Before the start of the new school year, you went into overdrive to get everything ready, from backpacks to lunches to brand-new outfits. Then, during those first few weeks when everything is supposed to go swimmingly (thanks to your epic preparation efforts), it happens: Your child wakes up covered in pee — they’ve wet the bed. It’s not a surprising scenario, experts explain, as there’s a clear link between anxiety, including back-to-school anxiety, and wetting the bed.
Hopkins Medicine reports that both physical and emotional stressors are “well-known contributors” to bedwetting. Unfortunately, it can create a bit of an anxiety cycle, too — children with some social anxiety around the bedwetting behaviors can experience more difficulties stopping, one study explains.
So, what should parents do to help their kids during the back-to-school transition and beyond? Here’s what experts recommend trying: to get back to cozy and dry nights… and less anxiety.
PSA: There are specific kinds of bedwetting.
First, it’s important to recognize what bedwetting is. The type of bedwetting that comes on suddenly after at least a six-month dry period is called “secondary enuresis,” says Dr. Stephen Canon, pediatric urologist at Vamio Health. “It typically occurs following some type of stressful event.” And for some, especially those starting a new environment, that’s exactly what back-to-school time is.
“It happens more likely to a child going to school for the first time rather than one who has already experienced the school setting. Helping the child learn to manage the stress will most often stop the bedwetting,” says Dr. Edgar Navarro Garza, a pediatrician at Harbor Health in Austin, Texas.
How can you tell if it’s from stress?
But he adds that determining the real cause for bedwetting can be “tricky.” It’s possible that something else has happened or there’s a physiological issue other than simply back-to-school anxiety that has occurred at the same time.
“Stress can be a trigger for many different medical problems. When a new problem arises like bedwetting, we should start by asking the family what has changed in the child’s life within the past days/weeks that could have triggered it,” Garza says. For example, parents can ask: “Is the child sick? Was the child injured? Has the fluid intake changed? Is it stress?” These might give them some clues on the potential cause.
Be careful not to overlook another cause.
There’s a chance, too, that it might not be from stress but from another medical problem, from a urinary tract infection to diabetes. “When older children or teens start bedwetting after previously having bladder control, they should see a doctor. It could be a sign of health problems including neurological issues, diabetes, a urinary tract infection, the bladder not being able to hold much urine, constipation, obstructive sleep apnea, or stress,” Garza says.
In addition, parents should watch for changes in the color of the urine or pain when urinating. “Other symptoms to see the doctor about would be changes in how much the child goes to the bathroom during the day, poor bowel control, a sudden change in mood, or gait changes that could point to a neurological issue.”
But, he adds, bedwetting isn’t as worrisome if your child is still younger and hasn’t developed complete overnight bladder control.
But most of the time, it resolves on its own.
Sure, you could go down the rabbit hole of Googling every possible condition between loads of pee-soaked laundry. But Dr. Jean Moorjani, Pediatrician at Orlando Health Arnold Palmer Hospital for Children, says that typically, there’s no serious medical problem. “Sometimes children can be dry at night for a long time, but then experience nighttime bedwetting again,” she says, including that this often happens around stressors like divorce, death in the family, a new sibling, a new move, or the start of school. Like so many parenting-related things, the solution might simply be getting to the bottom of your child’s stressors.
“Identifying and treating the stress that a child is experiencing is one of the best ways that parents and caregivers can help support them during this temporary phase of nighttime bedwetting. As your child adjusts to their new routine or new normal, then the bedwetting typically will resolve on its own,” she says.
What You Can Try Now
Aside from taking time to understand your child’s stress and ruling out other medical issues, you can try a few other tricks from our experts.
Part of the stressful cycle of bedwetting is it can lead to even more shame and lower self-esteem when a child is already stressed.
“The child can feel a lot of shame when the bedwetting happens, and then even worse, they hold that shame alone. So, now they have increased anxiety from school as well as increased shame and are dealing with that all alone, which increases the mobilization of the nervous system,” says Dr. Matthew Lederman, board-certified internal medicine physician in Los Angeles. “We know from the expressive writing data that just holding onto these emotions makes everything worse, and finding a space to share them without anyone reacting or trying to fix them is very healing.”
Even sharing your own story of a time you peed your own pants as an older child or adult can lighten the mood.
Heading to the Bathroom More Often
Before bed, instead of just using the bathroom once, you can encourage your child to go multiple times in the hours leading up to bedtime, Garza says. “You can also try setting an alarm to wake your child one time during the night to use the bathroom.”
Limiting Caffeine and Sugar
These ingredients can lead to more bedwetting, points out Garza. So, stick to just a bit of water before bed instead of sodas, juices, and other culprits.
Reviewing Your Family’s Typical Bedwetting Timeline
Bedwetting can be a family affair, Garza says. If you or your relatives bedwet for longer, your child might too. “About 15% of children still wet the bed when they are 5 years old, but by the time they are 15 years old, less than 1% experience bedwetting. Also, bedwetting is more common in boys than girls,” he says. So, determine if bedwetting at your child’s age really is abnormal, given their age, sex, and genetics.
Moorjani adds that it’s simply a matter of how old a child is when their brain and bladder get on the same page. “Sometimes it just takes a little longer for the pathway between the brain and bladder to develop when a child is sleeping.”
Getting More Information About School
If school is truly the stressor, gaining more information from others except your child can help you get the full picture of what they are stressing about. A quick chat with their teacher, bus driver, and other relevant adults might help you understand exactly what they are anxious about and if any of their behaviors are out of the ordinary during the day when you aren’t together.
With a bit of detective work, some patience, and perhaps a chat with your pediatrician if needed, your child will be headed for calm and dry nights again soon.