Bedwetting & Adopted Children

Dawn Davenport

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bedwetting and adopted child

Adopted toddlers and children often have issues with wetting the bed and potty training, even if they were potty trained before being adopted.  It can be frustrating for new parents to deal with, but it isn’t necessarily a sign of a problem.

I’ve had a lot of personal parenting experience with bed wetting. I also have done a fair amount of research on the subject and had an article on bed wetting picked up by the Associated Press.  There was a time, sorry to say, when a Google search of my name returned only bed wetting sites that had republished some of what I’ve written. Quite a claim to fame, eh???

Why Bedwetting is Common with Adopted Kids

Although I know it feels longer when you are up in the middle of the night for weeks, you have to keep things in perspective.  Your child is adjusting to a complete and total change to everything she knows.  Regardless how she acts, she is likely reeling emotionally and barely hanging on.  It can take months before your child is over the initial shock, and bedwetting during this adjustment time is very, very common, even with much older kids who had been totally dry pre-adoption.

Newly adopted kids often have erratic sleep patterns—not allowing themselves to fall into a deep sleep, frequent waking, etc.—all of which makes night wetting more common. If you adopted internationally, you need to add jet lag into the mix.  I’ve read where it takes about a month to fully adjust to a new time zone when the difference between the time zones is as great as between China and the US.

How Common is Bedwetting in Adopted Children?

To put things in perspective, 40% of all children are still wetting the bed at age 4, and 20% at age 6.  By the age of 12, only 3% of kids are still wet at night. I don’t have any hard research, but from what I hear, I’d say that 80%+ of newly adopted four-year-olds wet the bed at night.

Understanding the Different Types of Bedwetting

At the risk of over simplifying, there are three main types of bedwetters:

  • situational,
  • developmental
  • psychological

Situational bedwetters wet the bed when they are sick, emotionally fried, or overly tired.

Developmental bedwetters simply have bodies that are not ready to stay dry at night until they are older—sometimes much older.  Research shows that enuresis (developmental bedwetting) is likely caused by a combination of genes, deep sleep, sluggish arousal mechanism, and smallish bladder.

Psychological bedwetting happens when the child wets the bed (or their clothing during the day) as a way of controlling their world and parents.  This is pretty rare, and the key for parents is to avoid turning the situational and developmental bedwetter into the psychological bedwetter.

What Type of Bedwetter are Adopted Kids?

Adopted children usually fall into the situational bedwetting camp.  She doesn’t want to wet the bed any more than you want her to, regardless how she acts.  Your child might even be worried about it depending on how bedwetting was treated in her previous living situation, and very often children have been punished, sometimes harshly, for wetting the bed.

A situational bedwetter will probably stay dry most nights pretty soon regardless what you do, but the message you need to send to her right now is that this is nothing to worry about, you will help her, and you understand her.  However, I also think it is really important that you minimize the hassle and fuss so that you both get as much sleep as possible.  I can help with my bedwetting rules learned through years of soggy experience.

How to Handle Bedwetting with Adopted Kids

I truly, truly know how exhausting it can be as the parent in this situation. You too are adjusting to a total change to your life.  A decent night’s sleep would really help right about now. While I can’t promise you a totally uninterrupted night’s sleep for the near future, I do have a plan.

The goal is to get your little one back to sleep with the minimal amount of fuss possible. The more you do, the more awake you both become.  The added goal, especially with a developmental bedwetter, is to have them learn to get themselves back to sleep without involving you. (This likely won’t happen with a situational bedwetter because they won’t wet the bed long enough to learn this skill.)

