No. 18; Updated October 2023 

Many parents are concerned when their child continues to wet their bed at night past the age of three years old. Although most children are toilet trained between two and four years, some children are not able to stay dry until a few years later, and for some nighttime dryness occurs in older children. Child and adolescent psychiatrists and pediatricians stress that bedwetting is fairly common and not a disease. Occasional accidents may occur, often when the child is ill. Parents need to be understanding since even toilet trained children may have occasional accidents.

Some facts parents should know about bedwetting:

  • About 20 percent of 5-year-old and 10 % of 7-year-olds children wet the bed
  • Many more boys than girls wet their beds
  • Bedwetting runs in families
  • Bedwetting is also known as enuresis
  • Usually bedwetting stops by puberty
  • Most children who wet the bed do not have emotional problems

Causes of bedwetting include the following:

  • A child’s bladder is small and not ready to hold the child’s urine overnight
  • A child is a deep sleeper and does not wake up when the bladder is full
  • A child is constipated, and this is placing pressure on the bladder
  • A child does not empty the bladder completely before going to sleep

Continued bedwetting beyond the age of three or four rarely signals a kidney or bladder problem. The child’s pediatrician or family doctor can help rule out medical causes such as infection. Bedwetting may sometimes be related to a sleep disorder. Sometimes medications a child is taking can change how deeply they sleep and lead to bedwetting. In most cases, the child's bladder control might be slower to develop than other children. Bedwetting may also be the result of the child's tensions and emotions that require attention.

There are emotional reasons for bedwetting. For example, when a young child begins bedwetting after several months or years of dryness during the night, this may reflect new fears or insecurities. Often, this may follow changes or events which make the child feel insecure, such as: moving to a new home, parents’ divorce, losing a family member or loved one, being the victim or bullying or trauma, or the arrival of a new baby or child in the home.

Parents should remember that children rarely wet on purpose, and usually feel ashamed about the incident. Parents need to encourage the child and express confidence that he or she will soon be able to stay dry at night.

Parents may help children who wet the bed by:

  • Limiting liquid drinks before bedtime
  • Encouraging the child to go to the bathroom before bedtime
  • Praising the child on dry mornings
  • When starting to have dry nights consider a sticker chart to track the change and praise
  • Avoiding punishments
  •  Waking the child during the night to empty their bladder
  • Using “pull-ups” until a number of successive dry nights

Treatment for bedwetting in children usually includes behavioral conditioning devices (pad/buzzer/alarms) and/or medications if behavioral tools like the ones listed above are unsuccessful. In rare cases, the problem of bedwetting continues. Sometimes the child may also show symptoms of emotional problems--such as persistent sadness or irritability, or a change in eating or sleeping habits. In these cases, parents may want to talk with a child and adolescent psychiatrist or mental health provider, who will evaluate physical and emotional problems that may be causing the bedwetting, and will work with the child and parents to resolve these problems. Early supportive intervention will help minimize the potential emotional impact of persistent bedwetting on the child.


For additional information see:

If you find Facts for Families© helpful and would like to make good mental health a reality, consider donating to the Campaign for America’s Kids. Your support will help us continue to produce and distribute Facts for Families, as well as other vital mental health information, free of charge.

You may also mail in your contribution. Please make checks payable to the AACAP and send to Campaign for America’s Kids, P.O. Box 96106, Washington, DC 20090.

The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 9,400 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

Facts for Families© information sheets are developed, owned and distributed by AACAP. Hard copies of Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale or profit. All Facts can be viewed and printed from the AACAP website (www.aacap.org). Facts sheets may not be reproduced, duplicated or posted on any other website without written consent from AACAP. Organizations are permitted to create links to AACAP's website and specific Facts sheets. For all questions please contact the AACAP Communications Manager, ext. 154.

If you need immediate assistance, please dial 911.

Copyright © 2023 by the American Academy of Child and Adolescent Psychiatry.