Children who can control their bladders during the day, but who have never been dry at night for at least a six-month period, have what is known medically as primary nocturnal enuresis (PNE), the most common form of bedwetting.

If the child has always had a problem with wetting the bed, this is considered primary enuresis. If the child had not wet the bed for at least a year and then regresses to wetting the bed, this is called secondary enuresis. In most cases of primary enuresis the cause is probably related to a gastrointestinal problem or delayed physical development. Secondary enuresis is usually related to a stressful circumstance and the child will need to be evaluated by a mental health professional. Or in some instances secondary enuresis can be due to a urinary tract infection, sickle cell disease or diabetes.

Most of the children who wet their beds may feel that it's the result of either bad thoughts or bad actions. They feel that somehow bedwetting is a punishment. Similarly, many parents feel that their children's bedwetting is a result of a defect in their parenting. In a survey of 9,000 parents of kids' ages 6 - 17, 22% stated that they thought the reason their child wet the bed was laziness (survey conducted by ICR Survey Group from July 10 1996, through August 6, 1996). I am happy to tell you that this could not be further from the truth! Primary nocturnal enuresis is a common developmental phenomenon related to physical and physiologic factors. It does not come from emotional stress, poor self-esteem, or emotional immaturity.

Facts About Bedwetting

•    It is 3 times more common in boys than in girls.

•    The occurrence of bed-wetting in children is: 15% at age 5, 10% at age 6, 7% at age 8, 3% at age 12, and 1% at age 18.

•    The average bed wetter is between 4 and 14 years old. About 15% of children wet the bed after the age of 3.

•    It is common for the child to wet within 2 1/2 hours of going to sleep. A bed wetter will do so 1-4 times a night, 5-7 nights a week.

•    Bedwetting may be inherited. Studies suggest that if both parents have a history of bed-wetting, then their child will have a 77 % chance of wetting the bed. If only one parent wet the bed, a child has a 44 % chance of wetting the bed. There is approximately a 15 % chance that a child will wet the bed if neither parent has had a history of bed-wetting.

•    Normally, bedwetting ceases by puberty.

•    Bedwetting may also be the result of the child's tensions and emotions that require attention.

•    There may be a hormonal reason for a child wetting the bed. Some research has shown that a child may have insufficient nighttime quantities of a hormone called anti-diuretic hormone (ADH). Generally, ADH levels rise at night and reduce urine production during sleep. However, in some children there is inadequate nighttime ADH production, and so he or she produces more urine.

•    Possible underlying illnesses of bedwetting are diabetes or a urinary-tract infection.

•    A small or weak bladder that cannot hold one night's urine production also leads to bed-wetting.

•    Lack of adequate toilet training.

WHAT TO DO

•    Avoid embarrassment. If you used to wet the bed as a child, be sure to explain that to your child. If a child understands that bedwetting is hereditary or nothing wrong, it will help ease their anxiety and help them better understand that this is a very common problem and not their fault.

•    Never punish your child for wetting the bed. This will only add to a child's embarrassment.

•    Offer words of praise and even rewards when a child has had a dry night.

•    Establish a no teasing rule. Many experts in this area say it is a good idea to set up a 'No Teasing' rule in your family. This means not allowing anyone in the household, especially siblings, to tease a child who wets the bed. Explain to them that their brother or sister does not want to wet the bed on purpose, and teasing will hurt, not help. It is also a good idea not to make an issue of the bedwetting every single time it occurs.

•    Talking to your child about the problem in a private setting can be very beneficial. A child may feel embarrassed around their siblings or other adults. Studies have shown that many kids hide their problem and think that something is wrong with them.

•    You try to limit all beverages after 6 PM to just very small amounts. Avoid food and drinks containing caffeine, which is a diuretic. It may also be helpful to avoid any beverages that are carbonated, as well as citrus juices.

•    Always encourage your child to urinate before going to bed.

•    Bedwetting does not pose a threat to your child's health but showing to the pediatrician will help you to rule out a physical problem such as diabetes or a urinary tract infection. If your physician thinks there may be a medical problem that needs to be treated, then he or she may take a urine sample from the child to check for signs of an infection or other problem. Your pediatrician in some cases may also order tests or x-rays of the kidneys or bladder to see if there is a more serious underlying cause.

•    It is important to be patient and realize that the problem will not go away instantly. It is extremely common for children to experience some loss of self-esteem and feel embarrassment over their bed-wetting.

•    Use gold stars or happy faces to mark dry nights on a calendar if the child likes it.

•    Respond gently to accidents. Don't blame, criticize, restrict or punish the child who has wet the bed.