  1. Alter habits.  You are probably already doing this, but limit large amounts of fluids an hour or so before bedtime.  Have her go to the bathroom right before she goes to bed.  If you stay up for a couple of hours after that, it doesn’t hurt to take her to the potty before you go to bed. There is not much research that this will help, but at the least it makes you feel like you have a fighting chance at a full night’s sleep.
  2. Simplify bedding. Put a good (read: not the cheapo brand) plastic cover over the mattress and pillow.  Use the minimal amount of bedding to keep the kid warm, but not exceed one washer load, keeping in mind that you’ll also be washing two pairs of pajamas.  We used a bottom sheet and one washable and quickly dryable warm blanket. For a while, we stopped using a fitted bottom sheet because it made remaking the bed more work.  We just threw the top sheet over the bed and didn’t even bother to tuck it in.  We didn’t use a bedspread or fluffy decorative pillows.  My kids that wet the bed weren’t big on sleeping with stuffed animals, and readily agreed to put their animals beside rather than on the bed, but you might have to play that one by ear.  If your child decides to sleep with a furry friend, just stick it in the washer and dryer with the rest of the bedding.
  3. Minimize middle of the night fuss.   First and foremost, there should be no bath until morning. A little (or a lot) of pee will not cause a rash or harm her in any way. If she (or you) strongly objects, let her use a few baby wipes to clean herself quickly.  She needs to change into dry PJs, and go back to sleep.  The big question is where.  I’m not a big believer in changing sheets in the middle of the night since the goal is to disrupt everyone’s sleep as little as possible. For an occasional wet bed, I could be talked into it, but since your child is on a bed wetting roll, avoid the hassle of changing sheets in the middle of the night.  Here are a couple of options to consider.
    • Have a plastic sheet spread out on the floor and a couple of blankets, so she can make a floor pallet to sleep on.  Most kids only wet once during the night, but if you have one that is the exception, then keep the floor bedding simple and easily washable as well.
    • We brainstormed with one of ours, and he came up with this solution that worked really well.  He suggested that we keep a stack of pool towels by the bed.  If he wet the bed, he would simply lay a couple of towels on the bed then climb back in. I worried that he would still be damp and cold, but the bottom towel seemed to absorb the pee, and the top towel kept him dry.
    • If there is another bed nearby that she could use, make sure it is ready.  I know plenty of kids who climb in bed with a sibling or parent, but you will want to make sure that bed is protected with a plastic mattress cover.
    • Have dry jammies at the ready before they go to bed, and make sure the child knows where they are and can easily get into them on her own.  Also have a place to drop the wet pajamas.  We had an adjoining bathroom with a tiled floor, so we had them drop the wet pajamas on the floor to be picked up in the morning.  If we didn’t have that, I would put a piece of plastic (torn open garbage bag) on the floor and have them drop the soiled PJs on the plastic. You could just use a garbage bag, but getting wet pajamas into a garbage bag requires a certain amount of skill and requires being fairly awake for most little kids, so I prefer to create a situation that simply allows them to drop their clothes, but still protect the carpet from getting stinky.
  4. To use pull-ups or not—that is the BIG question.  There is a lot of debate amongst parents of developmental bedwetters and doctors about whether pull ups help or hurt the development of night time dryness.  The argument against using pull ups is that they are so absorbent that the child does not feel the first drops of urine, and therefore doesn’t rouse from her slumber enough to get to the bathroom or stop peeing.  There is some evidence that kids that use pull ups at night take longer to night time train.  The argument for pull ups is pretty obvious—ease of clean up.  The choice is yours, but keep in mind that many adopted kids have never used them in the past and may object. In my case, I was inconsistent.  In theory I agreed with the anti-pull up folks, so would go for periods of time without using them.  Then I would say “what the heck” and revert to using them again.  We always used them for travel and sleep overs.  Pull ups aren’t’ particularly useful for the situational bedwetter since you have to know in advance that the kids is going to wet the bed that night.
  5. Involve the child in the cleanup.  This rule is really more for the developmental bedwetter than the situational bedwetter. If your kid occasionally wets the bed after skipping his nap or having a huge glass of water after dinner, it really doesn’t matter if he helps with the cleanup since it happens so infrequently.  If however it happens a lot, it is good for the child to take on some of the responsibility.  The key, and this is the most important part, is that this is in no way punitive.  You must NOT think of this as punishing your child by having her clean up the mess.  Your child is simply helping take care of herself. We teach our children to button up their shirts by themselves and to take care of wet sheets for the same reason–it builds confidence and, in the case of bedwetting, it restores dignity.  Bedwetting can make a kid feel inferior and immature, so everything we can do to build their competence is a good thing. Across the board, your attitude with bedwetting should be one of working together to solve the problem. A four year old can help carry the pillow case and pajamas to the washer the next morning, while you carry the sheet and blanket.  Most four year olds would love to spray the mild cleaner on the plastic sheet cover and floor where the jammies sat while you wipe it down.  They will feel competent and proud to be able to help. Make sure you notice how capable they are, and thank them as well. They should also help make the bed up the following night.  Eventually and gradually, if your child does not develop night time dryness, she will grow into pulling the sheets off the bed in the morning and putting them in the washing machine.  Whoever is around when the washer stops should put them in the dryer. My kids would usually empty the dryer and take the sheets up to their beds, but almost always I was around to help them remake the bed before bedtime.  We just incorporated this ritual into our bedtime routine.
  6. Reassure your child. I have never heard of a child over the age of four or five who didn’t worry that something was wrong with them. With adopted kids, it is especially important that your actions show them that you are not upset and that this is just a normal part of adjustment.  Children need to know that everyone occasionally wets the bed.  It helps for them to know that drinking that big drink right before bed or skipping that nap makes it more likely. Developmental bedwetters need to know that plenty of kids their age wet the bed.   Even though the cause of bedwetting past the age of 4 or 5 is multifactorial, my kids latched on to the idea of small bladder size. I used two different size balloons and showed them how the large balloon could hold so much more than the small balloon.  One time, one of my children had a friend sleep over.  I overheard him explain matter-of-factly to his friend that his bladder was still growing and wasn’t big enough yet to hold an evening’s worth of pee.  His friend responded, “Yeah, I understand. My nose is bigger than yours, so it I guess my bladder is too.”  Huh?!?  No need to correct faulty logic.  Bottom line is that my child accepted his bladder size, and his friend accepted his nose size.

