washing and difficulties of drying wet bedding in poor weather. Inevitably, those from lower-income families are disproportionately impacted. 

A problem less well recognised is the associated disturbed sleep. Over a third of parents in the Bladder & Bowel UK survey were worried about getting less sleep themselves due to their child’s bedwetting.  

Research has established that children who are wet at night or children who have bedwetting are unable to wake to the bladder signalling that it needs to empty — but their sleep is still disturbed by those bladder signals. This results in poorer-quality sleep than their peers. Some children experience difficulties in their daytime functioning as a result, including with impacting their behaviour and concentration. The good news is that these improve with successful treatment.  

Find the right treatment for bedwetting 

Treatment for bedwetting can mitigate many of the psychological, social and financial costs. Three-quarters of the families who participated in the Bladder & Bowel UK survey said that they would ask their GP for advice. They could also approach their child’s school nurse.  

Healthcare professionals may offer initial advice and support, along with a referral to a local service for further treatment if required. There is also information available online. Children and parents do not have to suffer the consequences of bedwetting throughout an entire childhood. There are ways to treat it — with resources and professionals who can help.  

UK-URO-2300012 | June 2023