Treatment for bedwetting (enuresis) before the age of 5 years is typically not recommended. A child of this age will usually outgrow enuresis quickly and treatment can make the child more self-conscious and embarrassed. Some children do not respond to any treatment and must simply outgrow bedwetting on their own. Children develop nocturnal (nighttime) bladder control on their own time. They must not be rushed before they are ready.

If stress, an emotional problem, illness or another physical problem is causing enuresis, it needs to be treated. The child will generally stop wetting the bed once these issues are resolved. Emotional problems may require the assistance of a child and adolescent psychiatrist or other mental health professional.

Support and encouragement are very important for a child who wets the bed. Parents, caretakers and other individuals need to be sensitive to the child’s feelings. The child may be very frustrated, upset or even depressed about the problem. Bedwetting is not the child’s fault and he or she should never be punished for wetting the bed. The child is not bad or naughty and needs to understand this. It may help the child to hear about other family members who had the same problem in childhood. It is important for parents to talk to other family members, especially siblings, about bedwetting and to prohibit teasing of any sort. Parents should not overreact every time the child wets the bed.

To help prevent wetting the bed, children should empty their bladder just before bedtime. For some children, going to bed a little earlier (e.g., 30 minutes) helps. It often helps to restrict beverages in the hours before bedtime. However, this does not mean that the child should be denied a drink. Children should not be sent to bed thirsty. Small amounts of water (e.g., 8 ounces) are typically fine.

Certain foods and beverages are best avoided in the hours before bedtime. Sources of caffeine (e.g., chocolate, sodas or other carbonated beverages) can irritate the bladder and encourage urination. Dairy foods (e.g., milk, cheese) can be problematic in some children, but not all.

Some physicians recommend waking the child up at night to use the toilet. Children can use an alarm clock or the parents can wake them up. However, this may not prevent bedwetting for all children.

It is important to make preparations for easy cleanup. A rubber or plastic bedcover between the sheets and the mattress makes cleanup easier and protects the mattress from urine. Extra bed sheets and pajamas kept near the bed allow children to return to bed more quickly if they wake up at night and find that they have wet the bed.

The most effective treatment for enuresis is a moisture alarm. This is a device that detects wetness and sets off an alarm to wake the child. Many models are available without a prescription in most pharmacies. Depending on the model, wetness may be detected by a pad or clip-on sensor in the child’s pajamas or on the bed sheets. At the first sign of wetness, these sensors set off an alarm that may ring, buzz or vibrate to wake the child. Then the child can go to the toilet and finish urinating.

A moisture alarm can be extremely effective when used by a motivated child. This device is most effective when the child already demonstrates some degree of nighttime bladder control by having both dry and wet nights. It must be used exactly as directed and a noticeable response typically takes several weeks. It may take three months or more before bedwetting stops. Some children begin wetting the bed again after the device is discontinued.

Some pediatricians recommend bladder stretching exercises. In this technique, the child waits a few minutes to go to the toilet after feeling the urge to urinate during the day. This may help to increase bladder capacity.

There are also other techniques that may help. Positive imagery helps some children with enuresis. Here, the child imagines waking up when he or she needs to urinate. The child also imagines waking up in the morning dry. Massage, acupuncture and hypnosis may help some children, but these have not been proven effective and require more research.

Parents are encouraged to avoid treatments that promise a miracle cure. A pediatrician is the best source of information regarding which treatments may actually work for any particular child.

Children aged 7 years or older may also be treated with medications that either suppress the amount of urine produced at night or affect the bladder muscles and capacity. However, this tends to be a last-resort treatment and is usually only attempted when other treatments have not worked. These medications are available in pill form or as a nasal spray. They have side effects, which can range from flushing of the face to seizures, and some can be dangerous, particularly in cases of overdose. They are not recommended for long-term use, but may be beneficial for special occasions, such as sleepovers or during summer camp. They may not work for all children. When they do work, the effects are temporary. Children typically begin to wet the bed again when the medications are stopped.