Q. My daughter still wets the bed at age six. She has been seen by a urologist who didn’t find anything wrong. Needless to say, she is extremely embarrassed about this situation. She can’t sleep over at a friend’s house and it’s awkward to explain why.

She has been taking Ritalin for ADD this year. It has helped her concentration, but I don’t know if it contributes to the bed-wetting. Our doctor recently prescribed imipramine to see if it would solve that problem. It seemed to help for a few days. I stopped giving it to her, however, because it seemed to make her irritable. I worry that taking both drugs every day might have lasting effects on her. Is there an approach that minimizes medications?

A. When Ritalin (methylphenidate) and the antidepressant imipramine are taken together, blood levels of imipramine may be higher than expected. This could lead to side effects such as insomnia, nervousness, digestive upset and irritability.

Sleep expert Martin Scharf, Ph.D., suggests reducing snacks and drinks (especially caffeinated soft drinks) in the evening. He also recommends bladder stretching exercises by asking the child to delay urinating during the day for gradually increasing periods. Your daughter should go to the bathroom just before bedtime and then you should wake her an hour later to pee again.

A wetness alarm (DRI Sleeper, Nature Calls, Wet-No-More) that sounds a tone at the first hint of urine can be helpful. She should be rewarded for each dry night. Be patient, as it may take several months to see improvement.

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  1. Trey

    The best part of the comments and this article is the advice to get a doctor’s take on why your child may be bedwetting. This will help rule out any physical issues such as overactive bladder, or even an allergy or reaction to milk.
    Limiting caffeine to kids is a good idea whether they wet the bed or not!
    Alarms are wonderful, and are always recommended over using pull-ups (even if they are called “absorbent underwear”.) Alarms come in all colors and functions, but I recommend a variable tone model with vibration. Lights are nice, if included, but the vibration and especially the variable tone are more important. Some attach to pajamas with a safety pin, others with magnets, so you can choose which one suits you best.

  2. WSmith

    I had read many years ago where bedwetting is associated with low levels of Vitamin B. These levels could be checked and easily supplemented with Vitamin B Complex if indicated.

  3. C=PAP user

    Some young children with sleep apnea wet the bed without realizing it. One option is to take your daughter to a hospital Sleep Clinic for overnight testing while you are in the room to analyze the effects of her restlessness on the quality of her sleep.

  4. BW

    I’ve lived as many decades as your daughter has years. I have maybe had two or three nights in my entire lifetime I could sleep through the night. I have diabetes insipidis, which I inherited. No cure, but treatable (DDAVP, a nasal spray, works pretty well). How much I drink and when has not a lot of effect on nighttime need to go … I drink almost nothing after 3:00 PM, but still I get up a lot. A part of life.

  5. Bill

    We had very good luck with a wetness alarm. (At that time called a potty trainer.) Our daughter was awakened or we were and soon she was very proud of the fact that she would wake up and potty on her own!!

  6. P. Adrian

    I am 75 yrs old. As a child I was a bedwetter. In a time when children were punished for it my mother very wisely ignored it. It continued from time to time until I was a teen and began periods. At that time it would happen a night or two before my period would start. This continued until I was 16. Why this happened, who knows! My mother continued to wake me every night and sometimes twice if she were awake. Of my 4 sons and 1 daughter only my daughter was a wetter. I took a page from mother’s book and ignored it. However when she was 12 or so she was so upset over it I began to investigate it with the doctor. There were no medical reasons for it. The MD put her on Tofanel with the thought that she was a very deep sleeper and this might help raise her level of sleep. It worked! The minute she would start to pee she would wake up and RUN to the bathroom where previously she would sleep until morning, wet or not. She took about 6 months to break the bedwetting “habit”.
    One of my sons was the first patient our MD put on Ritalin. He was 10 or 11. In those days a child could carry a dose in their pocket with a note from mom. He only took it for school. When home he did not. He only took the afternoon doses if he felt he needed it. He only took it for one school year. Of course, you can’t do that with a 6 yr old but what I am getting at is maybe she only needs Ritalin in stressful periods.

  7. BD

    You might consider chiropractic treatment, acupuncture (there are acupuncture treatment methods that don’t use needles), and naturopathic/herbal approach.

  8. PG

    My daughter had the same problem as did several friend’s children. She told me, “I want to be dry at night but my bladder just won’t wake me up.” She was so ashamed to have to wear diapers at night. We tried all of the common treatments to no avail. After recommendation from our pediatrician we did a trial of eliminating all dairy products for two weeks. After only 4 days she was dry at night and remained dry so long as she was off dairy products (cow-based.)Sometimes she couldn’t avoid it and would find herself wet.
    The Ped said it was a sensitivity to the cow’s milk protein and that she would probably outgrow it in time, which she did. I found substitutes in sheep yogurt, almond milk, sheep or goat cheese and I gave her a calcium/magnesium supplement for children. I passed the word along to friends and those whose children would go along with the elimination diet had success too. It’s worth a try.

  9. fhaley

    I wanted to share how difficult it was for my son. He wetted the bed until he was eight and it was extremely difficult for we traveled often to see family with many cousins the same age who would all sleep in one room on the floor, we always made special arrangements for him and would get him up early to avoid a scene. He used pull-ups most of the time which were awesome.
    We finally did an ultra sound and our urologist told us that he had an over active bladder, that urine sprays into the bladder much faster than normal. He is 26 now and still uses the bathroom more often than others. The Dr. also said this is hereditary, which then made me remember that my sister had the same problem until she was nine and my Dad told me that he had the same problem. What is weird is that out of all of my siblings 12 children only my son has that problem.

  10. Sue

    So sorry she has to take medication! People’s Pharmacy offered great advice. I do not allow my daughter drinks close to bedtime and if she says she has to, I give her only quarter of a cup. I also make her pee before bed, now THIS MAY SOUND FUNNY BUT IT WORKS: on the island where I am from, if a child does not feel to pee and you want them to, you let them sit on the toilet and you make this sound “shhhweeeee” a few times in succession, kinda like the sound of running pee, shhhhweeeshhweee, it sounds crazy but it works.
    You can even try it on yourself, if it takes more than a few seconds to happen you can also turn on the tap at the bathroom sink and tell her to look at the water and make that same sound and that should do the trick. I know it sounds weird but it has never failed me or the kids before bed or before going out.

  11. Mr Walt

    Our son had this problem & we used the alarm with great success within a couple of weeks. We left the alarm on his bed for a couple of months, but he didn’t wet the bed after the two weeks.

  12. Jean

    My son and my granddaughter had the same problem. The Drs. and all info I could find was that the nerve that triggers the brain to tell the bladder that one has to urinate is not matured yet, therefore the child will wet the bed. They both finally grew out of it. My son was about 7 and my granddaughter ws 12 when they quit.

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