Perspectives and advice on nocturnal enuresis

Most children are toilet trained between the ages of two and three, and about 95% of children are consistently dry by the age of four. But it takes longer to stay dry at night. By the age of four, most children stay dry all night, but many still wet the bed. By age seven, about 1 in 10 children still wet the bed at least once a week. Using the toilet during the day is a new skill that children learn, but staying dry at night is an unconscious skill that cannot be "taught" or "practiced." Discipline, practice, or rewards will not help overcome the problem.

Take these two examples from my pediatric practice.

• I remember a seven-year-old boy who was very upset because he was still wetting the bed. His mother said he slept so soundly that it was practically impossible to wake him when he was asleep. The family was relieved to learn that his deep sleep was contributing to his bedwetting; his own bladder couldn't wake him, even when it was full! Over the next few years, he began to go through more and more dry nights, and he completely overcame the bedwetting by the time he was nine.
• When his younger brother started having the same problems, he was relieved to know that his older brother had overcome it. While waiting for bedwetting to resolve, children should use nighttime training pants, like disposable pads, to stay dry and more comfortable.

Although some medical conditions can contribute to bedwetting, many children who wet the bed have no health problems. It is important for parents to reassure them that it is nothing to worry about. A child who starts wetting the bed after having been consistently dry may have a bladder infection or another health issue and should be examined by a doctor.