Learn All About Childhood Bedwetting and Genetics

The average age of potty training can begin between 18mos to 3yrs and this depends on many factors of readiness including: physiological readiness, cognitive readiness, verbal readiness and motor readiness. In this article, we will assess potty-training readiness, as well as look at the underlying causes of child bedwetting and some behavioral modifications we can use to address these causes.

Is your child ready to begin potty training?

In simple terms:

• Is your child uncomfortable when wet? Alerts you with words, signs, or gestures that their diaper is wet or dirty and they want to be changed right away?
• Are they crossing their legs/ or holding themselves when they have to go?
• Can they take their pants on/off?
• Do they show interest in using the potty or show interest when you go to the bathroom and flush the toilet?

The research suggests, developmentally, bladder control (ability to hold an urge) does not occur until 4 years of age but because the signs of readiness can occur earlier between 2-3 yrs parents usually can start potty training at that time. ​During the process of potty training, bedwetting is common.

But what happens when your child has mastered dry days but continues to bedwetting at night?

Turns out there are some clear reasons why persistent bedwetting can occur.

1. Childhood Bedwetting and Genetics: Research shows that if one parent wet the bed as a child there is a 40% likelihood for your child bedwetting; this statistic increases to 77% if both parents wet at night (1).
2. Decreased antidiuretic hormone (ADH)
   1. This is a chemical produced in the brain that tells the kidneys to produce less urine at night. If the body is not producing enough of this hormone then more urine is produced and the child either wakes up many times during the night or wets the bed.
   2. Upper airway obstruction
      1. 43.5% of children with snoring or obstructive sleep apnea became dry after an adenotonsillectomy (Murillo B. Netto, 2021)
3. Constipation
   1. Management of constipation can help decrease pressure onto the bladder due to an over stretched rectum
4. Bladder-Diet irritants
   1. Limiting sugary drinks, soda, and acidic foods
5. Neuropsychiatric disorders- ADHD
6. Toilet training difficulties

If bedwetting continues past the age of 6 it is recommended to seek help. In the meantime here are some suggestions from pelvic health experts

1. Behavior Modification to address Bedwetting

   1. Daytime voiding should happen 5-6x per day and should be timed from when your child wakes, every 2 hrs
   2. Constipation management: try adding in fiber rich foods, perform the ILU massage on your child's belly 2x a day and get your child using a footstool so they are in the right popping position. (Check out this video owner, Heather Jeffcoat, DPT did on her instagram for a demonstration.)
   3. Dietary:
      1. Decrease fluid intake before bed

For more support and education on how to improve your child's bedwetting contact our office to schedule an appointment with our therapist, Sarina Karwande who specializes in pediatric pelvic health conditions. Having your child individually assessed will save time and improve outcomes for your child and family.

Citations:

1. Bedwetting: Causes & Treatment - Urology Care Foundation. (n.d.). Bedwetting: Causes & Treatment - Urology Care Foundation. https://www.urologyhealth.org/urologic-conditions/bed-wetting-(enuresis)
2. Ribeiro, A., Bastos, J. M., Netto, de Figueiredo, A. A., Cândido, T. C., Guércio, W. B., & Zica, B. O. (2022). Enuresis and upper airway obstruction: BNP and ADH hormones behavior before and after airway surgery. International braz j urol : official journal of the Brazilian Society of Urology, 48(6), 937–943. https://doi.org/10.1590/S1677-5538.IBJU.2022.0313
3. Eggert P, Kühn B. Antidiuretic hormone regulation in patients with primary nocturnal enuresis. Arch Dis Child. 1995 Dec;73(6):508-11. doi: 10.1136/adc.73.6.508. PMID: 8546506; PMCID: PMC1511443.