My children gradually outgrew night time accidents when they were between 6 and 8.  There are medications and bed alarm systems, but we never needed to use them.

When I was writing the AP article on bedwetting, one of my former bedwetters was 12 years old.  When I told him in passing that I had been asked to write an article on bedwetting because of my “expertise”, he was genuinely confused about where I would get such expertise.  He had no memory of wetting the bed until I jogged his memory.  He was young when he stopped (6 ½  to 7), and he had not suffered from the sleep over or camp anxiety caused by bedwetting, but still his lack of memory surprised me.  Now mind you, this same kid can remember every time I have screwed up as a parent and unjustly accused him or lost my temper too quick, but couldn’t remember the times when I think I did something right, like how we handled bedwetting.  However, I suppose that is the goal—to treat bedwetting as just a natural and normal part of life that it doesn’t warrant remembering 6 years later.

First published in 2011; Updated in 2016
Image credit:Viki Reed

19/10/2016 | by Dawn Davenport | Categories: Adoption, Adoption Blog, Blog, Other Adoption Resources | 18 Comments



18 Responses to Bedwetting & Adopted Children

  1. Cheryl F says:

    To Clarice-We adopted our daughter at age 14 seven months ago and she started having accidents during the daytime and wetting the bed at night,so we also put her into the cloth pin on diapers and rubberpants 24/7 and she turned 15 last month and is still in the diapers and rubberpants.We are hoping her accidents and bedwetting will stop anyday now.

    • Dawn Davenport Dawn Davenport says:

      Cheryl F, it is tricky on how to best handle “accidents” in tweens and teens, but a good rule of thumb is to do so in a way that allows them to maintain their dignity and to put as little emphasis on the wetting as possible. Why would you not use the adult disposable diapers with her? They are designed to be almost invisible and mimic regular underpants so no one else will know that she is having this problem. Since this problem began after the adoption, it may very well be caused by the stress of all the changes in her life, but in addition to getting her into psychological counseling to help her cope, she should also be seen by her pediatrician to rule out kidney, bladder, or other medical issues. Please follow through on this for her sake. No 15 year old wants to be wetting themselves.

  2. G. Wetter says:

    A couple of the comments caught my eye and definitely is a no no. As a chronic bed-wetter up to the age of 12. I have plenty of retrospect. I was made to wear baby diapers (Pampers) until they didn’t fit any more then I gradually after the next year ended up dry.

    Here are a few things you should and shouldn’t do.

    1. Don’t make a big deal out of it. Like one person posted keep bedding to a minimum. Use absorbent mats, plastic sheets, towels. You don’t want to embarrass him by making it a big deal in front of other siblings in the house. If you let him wash his own sheets and put them back on the bed it will give him a sense of responsibility. (Don’t make it a march of shame, to the laundry with wet bedding in front of the other children.) But the less a parent is involved the more responsible and grown a kid feels.

    2. Don’t talk about it to relatives. Keep it confidential. Nothing else in my memory hurts me more than my foster mother telling my aunts and cousins I wet the bed. Tell the child “Most people have problems at night once in awhile even adults.” You have to just deal with it.

    3. Don’t and I mean Don’t use Diapers or Pull-ups or Goodnights. HUMILIATION TO THE FULLEST. Nothing stressed me out more than having someone at school find out. Threats of making me wear a diaper to school didn’t stop me from wetting. Threats of putting me in a crib didn’t make me stop. Holding water back didn’t make me stop.. In fact restricting water is the worst thing you can do. I was so thirsty some nights my mouth was dry. and I still wet. I would wake up and gussel water. Then go a lot at school.
    4. Best thing to do for bedwetting…. Have a calendar on the wall with the child putting stars on the dry nights. Gold Stars for dry nights. Silver stars for small accidents. No stars for wet beds. I tried so hard and after a few months I saw that I was staying dryer and dryer every month. Stop teasing, threats and humiliation. these don’t work. How hard is it to throw a few bedding items in the wash and dryer and throw them back on the bed. How can any parent be that frustrated with something that’s so trivial.

