By Drs. Sally Robinson and Keith Bly

Bedwetting is more common than most people think. In the United States, about 5 million children over the age of six wet their beds at night. Though it can be frustrating for parents and children alike, enuresis (bedwetting) is not a disease but a common symptom.

Bedwetting is rarely a sign of a kidney or bladder problem; instead, it is usually a reaction to stress, or it is associated with a sleep disorder or slower than normal development of bladder control. It is also believed to be hereditary, meaning that a family member may have wet the bed as a child.

Bedwetting can be embarrassing for a child, especially if he is older, because it can limit his participation in activities such as slumber parties, campouts and summer camp.

Following are some tips to help your child:

• Tell her that she is not to blame for wetting the bed.
• Change pre-bedtime habits. Allow only 2 ounces of liquid after 6 p.m., and do not give liquids right before your child goes to sleep.
• Do not give your child food or beverages that contain caffeine. Caffeine increases urine output.
• Encourage your child to use the restroom before he goes to bed.
• Talk about the problem to your child’s doctor at her annual check-up.
• Do not punish or blame your child if he has an accident.
• Praise your child if she makes it through the night without wetting the bed.
• Protect your child’s mattress with a plastic cover.
• Let your child help change the wet sheets.
• During the day, have your child hold his urine as long as possible. This will stretch the bladder and allow it to hold more.
• Wake your child to urinate two or three hours after he goes to bed.

Sometimes a change in diet is helpful in preventing bedwetting, especially if your child has a history of allergies. Also helpful are bedwetting alarms, usually available at your local drug store, which are activated by moisture and wake your child up if she begins to wet the bed. This teaches your child to wake up if he has a full bladder. Finally, your child’s doctor may want to treat the problem with a medication, available in both nasal spray and tablet form.

Remember that keeping your patience and giving your child support are the most important things you can do to help him resolve this problem. Most children outgrow nocturnal enuresis by the time they reach their teens.

If your child is also wetting during the day, complains of burning while urinating, loses weight or passes blood in her urine, or if the problem is affecting her self-esteem, call your pediatrician.
Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.