Managing bedwetting in neurodivergent children

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    Bedwetting solutions for children with intellectual and developmental disabilities

    The following article was authored by Vizient-awarded supplier Kimberly-Clark. It originally appeared in Pediatric Tech Watch, Vol. 10, published November 2023.

    Bedwetting, also known as nighttime wetting, incontinence or nocturnal enuresis, is a medical condition that can affect any child. It happens when a child five years or older is unable to control their bladder and urinates at night during their sleep. For some kids, bedwetting may be an unavoidable part of growing up, even lasting through their teenage years. While it can be embarrassing and stressful, it’s important to remember that bedwetting is common – one in six kids experience it.

    In general, children with intellectual or developmental disabilities (neurodivergent children), such as autism and attention-deficit hyperactivity disorder (ADHD) are more prone to bedwetting, according to a study in the Journal of Pediatric Urology.1 Goodnites’ proprietary Bedwetting Diary Study revealed one in 10 bedwetters had a disability, with the most prevalent being autism and ADHD.2

    The two types of bedwetting

    • Primary bedwetting happens when a child isn’t able to control their bladder from infancy and continues to wet the bed at least once or twice a week through primary school.
    • Secondary bedwetting, also known as secondary enuresis, makes up about 25% of all bedwetting cases.3 It happens when a child can control their bladder, has been accident-free for at least six months, then starts bedwetting again. Because secondary bedwetting is often unexpected, it can add extra stress on the entire family.

    The link between autism, ADHD and bedwetting

    Studies4 have shown that kids with developmental disabilities, like autism and ADHD, are more likely to experience bedwetting than their peers who develop typically (neurotypical). The connection between autism, ADHD and bedwetting isn’t fully understood, although researchers believe bedwetting, in any child, may be related to a combination of factors.5

    • Reduced bladder capacity
    • Increased production of urine at night
    • Difficulty with self-regulation and sleep disturbances
    • Sensitivity to sensory stimuli, including the feeling of a full bladder and reduced sensitivity in the urge to urinate

    Children who experience bedwetting often feel anxious and lose confidence in themselves. These feelings can be intensified by frustrated parents who may respond with ineffective solutions such as punishment, yelling or shaming, only to make matters worse. It’s important for parents and caregivers to be patient, understand the condition and how it impacts their child. It’s also important to explain to any child who experiences bedwetting that it is not their fault.

    Impact on families of bedwetting children

    In January 2023, Goodnites conducted a survey among 1,000 U.S. parents of children with autism and ADHD, ages 3 to 17. The survey uncovered the physical, emotional, relational and mental impact that bedwetting has on these families. The study found:8

    • Three-fifths of parents of children with autism and/or ADHD who experience bedwetting express increased feelings of anxiety (60%) and helplessness (58%).
    • About two-fifths of these parents also state that bedwetting has made their child more anxious (41%) and lowered their child’s self-esteem (38%).
    • Half (50%) of parents say their child’s bedwetting has caused them to feel like a failure as a parent and roughly half (48%) of parents feel bedwetting has led to concerns that others will judge them.
    • Participants expressed that they feel friends (71%) and family (65%) don’t understand the challenges of parenting children with autism and ADHD.

    Collaborating with the Autism Society of America

    Goodnites, the #1 bedwetting underwear6 brand, announced a new collaboration with the Autism Society of America, the nation’s largest and oldest grassroots autism organization. The mission is to educate, support and provide solutions for families of children with autism who need a longer-term bedwetting solution. With this collaboration, Goodnites will unveil new proprietary research illustrating the impact of bedwetting on families of children with ADHD and/or autism, including the launch of a resource hub to provide free access to bedwetting education tailored to the autism and ADHD communities, and enabled by contributions from the Autism Society of America.

    Since inventing the absorbent bedwetting underwear category in 1994, Goodnites has been helping kids, ages three to 17, to have a dry night’s sleep with 35% fewer leaks.7 While bedwetting is a common occurrence among most children, children with autism and/or ADHD may face a longer timeline with bedwetting. To better serve the needs of children who experience longer-term bedwetting and provide size inclusive products with outstanding comfort and fit, Goodnites launched an XL size in 2021. Following this launch, consumer data9 showed that the second largest group of XL buyers were parents of children with disabilities. One in six children experience bedwetting and of those who experience bedwetting, one in 10 has a disability, with autism and ADHD being the most prevalent.2

    Conclusion

    Bedwetting is a common occurrence among many children. However, it can have a greater impact on families of children with autism and/or ADHD who experience additional physical, emotional, relational and mental tolls on their everyday lives. Through education, Goodnites is raising awareness and amplifying influential voices in the neurodivergent and parenting space to help reduce the shame and stigma associated with bedwetting.

    About the Author

    Kimberly-Clark holds Vizient supply agreements in several product categories, including infant diapers and wipes. View details in Vizient Catalog.

    References

    1. Gontard A, Pirrung M, Niemcyk J, et al. J Pediatr. Urol. Incontinence in children with autism spectrum disorder. October 11, 2015. Accessed Aug. 22, 2023. https://pubmed.ncbi.nlm.nih.gov/26052001/
    2. Kimberly Clark Study 25177; 3. 87971 Goodnites’ proprietary Bedwetting Diary Study. Kimberly Clark data on file.
    3. Secondary Nocturnal Enuresis. National Kidney Foundation. Accessed Aug. 22, 2023. https://www.kidney.org/patients/bw/BWbedwetSecondary
    4. Autism and Bed Wetting: Understanding the Connection. Sleep Sources. Accessed Aug. 22, 2023. https://www.sleepsources.com/blog/autism-and-bed-wetting
    5. Bedwetting: What Causes It? WebMD. Feb. 25, 2012. Accessed Aug. 22, 2023. https://www.webmd.com/children/features/bedwetting-causes
    6. Kimberly Clark CLAIM-16507 point of sale data Nielsen Youth Pant Category Share Data 2023. Claim validated by internal legal and third party. Accessed Aug. 22, 2023.
    7. Kimberly Clark CLAIM-22866 Absorption of Goodnites® Boy Large vs. Ninjamas® Boy Large: 35% better leakage protection OR 35% less leaks: In recent White Sox HUT 40016 with Boy L products, Goodnites® Youth Pants performed better in leakage protection compared to Ninjamas Youth Pants. Goodnites® had a leakage rate of 8.4% and Ninjamas had 13.0%, therefore Goodnites® had 35% fewer leaks than Ninjamas. Claim validated by internal legal and third party. Accessed Aug. 22, 2023.
    8. Goodnites® survey of 1,000 U.S parents of children with Autism and/or ADHD. Published 2023. Kimberly Clark data on file,
    9. Numerator Survey 2021. Kimberly Clark data on file.
    10. Goodnites® Announces National Campaign and Partnership with the Autism Society of America to Raise Awareness and Provide Solutions for Bedwetting Needs of Families with Neurodivergent Children. Press release. Accessed Aug. 22, 2023.

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