    • Tracy Whitney Tracy Whitney says:

      Thank you for sharing so frankly from your experiences. It sounds as if you had some really embarrassing experiences with this issue. We greatly appreciate you sharing for the sake of supporting and helping parents understand the child’s perspective. Thanks for reading!

  3. Rick says:

    I am 41 years old. I was adopted at the age of 6. I lived with my adopted family from age 4. I wet the bed quite often through most of my childhood. I can say for certain it was never on purpose. I didn’t sleep well. I remember having a lit of nightmares as a child. Some were about my previous foster home. Some were just weird like being chased by an aligator through a mall. I don’t kniw if the nightmares kept me from waking up or just constant interuptions in my sleep caused me to be too tired to wake up when I had to pee. All I know is I wet the bed. And yes I would hide it and for good reason.

    In my previoys fosterhome I was once forced to pull down my pants while the foster parent pretended to remove my penis with a toy chain saw. Then I was told that I wouldn’t be able to wet the bed anymore. Furthermore, I was told I was no longer a boy since I no longer had a penis. Also there were times I was denied food and locked in a dark room while they banged on the door and teased me for wetting the bed. So trust me if I coukd have avoided doing it I would.

    My adooted parents thought I was lazy and that I simply would wake up and decide not to make the trip to the bathroom. They too had their ways of ridiculing me when I wet the bed, such as making me wear the wet underwear on my head. Or putting me in a dress and calling me by a girl name.

    So again. If it was avoidable, I would have avoided it. If course hiding it just led to more trouble when my adopted parents sniffed out the pee smell in my room an found dirty underwear under my bed or in the corner of my closet.

    I share this not for sympathy but to shed light on it for other kids. You don’t know what they have been through and they wouldn’t do it if they had a choice. Be understanding and patient. They need that! They need to be able to trust you to not humiliate them. They really want to make you happy. They feel like they can be replaced or remived from your home at any time so don’t give them any more reason to feel that way, please!

    • Rick says:

      Sorry for the spelling errors. I had no time to proof read. I had to take my daughter to basketball practice. I was typing on my phone. You know how that goes!

    • Dawn Davenport Dawn Davenport says:

      Rick, what happened to you breaks my heart. It literally brought me to tears. You deserved so much better. Thank you so much for sharing so that others can learn.

      • Rick says:

        Well thank you for the article! It is important for foster parents and adoptive parents to understand that this is a common issue in order to help put it in perspective. Furthermore, if they can help their foster or adopted child normalize the issue that would help as well. Foster kids and adopted kids already feel different. Making a big issue of something like bed wetting doesn’t help the healing process or help the child feel accepted in their new home. Bringing unneccesary attention or negative reinforcement to it just alienates the child even more and adds one more way they are different.

        Fear of rejection is an every day thing for a foster/adopted child. It is important for parents taking in another child to minimize anything that makes the child feel different or unwanted. An adopted or fostered child already carries enough shame or guilt (even though it is not their fault) for being unwanted by their biological parent(s). Adding additional shame only further aggravates the the lack of trust they already have for their caregiver.

        I encourage any foster or adopted parent to be patient, loving, kind, and understanding when it comes to issues like bedwetting. Furthermore, issues like lying and even stealing are common with foster/adopted children. Again this boils down to a lack of trust for their caregiver. Now lying and stealing should have consequences. I am not advocating allowing these behaviors to go unpunished. However, they should be approached in a way that shows compassion and understanding.

        Building trust and developing a relationship of unconditional love is the best way to get through to any child, especially one who has already been rejected by his or her own mother. Bedwetting, however, does not need shame or pushiments associated with it. It is embarassing enough on its own.

  4. Clarice A. says:

    We have a new adopted 15 year old daughter who is a bedwetter and she wears cloth diaper and plastic pants to bed every night.She broke out in rashes from goodnites and other disposables,so the cloth diapers and rubberpants work for her.

