Nocturnal Enuresis- Pediatric Care Plan

By K Health
Medically reviewed checkmarkMedically reviewed
June 17, 2019

Patient Instructions/Care Plan Information

If you have any other questions about bedwetting, or the treatment we discussed today, please let me know. Attached is a detailed care plan that includes more information about nighttime bedwetting as well as things you can do to help your child. If symptoms do not improve, please take your child to be evaluated by their doctor. I hope your child feels better soon and thanks for choosing us! 

What is nighttime bedwetting?

Nighttime bedwetting (also known as ‘nocturnal enuresis’ or simply ‘bedwetting’) refers to involuntary or accidental nighttime urination. It is very common among children until ages 5 to 7, after which it tends to gradually self-resolve. By the ages 13 to 15, only about 1-2% of children are still bedwetting. 

Bedwetting is not the child’s fault, regardless of the age. 

If it continues or reoccurs in a child that is already out of nighttime diapers, it may require further evaluation and care, and in some cases may be related to life-stressors such as divorce, relocation, a new sibling etc. 

If it occurs in children who also have daytime wetting or other urinary symptoms, other causes should be investigated.

Diagnosis

Bedwetting can be diagnosed by a medical history and physical exam which is also used to rule out potential causes such as:

  • Bladder dysfunction
  • Urinary tract infection
  • Constipation
  • Pinworms
  • Obstructive sleep apnea

Treatment

It is recommended to start treatment when the child and the parents are motivated by some end goal or external motivator (such a child wanting to have sleep-overs). It also involves addressing other issues (like snoring or constipation), where relevant.

Medications

In some cases, a medication called desmopressin is prescribed by doctors for infrequent bedwetting or for short term use.

Bedwetting alarm

Another common treatment are special bedwetting alarms that work by conditioning the child to wake up as bedwetting occurs. It can take up to 3 months to completely resolve bedwetting. 

These can be purchased here

Other strategies to manage bedwetting:

  • Eliminate or reduce salty, spicy, sweet, or caffeinated foods and drinks
  • Ensure sufficient fluid intake during the first part of the day and reduce fluid intake from the afternoon onwards
  • Ensure your child goes to the bathroom before bed

See a doctor in person if…

  • Your child has issues with daytime incontinence (daytime wetting)
  • Your child voids large amounts frequently
  • Your child is excessively thirsty
  • Your child is losing weight 
  • Your child is snoring at night
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health

Reliable, relatable medical information written by hundreds of board-certified clinicians, updated regularly to ensure accuracy.