Bedwetting in Children: Causes and Treatment

Published at 11 January 2026

Bedwetting (nocturnal enuresis) is very common among children, and the majority outgrow it over time. The first and most important step is to consult a pediatric urologist to rule out any underlying medical causes, such as urinary tract infections, bladder problems, diabetes, constipation, or other conditions.

After a thorough evaluation, the doctor will recommend a combination of behavioral therapies and practical advice to help the child overcome bedwetting gradually. If these measures are insufficient, the doctor may suggest bedwetting alarms, and if those fail, medications may be considered. (1)

1. Behavioral therapies and general tips

Here are some strategies that can help your child: (2)(3)

Handle the child gently; never punish: Bedwetting is involuntary and the child is not aware of it while sleeping. Scolding or punishment is ineffective. Most children improve naturally over time.
Encourage and reassure the child: Explain that many children experience the same issue to protect their self-esteem.
Scheduled bathroom trips: Have the child urinate 5–7 times per day, including once just before bedtime. Ideally, the child should go to the bathroom twice before sleeping, spaced about 30 minutes apart, to empty the bladder completely.
Limit fluids: Stop all drinks at least one hour before bedtime, including milk and water.
Avoid sugar and caffeine in the evening (e.g., tea, coffee, chocolate).
Keep the bedroom close to the bathroom for quick access.
Avoid making a permanent habit of waking the child at night, though temporary assistance can be used to help them learn bladder control.
Respect privacy: Do not discuss the child’s condition with relatives or friends, in their presence or absence.

Bedwetting alarms

A bedwetting alarm alerts the child when urination begins, prompting them to wake up and go to the bathroom. It is usually recommended for children 6 years and older, as it requires cooperation. The alarm works via a loud sound or vibration when moisture is detected. It can be attached to the bed or the child’s pajamas. Over time, the child learns to associate a full bladder with the need to wake up. (4)

Effectiveness and usage:

Considered highly effective long-term, with success rates up to 70%, and fewer side effects compared to medications.
Initially, parents may need to wake the child and accompany them to the bathroom, but eventually, the child learns to wake independently.
Regular use for 3–4 months is recommended for the child to learn bladder signals.
Improvement often appears in the first few weeks, such as reduced wetting or fewer alarm triggers, and the ability to wake up on their own.
For successful cases, continue use for at least 3 months, plus an extra month after reaching ~90% dry nights.
Some children may experience relapses (29–66%); the device can be reused.
If there is no improvement after 3 months, other options may be considered, but success can still occur as the child grows.

Medications for bedwetting

Medications are usually reserved for children who do not respond to behavioral therapy and after ruling out medical causes. (4)(5)

Desmopressin

Brand example: Minirin Melt
Recommended for children 6 years and older.
Works by reducing urine production.
Taken 30–60 minutes before bedtime, lasting up to 8 hours.
Can be taken daily or intermittently for 3 months, then paused to evaluate progress.
Useful for special situations, such as travel or sleeping away from home.

Precautions:

Generally safe.
Limit fluids from 1 hour before taking the medication until 8 hours afterward to prevent water retention or hyponatremia.

Effectiveness:

About 30% of children achieve full dryness.
Around 40% show significant improvement. (6)

Relapse:

Relapse is common (~70%) after stopping the medication.
Gradual tapering is recommended to reduce relapse risk.
Medications control symptoms, not the root cause; they are used temporarily until the child learns bladder control.

Other important notes:

Evaluate progress after 3 months: Stop medication for a week to assess the need for continued use.
Pause during certain conditions: For children experiencing diarrhea, vomiting, or high physical activity, use intermittently or temporarily stop the medication.
Dose adjustment: The doctor may adjust dosage during the first 2 weeks depending on improvement. Parents play a key role in monitoring progress.

Other medications

Less commonly used options include: (1)(4)

Oxybutynin (Ditropan): For resistant cases, usually combined with other therapies.
Imipramine (Tofranil): Used cautiously and in low doses due to side effects.

Final notes

Bedwetting occurs at least once a week in ~15% of 5-year-old children.
Most children outgrow it over time.
By age 15, only 1–2% still experience bedwetting.
Parents should approach bedwetting with patience and psychological support, as punishment may worsen it.
Early medical guidance and adherence to treatment improve outcomes.

Al Ahli Hospital offers specialized pediatric urologists who provide the latest and most effective treatments for bedwetting, ensuring a comfortable and supportive environment for your child.