  5. travis says:

    I do foster care for kids age 6 through 12 I will say I have had a lot of kids pass thrue my home and what I have learned is that about 60% wet the bed what I do is I have a bucket in the room I take 3 diapers wet them with water and put them in the bucket I tell them that if they wet the bed there are pullups (underjams) in the drawer they can ware and just put them in the bucket they don’t have to tell me if they do till they are ready putting the bucket in the room with used diapers in it helps them to think they are hiding it and they tend to not be embarrassed they have all told me when they were comfutable doing so and were less embarrassed because they were able to tell me on there terms thay tend to open up after a few weeks when thay are more comfutable in the new environment it has worked every time just a suggestion for parents to try when the new kid arrives in your home good luck

  6. Tiffanie Upshaw says:

    We are dealing with this very issue. Our almost 9 year old son (internationally adopted 2 years ago) has been day and night time wetting since he came home. We’ve been following the same strategies listed…even the vibrating watch. Been to pediatric urologist. All to no avail. It seems perhaps he falls into the psychological category rather than developmental. He doesn’t fully empty his bladder day or night. Just releases enough to wet his undergarments without it coming thru to his outer clothes. He’s told us he does it on purpose to try to frustrate us…. but I’m not sure I believe him. He’s a chronic liar. So exhausted by all of this.

    • Dawn Davenport Dawn Davenport says:

      Tiffanie, I’m not sure I believe his either. Most children really don’t want to wet their pants and are deeply embarrassed. The best advice I can give you is to take the pressure off. It sounds like you’ve ruled out physical or medical problems. If that’s the case, try to make ways for him the handle his own hygiene and allow him the space and dignity to handle it.

  7. Melanie says:

    Very helpful article! The road does seem long, especially when you don’t know when it is going to end. It is nice to be reminded I am not alone, and I’m thankful to add some finessing and additional tools to my strategies!!

    Other bedding ideas:
    * I have a friend who swears by a double made bed (sheet plus waterproof layer, then sheet plus waterproof layer, so the top one is removed when wet and the next is ready to go).
    * If you live somewhere that this will not be too warm for, a fleece blanket over the wet bed works as well as the towels. It might even work as a bed pad, though I haven’t tried it that way, just over top of already wet.
    * I have a stack of washable bed pads from a relative that have saved my sanity and loads and loads of laundry. My oldest is five and now just removes everything wet on his own in the middle of the night, putting a dry pad on and going back to sleep. After this article, I might have him finesse the routine and leave off the dry until the morning. He needs his sleep and those precious minutes aren’t worth his time. The three-year-old could potentially do it on his own, but usually ends up crying out and waking me while he is trying to. I wish this was not something they were gaining great life skills with, but I’m realizing how proud of them I should be!

  8. Jill Watson says:

    I appreciate this, as we are in the middle of it. I have 2 from another country, ages 7 &10. The older one is wetting. The younger wants big sister sleeping with her, but doesn’t want her bed as a toilet (her words).

    The older does not wake up when she does this. She also won’t admit to it or tell anyone. She also did it in the hotels while we were in their country, so not totally a jet lag issue.

    We’ll try the plastic sheet and pad… it’s only been a few weeks.

    • Dawn Davenport Dawn Davenport says:

      Jill, keep in mind that she is likely not telling you because she is embarrassed. If she is a developmental bedwetter (meaning that she had wet the bed consistently in the past) she has probably been punished for wetting the bed, often very harshly. It truly breaks my heart. This is not something she has any control over. She is most likely ashamed and scared. She needs to understand that some kids wet the bed and some don’t. If it’s related to the total change in her life it will probably resolve itself in a few months. If she is a developmental bedwetter, it will resolved itself in a few years. Either way, bedwetting is not the end of the world (unless you make it). Helping her regain her dignity will go a long way to helping it resolve quicker.

      I would also want the younger child to understand that this is a normal thing to happen, that most people have wet the bed on occasion, that it isn’t something that the older sister has any control over, and that it is NOT acceptable to tease or make her feel bad about it. If the younger child is doing this, it is probably because she has heard others do this in the past, which gives you insight into what the elder child has had to endure.

      • Melanie says:

        I absolutely remember sleeping at a friend’s and wetting the bed – age 12! – and being SO embarrassed and mortified. I never said a word to her mom. I’m not even sure I ever told my own mom. I don’t know what I was thinking, other than realizing as I have processed a lot in my adulthood that I just didn’t have the verbal or emotional tools. I can guarantee your daughter is incredibly embarrassed. It feels as though that is not something that should be happening anymore when you are that age. I don’t know whether my friend ever found out, but I can’t imagine how dismayed I would have been if I had been teased on top of feeling so ashamed. Some wonderful supportive dialogue and reassurance from you will go a long way in ensuring her emotional security, regardless of how quickly this resolves. Sending your sweet girl some love and support.

        • Dawn Davenport Dawn Davenport says:

          I have spoken with several adults who continued to wet the bed until adolescence. It is so very often something they continue to feel shame and embarrassment about. As I mentioned in the article, there are 3 distinct ages that kids usually outgrow this problem. For a few kids that age is early adolescence. As parents, we must reassure out kids that they will eventually be dry at night and that this is not their fault.

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