Bedwetting (Nocturnal enuresis)

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Continuing to wet the bed past a certain age is a common and heart-wrenching problem for all concerned but it can be seen that, so long as a holistic approach is used that takes into account what is causing the problem, it can definitely be cured

The general recommendations in this article are entirely suitable for a parent to work through themselves but, especially if things are quite bad, or you just know that your child needs further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide them on to a safe and effective treatment program. There's a short write-up to suggest how you might go about finding such a person here

Case Histories

Used wisely, a holistic approach that includes herbal medicines can be of great help for a child that is struggling with this vital developmental step. Herbs have been humankind's only medicine for virtually our entire evolution so of course we found allies in the natural world to help us with every part of our lives, most certainly including those areas that affected the ones who were the most precious to us of all.

I've been in full-time practice since 1989 in Christchurch and, like everywhere in the world, there are many children and their families who are being tortured by bedwetting long after it would normally have come to an end. Whilst each case is different, there is also important common ground between children and there are some general suggestions given here that may benefit anyone.

Firstly however, from the clinic files, the following two case histories are shown to illustrate some individual approaches to this most troubling problem.



Callum was bought in to see me when he was 10 years old. It was early in the school year and both he and his parents were in a state of quiet panic that his first ever school camp was planned for later in the year and, as things stood, he simply wouldn't be able to attend for the high likelihood that he would have an accident that could 'scar him for life'. He didn't wet the bed every night, but it happened at least 2 or 3 times a week and it was definitely worse if he was nervous or upset about anything.

They had been to different health professionals to seek help and tried a number of behavioural interventions, electronic alarms etc. They had also been to a natural health practitioner who had used a pseudo-scientific method (hair-analysis) to suggest that Callum had a wide number of food intolerances but rigidly adhering to a heavily restricted diet, whilst creating considerable further stress, had made no positive difference.

From his look and his way of speaking and moving, Callum was obviously an alert, sensitive boy. From careful examination of his tongue and pulse (more about that ancient art here) and from palpating his spine and belly it was clear that Callum was holding far too much tension in his body than was good for him. Imagine a high string on a violin that was wound up to far too tight and you will get the idea.

My overwhelming impression was of a boy who had a problem that was making him tense and that his tension, in turn, was worsening, or even causing, the problem. Whether there were other factors involved or not, the first priority was to help him achieve some physical and perhaps mental relaxation before we could expect his condition to begin to improve. So, we started with the following

The Prescription

Relaxing Nervine Formula

Chamomile 50mls
Wild Yam 40mls
Skullcap 40mls
Corn silk 40mls
Licorice 30mls
Lobelia 10mls

We make our own tinctures from organic dried herbs, so it might be important that you understand that the optimal dose range will vary with different preparations made by different companies or practitioners,

The above liquid extracts were combined into a formula to make 210mls. This will easily fit into a 200ml amber pharm round bottle and is enough to last close to a month if taken at the safe and effective dose of 4mls twice a day, which is what we used.

The above herbs are some of the best relaxant remedies in Nature and may be learned about in much greater depth by going to their entries in the Herb A-Z found here

GI tea & Relaxing tea

I also gave Callum's parents two teas to let him start getting used to having. Children are usually very adaptable to taking herbs if they understand why they are taking them and they are given the choice to use them without too much pressure. Both of these teas are very pleasant, the GI tea especially with a little honey, and could be used quite freely by Callum to help relax his gut with the GI tea, (more about its recipe and instructions here) or his nervous system with the Relaxing tea (more on it here)

The Work

The 'work' is an essential part of any treatment program. It is what the patient does to help address the causes of why they have become unwell, or in this case, why something was not developing as it should have.

Callum's 'work' was to have regular massage, at least 3 times a week, from one of his parents over his belly and his spine. I gave them a preparation we make up in our clinic called 'Relief cream'. I will aim to put the recipe for this up on the site some time but, in the meanwhile, feel free to contact my assistant directly via email and she will send you the recipe. Honestly, though, any kind of relaxing herbal cream or oil would work fine, the main thing by far is the healing touch of the parents with the intention to help him to let go his tension and relax.

