There are several different reasons children struggle with bedwetting past the age of 4. It’s normal for a child to be unable to hold their bladder all night up to age 4 and sometimes even up to age 7. However after age 7 its considered diagnosable (nocturnal enuresis). If child was nighttime trained and then regressed it could also be a diagnosable problem. See reasons below.
Note: If children are wetting during the daytime past the potty training stage, that is likely a medical problem or trauma related. Seek a doctor’s recommendation.
1) Medical/Health problem
The child could have a bladder problem, Urinary tract infection (UTI), immature bladder (not ready to be able to hold it all night), some other health issue. It could be genetic too.
Solution: To rule this out see your child’s pediatrician and/or an urologist.
2) Heavy sleeper
Some kids sleep too heavily at night and are unaware when their bodies need to go. Their body doesn’t automatically wake them up at night to go.
Solution: Limit fluids a few hours before bedtime, wake them during the night to use the bathroom, try a ‘Bell Pad technique’ device that vibrates or rings when child starts to wet and it wakes them to finish peeing in the bathroom. Try a reward system for a dry bed. If these don’t work there are medications that can help. See urologist for options.
If a child has been through a traumatic experience, especially sexual abuse, it can cause bedwetting. The child may be sleeping fitfully, having nightmares, or their body is unconsciously trying to fend off people by wetting self to push people away.
Solution: Seek a child therapist. If you’re not sure if your child has been through a trauma or been abused but you see some signs, have them evaluated by a doctor or therapist.
If the child is refusing to get up during the night or wetting the bed in the morning, it could be because they are lazy and don’t want to get out of bed to use the bathroom. If the other reasons above have been ruled out this might be the problem.
Solution: Provide reward/sticker chart for using bathroom and dry bed. Have child strip sheets off bed and wash them themselves or bring to laundry area for parents. Have child make their own bed with clean sheets (or help make the bed). Have child wash their body themselves in the morning. If problem continues see a therapist.