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Expert Q&A

	By Jenny Lewis, M.D. Pediatrician

My 8-year-old son wets the bed. I have been told so many different things that I am not sure which is true or not. Is bedwetting not a sleep disorder? I have also heard that their bladders do not grow fast enough. When we had mentioned this to our pediatrician, he didn't seem too concerned about it, and the general attitude was that he would grow out of it. As I am sure this is true, I am hoping that it is before he is 12. I have a friend whose son was 12 or 13 before his bedwetting stopped. I am not concerned about this for myself but for his own self-esteem. Any suggestions?

There are many reasons why your son may still be wetting the bed, and I presume, as you have discussed this with your pediatrician, that he has no signs of this being due to a urinary tract infection or other health reasons. Ninety-seven percent of boys with primary nocturnal enuresis (never been consistently dry at night) do not have a physical cause for their bedwetting. Many do have a small bladder capacity which means that unless they learn to get up in the night to pee, they will wet the bed, while the others, with normal-sized bladders, just sleep through the signals their bladder gives them that they are about to pee. Nocturnal enuresis is often familial so your son may feel better knowing his dad or uncle had the same problems as a child. Children do not wet the bed on purpose, so anger, humiliation and punishment have no place in the treatment of bedwetting.

It is true that 15 percent of bedwetters become dry each year, but as your son seems to be distressed now I think you should take some action to help him at this time. The most long-term effective treatment methods involve systematic waking of the child until he learns to wake himself. This should be undertaken with the childų cooperation and with lots of encouragement and rewards for success from the parents (sticker chart, etc).

It is important that however the child is woken, he walks himself to the bathroom. The training may take two or three months but those children with intermittent wetting and a normal-sized bladder will probably end up sleeping through with a dry bed, and those with a small bladder will have learned to wake and pee in the night.

There are medicines that help kids be dry, but when they stop taking them they usually go back to bedwetting. I would recommend asking your pediatrician for specific advice on how to put a plan into action. Good luck."

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