I gave them some simple demonstrations of how to do the massage and then made sure they both had a go (with Callum of course being the willing participant) so they learned by doing. As is usually the case when I do this kind of work with people, you can almost immediately feel how everyone feels better, they have a job to do, it's not hard and will only take their time, and they can instinctively understand how it will help, which of course it always does. Never underestimate the power of love to help the healing process along!

As it happened I only needed to meet Callum and his parents for one further visit. They came back a month later and, from all the smiles in the consulting room, and the much more visibly relaxed Callum, I knew things had been going very well. He had still had a bad first week, and the parents confessed that they were already thinking the worst but. of course, it takes time to unwind such a tense system and by the second week things were clearly improving. He was visibly more relaxed, less fidgety and agitated, and only had one accident the whole week. There had, in fact been only one further accident a few days before the visit, but in relation to an incident at school that had clearly tripped him up. Even that last accident was helpful as it reinforced how much of the condition was related to nervous tension and everyone could now clearly see that thus was indeed the underlying cause of the problem, in this case.

In such ways our worst troubles can become our best allies. I didn't see Callum again, but I went on to treat his mother for a much trickier problem and I still see her from time to time. Enough to know that Callum, now an 18-year old, has greatly gained in confidence and is doing well in life, he is acing his studies, apparently he is bright and funny, and is obviously very close with his family and parents understand and love him for the sensitive soul he is.



Gemma was an 8-year old girl when we first met. The great majority of my patients with troubles in this area have been boys but I remember her case not just because she was one of the few girls but because she was so clearly traumatised by what had been happening to her. I well recall her bright red-faced embarrassment and her hiding behind her mother. There is a feeling that is described as something like 'wanting the earth to open and swallow you up' and I'm sure that is something like what was going on for her at the time...

As it happened, her history showed that she had been very good staying dry through the night from around the age of 3 but had then relapsed when she was 4 and now not only had a wet bed nearly every night but also complained of being sore 'down there' and had apparently had quite a few red rashes in her genito-urinary area.

I don't examine my patients without their clothes on and I imagine that part of her hiding behind her mum's chair when we first met was the thought of a man doing what her female GP had done a few times because she had been carefully checked out for urinary tract infections and swabs etc. had been taken, only nothing ever showed up, so she was sent down the usual behavioural modification routes, again to no avail.

I carefully checked Gemma over in every other way I could but didn't come up with any obvious signs or clues to what else might be going on. From her history and her symptoms, it seemed quite possible that she did have an undiagnosed inflammation or even infection in her urinary tract but, the simple fact is that our methods of testing for these things are not perfect and even without any clear evidence of infection, I thought the best approach was to treat her as if she did have an infection and see if things improved. One of the advantages of herbal medicines in this regard is that, unlike an antibiotic, if the treatment didn't work then there would be no harm caused to Gemma in the process.

The Prescription

Echinacea 50mls
Astragalus 50mls
Uva ursi 40mls
Corn silk 30mls
Elder Berry 20mls
Licorice root 20mls

To make 210mls, and the dose of 4mls twice a day. As you can see, nearly half the formula is made up of Echinacea & Astragalus, two of the greatest herbs in all of Nature to support and strengthen the immune system. You will also see that Uva ursi and Corn silk are the tea given below, this is not an accident, it is good to have plenty of them to soothe, cleanse and disinfect the urinary tract if there was in any residual micro-organisms there that had been evading detection.

UT tea

Children are usually very responsive to herbal medicines and a little goes a long way. The parents were asked to make a small amount in a fresh batch each day and just to encourage Gemma to have as much of it as she felt able to. This tea has been exceptionally beneficial to a great many people who have been plagued by chronic urinary tract infections, the recipe and instructions are written up here

The Work

In taking this approach we were, in effect, treating Gemma as if she did in fact have some kind of infection that her body was not able to get on top of. If she got better, then our theory would be proved correct, if not then we would been wrong and would have to go back to the drawing board.

However, this approach depends on you being able to be sure that the medicine will be enough to clear the infection and I would never underestimate the power of microbes to hang on. They have been here a lot longer than we have and they know how to survive!

