What is it? Bedwetting (nocturnal enuresis is the medical term) is defined as wetting the bed at least once a week at an age when the child no longer wears diapers during the day.
When does it occur? Statistically, almost 80% of three year olds, 40% of four year olds, 25% of five year olds, 20% of six year olds and 7% of seven year olds will wet their beds consistently at night. That means in a second grade class of 40, there will be roughly three children who wet their beds at night on a regular basis.
To whom does it occur? Bedwetting is more common in boys than in girls.
Why does it occur? Bedwetting occurs most commonly in deep sleepers. These children simply miss the cues when their bladder distends and rather than waking up and running to the bathroom, they simply wet their beds. Rarely, it is caused by a urinary tract infection (those kids have daytime wetting and pain).
What can be done? Under age 7 years, we recommend using Pull-Up type night time diapers. There is no one brand that is better than the rest. Because being dry at night is not under conscious control, it does not pay to test the child and see if he/she can be successful. That approach only leads to frustration and poor self esteem. Once a child is dry for a week, it is useful to discontinue the Pull Ups. There is no such thing as a magic moment for night time training that if missed, will cause persistent bedwetting. Most parents try waking their child at some point in the middle of the night to see if they can be successful. The deep sleepers stagger over to the toilet and simply cry. Because it is a sleep related disorder, this approach rarely works. The most natural approach is to use biofeedback or self hypnosis to train the body to wake on its own. Although this is not typically a covered service by most insurance companies, it is effective in 70% of cases in just 4 office visits. Desmopressin, a synthetic hormone, is a medication which has been approved for bedwetting. However, we are reluctant to modify the endocrine system in an attempt to solve this problem and so, this medication is used only as a last resort in patients who are going to sleep away camps for the summer.