Talk to your doctor about bedwetting.

When should you ask for help?

Many parents wonder if bedwetting is worth discussing with a pediatrician. Depending on the circumstances, the timing is different for each family, but Dr. Michael Ritchey, a pediatric urologist in Houston, Texas, says he doesn't treat bedwetting before the age of 7 and that parents should instead try different strategies. Before consulting their doctor about bedwetting, many parents try reducing fluids before bedtime or waking the child several hours after they've fallen asleep, says Dr. Ritchey.

Children are usually not treated before the age of 7, as it's common for the problem to resolve itself spontaneously at that age. However, if the child perceives bedwetting as a problem and asks their parents for help, then it should be discussed with the pediatrician. Joan Dyer*, a mother of three, says her eldest son hadn't had a nighttime accident for several months. "So when he had a few accidents, I wasn't too worried," she says. Four months and several soaked sheets later, the nighttime accidents became constant. "We tried cutting down on his evening drinks and waking him up to go to the bathroom, but it didn't improve," she says. "We decided to talk to his pediatrician at his 5-year checkup." Some children experience secondary enuresis, meaning they begin to lose control of their bladder at night after having been consistently dry. Secondary enuresis can have the same causes that affect children who have always experienced bedwetting, such as excessive nighttime urine production or a family history of it.

'Simple' bedwetting is considered a benign problem that most children outgrow, says Dr. Barry Kogan, spokesperson for the National Kidney Foundation's Pediatric Nephrology/Urology Committee. However, some signs suggest that your child may have something other than normal bedwetting and could need medical attention.

According to Dr. Kogan, these signs include:

• daytime enuresis in addition to nocturnal enuresis;
• severe constipation;
• fecal incontinence;
• urinary tract infections.

According to the American Academy of Pediatrics, only 1% of bedwetting cases are related to medical problems, but ruling out these issues can help you and your child cope better. Furthermore, if bedwetting becomes a problem for your child (or for you), a visit to the pediatrician could be reassuring for everyone.

Prepare for the visit

If you decide that a visit to the doctor is necessary, the following information may help with the assessment:

• family history of enuresis;
• the frequency of enuresis;
• habits associated with enuresis, e.g. it occurs after consuming caffeine or when the child is tired;
• daytime enuresis in addition to nocturnal enuresis;
• any unusual aspect concerning your child's urination (straining or pain) or the appearance of their urine (cloudy or pink);
• bedwetting developing six months or more after remaining consistently dry;
• the medications your child is taking.

Kay Davidson*, a mother of one, decided to talk to the doctor about her son's bedwetting during his medical examination at age 5.

Our pediatrician wanted to wait and see if the problem would resolve itself before starting treatment, she said. And the doctor was right, because they eventually discovered the culprit was a prescribed allergy medication. In addition to bedwetting, her son had also started falling behind in school. When he stopped taking the medication, his schoolwork improved and his sheets stayed dry. Now 7 years old, he stays dry at night, Davidson said. If you suspect a medication is contributing to your child's bedwetting, or if your child has behavioral issues in addition to bedwetting, talk to your pediatrician.

During this time

If, after a doctor's visit where all medical problems have been ruled out, the doctor recommends waiting and seeing, what can you do to help your child until they are dry? Dr. Ritchey suggests having your child wear disposable bed pads at night. Your child won't suffer from bedwetting any longer because they are wearing such a product, he says. Patience and empathy may be the best medicine during this difficult phase. Parents can stop focusing on the bedwetting and instead focus on all the other good things the child is doing, says Dr. Kogan. It's important for the child and the family to realize that the child is accomplishing many good things.

* Names have been changed to protect privacy.