It was equally important for Gemma to be getting good nutrition and all the rest she might need to get well so a large part of our consultation was about checking the quality of her diet and her routines for rest. There were a few things that needed tweaking there. Less sugary foods and more proteins (we literally need protein to make our immune 'army') and her bedtime needed to include more downtime before she actually went to bed as it turned out she was not good at getting off to sleep, partly of course from the worry of wetting the bed, so she needed to get into some new routines of restful activities to help her unwind rather than letting her watch technology quite so late.

We met a month later and the response to her treatment program had been excellent. The notes say that she'd had no accidents for 18 days at the time of our meeting and the irritation and soreness had also completely gone.

I suggested that, now that we must assume that she really had been suffering from a low-grade chronic infection and this condition had been happening for nearly 4 years, to keep the treatment program going either once or twice a day for a further 3 months, give or take. They obviously did that by the 2 further repeats she got but, as I said to come and get more of her herbs in the future if she needed, in other words if the problem returned, and this was several years ago now, I see from her notes that she has not needed to come back, so I am sure that her condition has been resolved.


General Recommendations

I've chosen the above two cases to demonstrate that most wonderful of outcomes, namely a quick cure. Of course, not all cases are so clear-cut, let alone so fast, but these cases serve to demonstrate one of the most important principles of healing, which is to treat the cause. If we can do that then there is an excellent chance of a rapid resolution.

Now I want to share several other approaches that may be of value to consider. Starting with, depending on the age of the child, it sometimes helps to call this problem by a different name to allow for a different approach to its treatment.

'Nocturnal enuresis'

Clearly, this is a problem that can create a lot of anxiety it in the child and the older they get the worse they feel about it.

It is also clear that being ashamed of it does not help them stop doing it and, at least in some cases, it may make things worse. Words can be very important to some people, including children and, at least in some cases it can be recommended to change the language to make a fresh start. The terms bedwetting or 'wetting the bed' can be changed for using the medical term enuresis, properly it is called nocturnal enuresis, but enuresis is easy enough to remember.

Changing the name can make a significant difference for some children, it can help get out of an embarrassed, hard-to-talk-about-it place into a more constructive mind-set that this is a well-understood medical problem and there are a number of possible solutions for it.


Common Causes of Enuresis

The following are some primary causes of bedwetting, or enuresis:

Natural Development

There are some simple questions that can tell us if this particular area is the one that needs the initial attention;

a) does he or she have a good level of control of those muscles we use both when we go to the toilet and when we need to hold on?

A practical way to test this is to try to stop the flow of urine once it has started but before it has finished. Most children won't be able to do this at first but can learn with a little practice. If this is clearly a weakness then simply practicing trying to stop the flow of urine before it's finished, even just twice a day, can make a rapid improvement over as little as a week is a core reason behind the enuresis is simply some delayed natural development.

b) for boys: is his foreskin too tight?

You may need to help a little boy to retract his foreskin to urinate a few times until he gets the hang of doing this himself and can then easily empty his bladder fully.

c) is he or she getting a good balance of water in and urine out during the day or is it quite erratic?

Keeping a chart of exactly how much fluid is being drunk and when it is being drunk for a few days might give some necessary insight as to why his or her natural rhythms are not getting well established. As an example of this last point, the following is copied from an online discussion with a

My son was a late bed wetter, well into his teens. We had some success with an alarm but didn't completely get on top of it.

What sorted it in the end was an appointment with a nurse who specialises in dealing with children and teenagers with incontinence issues. She was brilliant, she made him feel okay about it and not alone, and by getting him to fill in a timetable of when he was drinking and urinating for a week or two, she soon sorted the fact that my son's drinking, and thus urinating pattern, was all awry.

The program he had to follow consisted of set volumes to drink at set times of the day to change when he was drinking and increase bladder volume and control and it worked a treat - very quickly too


Food Intolerance

I mentioned above in Callum's case history that he had been wrongly put on a restrictive diet, but I have also had cases in my own practice where removing a food or food group that was genuinely creating a problem has bought about as fast and as big a turnaround as described in the cases above.

