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Expert Q&A

	By Keath Castelloe Low child and adolescent psychologist

My son wets the bed. My strategy is to try and ignore it so I don't embarrass him. My friend does the opposite, and is constantly saying encouraging things to her bedwetting daughter. Which is the best approach?

Actually, you are both on the right track. The best way to deal with bedwetting is a matter of fact, patient and reassuring approach. Punishment is never appropriate.

Children wet the bed for a number of reasons. It may be simply that his bladder is small and not quite developed enough to hold urine for the full night. It could be that the nerves around his bladder are not yet matured enough to signal a full bladder. He could also be a very sound and deep sleeper who just doesn't wake up easily when it is time to "go." Stress can trigger nighttime bedwetting. A urinary tract infection or even type I diabetes can be the culprit.

Nighttime bedwetting, also known as nocturnal enuresis, is actually quite common in children up though 6 years of age. It is also more often seen in boys than in girls.

Below are some strategies you may want to use to address your son's bedwetting.

• Continue to be patient, loving and reassuring.
• Be sure your son uses the potty right before going to bed.
• Try to restrict his fluid intake a few hours before bedtime, so that his body will produce less urine at night.
• Sometimes it is helpful to wake a child up to use the bathroom in the nighttime right before your own bedtime. This way he has another opportunity to empty his bladder at night.
• Be sure to put a waterproof pad on the bed to protect the mattress.
• If he does have a bedwetting accident in the middle of the night, have an extra set of clean sheets available to make a quick switch and get him right back to bed.
• If the sheets are wet in the morning, have him help you remove the sheets from the bed and take them to the washing machine. He can also help you put a clean set on the bed. This way he takes responsibility for his behavior and has the opportunity to take on a more grownup role. This should be a positive time and you do not want him to feel this is a punishment.
• Praise him for his efforts.
• If his bedwetting is distressing to him you may want to assess whether wearing a PULL-UP would be helpful.

If you ever have concerns about your son's bedwetting be sure to consult his pediatrician.

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