We've asked paediatrician, Dr Christine Riyad, for advice.

You're not alone! Nocturnal enuresis, or bedwetting, is common in young children. At the age of five, many children are still developing nighttime bladder control. About 15% of five year olds experience bedwetting, and most outgrow it naturally. It is twice as common in boys and often runs in families. If a parent had a history of bedwetting, their child has about a 50% chance of experiencing it too.

Types of bedwetting

• Primary enuresis: when a child has never had nighttime bladder control and consistently wets the bed.
• Secondary enuresis: when a child has been dry at night for at least six months but starts wetting the bed again. This may indicate a urinary tract infection, other health conditions, stress or neurological concerns.

Why does bedwetting happen?

Nighttime dryness is a complex developmental process. Children first learn to recognise when their bladder is full, then to hold urine voluntarily, and finally, to wake up when they need to go during sleep. While daytime control is usually achieved by age four, nighttime control can take longer -often until ages five to seven.

In babies and toddlers, the brain-bladder connection isn’t fully developed, so the bladder releases urine automatically when full. As children grow, this connection strengthens, allowing them to control when they empty their bladder.

What are some common causes of bedwetting?

Genetics

If both parents experienced bedwetting, their child has a 75% chance of having it too.

Obstructive sleep apnoea/snoring

In rare cases, a partially blocked airway during sleep can disrupt breathing and alter brain chemistry, triggering bedwetting.

Constipation

A full bowel can press on the bladder, increasing the likelihood of accidents. Treating constipation often improves bladder control.

Medical conditions

Issues like bladder or kidney disease may cause both daytime and nighttime accidents, often accompanied by symptoms like pain or frequent urination.

Neurological concerns

Rarely, spinal cord problems can lead to bedwetting, especially if a child also experiences numbness, tingling, or leg pain.

The good news

Bedwetting is usually not a serious health concern, and most children outgrow it with time. However, every child develops at their own pace.

What can help?

Here are some strategies to support your child:

• Encourage regular bathroom breaks throughout the day (4–7 times), especially before bed.
• Make nighttime trips easier with a nightlight or an open bathroom door.
• Limit fluids and salty snacks in the evening, but ensure proper hydration earlier in the day.
• Avoid sugary drinks like chocolate milk, fruit juice or lemonade, especially at night.
• If your child wakes up for another reason, take them to the bathroom to reinforce the habit.
• Use absorbent bedding and mattress protectors for easier cleanup.
• Track progress with a dry/wet night calendar.

The emotional impact

Bedwetting can be frustrating for both children and parents, but a supportive approach makes all the difference.

Stay positive and reassuring.

Bedwetting is not your child's fault. Punishment or shame can make it worse.

Involve your child.

Encourage them to help change wet sheets as a way to take responsibility, but never as a punishment.

Set a no-teasing rule.

Ensure siblings or family members don’t make fun of them.

Be honest and reassuring.

Let your child know most kids outgrow bedwetting, and they are not alone.

Keep perspective.

If you don’t make a big deal out of it, your child likely won’t either.

When to see a paediatrician?

A paediatrician will assess bedwetting through a detailed history, physical exam and urinalysis to rule out medical conditions. They will ask about your child’s urinary habits, sleep patterns, bowel movements, and family history. Most cases do not require X-rays or specialised tests.

The decision to pursue treatment depends on the child’s age, emotional wellbeing and the family's concerns. Your paediatrician will discuss the available options with you and help determine the best approach based on your child's individual needs.

Dr Christine Riyad is a US board-certified paediatrician and a graduate of the Medical University of South Carolina. She completed her residency training in general paediatrics in the United States before sub-specialising in paediatric rheumatology at Great Ormond Street Hospital in London. She later became a Fellow of the Royal College of Paediatrics and Child Health, a designation awarded to paediatricians who have demonstrated advanced expertise in the field.