A correlation has sometimes been seen between a tendency towards food allergies or intolerances and enuresis. How food intolerance might contribute to bedwetting can only be speculated on but perhaps the general aggravation of the immune system that happens with it causes some degree of inflammation in the urinary tract tissues just as it can in the skin, e.g. eczema, or the bronchial tubes, e.g. asthma.

This is a tricky area, and before zeroing in on it look for other indicators of intolerance, such as eczema or asthma, dark rings under the eyes or frequent complaints of digestive upsets. If this subject needs to be explored further, read here.


Chronic Infection

This was obviously the crucial issue in the case of Gemma as described above and it was not unusual that a chronic infection must have been the core issue for her, or that it hadn't been able to be detected.

For many decades, the established view on infection was black or white; you either had an infection or you didn't. In recent years, there has come an understanding that things are much more complex than that. We have many billions of micro-organisms living on us and inside us and that the right balance of this 'micro-biome' is an essential part of our health, for better or worse.

It may be wise to consider the possibility that the child with enuresis may have a low-grade bladder infection that is causing just enough inflammation and irritation to trigger an accident when the child falls deeply asleep.

The first step to explore this is a simple and inexpensive test to see if there are small numbers of white blood cells in the urine. The presence of these cells may not be at the very high levels that come with an acute bladder infection, but they shouldn't normally be there and may be the sign that there is a chronic and low-grade infection pushing things along.

Sometimes we suspect it might be an issue but the only way to be sure is to practice some empirical medicine, i.e. treat for an infection and see what happens as we did with Gemma.

Fortunately, we have some safe and effective herbal medicines to do this that will not do any harm to the child but, if this is the right track to be on, will be seen to be obviously helping within a week, or two at the most. These herbs, and how they may best be used in a tea-form, are described in detail in the article on urinary tract infections here.

Arctostaphylos uva-ursi (Bearberry) a potent urinary tract anti-biotic


Nerve impingement

Nerve impingement can certainly be a major factor for some children with chronic enuresis. It was presumably the main driver in the case of Callum, i.e. just too much physical tension somewhere in the complex system of nerves that control bladder constriction and relaxation. Or perhaps the nerves that monitor and respond to signalling from a distended bladder with the reflex to need to empty and so alert some higher brain centres that evasive action is required.

Herbs are great for the nerves but, as we did with the massage from the parents, I think that some physical treatment of the child is essential in this area.

If it is thought that this might be a causative issue, one way to test it out would be to visit with a practitioner who is skilled in analysing and adjusting the spine and see what happens if they find that there is a problem in the alignment of the pelvis or the low back and help to correct it.

If you find that you visit with a chiropractor, osteopath or some other spinal therapist and that your child improves after treatment but then reverts to the enuresis after a while then this means that you are not on the wrong track, or they would not have improved in the first place, but that you need to find some exercises that the child can do to prevent the spine getting out of alignment and the nerves getting pressed on again. This is usually to do with correcting some postural imbalance in sitting, standing or walking.

A holistic minded spinal specialist should be able to teach your child such exercises but if it is not their forte then you might find visiting someone who works in the Yoga school, or the Alexander technique, or perhaps the Feldenkrais method to get the tools he or she needs to learn to get well and stay well.


Be Patient & Holistic

Enuresis is a truly distressing problem for everyone concerned. Whatever you do to fix it you are going to want it to work brilliantly, and immediately! This is completely understandable, but it is also the number one reason why treatments fail because even when you are on the right track and the incidence of enuresis has been reducing, just one accident can be enough to cause people to lose hope much too soon and so stop what they have been doing. Don't give up too quickly, a cure for a chronic problem will often take time.

It may be wise to try more than one of the above approaches at the same time. No-one ever cares if they don't know for sure what helped when the problem has been cured, and maybe it needed a combination of things. Enuresis should never be put in the too hard basket., it will get better eventually, the more you and your child can adopt a holistic, problem-solving mind-set, the sooner that time will come.

Zea mays (Corn silk) a calming, soothing urinary tract herb

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd