Bedwetting at night ('nocturnal enuresis') is common in young children up to the age of about five years. Fifty per cent of three-year-olds and about 10 per cent of five-year-olds wet their beds. Its a little more common in boys than girls. Although most children with bedwetting have no physical or emotional problem, it can become a social problem for children and their families if it is still happening when the child is six or seven.

There Are Two Types Of Bedwetting:

• The child has never been dry (not wet the bed) for more than a few months at a time.
• The child has been completely dry for more than a year, then starts to wet the bed. It is mainly in this second group that a major emotional event or a urine infection could have started the bedwetting.

What is the the cause?

Bedwetting happens during deep sleep. The precise cause is not known although there have been many theories over the centuries. The problem tends to be more common in some families than others. Because it happens during deep sleep, the child has no conscious control over it. The child cannot decide to do it or not to do it. The wetting episodes do not occur only when the bladder is full. Many parents notice that even if they wake the child during the night and take him or her to the toilet, within an hour of going back to bed a wetting episode occurs.

What can parents do?

• Do not scold or punish the child, even though it is natural that you may sometimes feel angry.
• Do not restrict fluids; it will not help with the problem.
• A night light might be useful for children who tend to wake during the night to go to the toilet or to change their pyjamas.
• Regular waking of the child during the night is usually not recommended because disturbing the child's sleep could be harmful.
• Investigate the use of absorbent pads that could be placed beneath the bottom sheet to keep the bed more comfortable.

It is better not to send the child to bed in a nappy. This might tend to encourage immature behaviour, reduce the child's feeling of security and, in older children particularly, could lead to skin irritation.

If your child has wet the bed, see that he or she has a bath or shower before going to school: the smell of urine clings and this could cause other problems.

When should parents seek advice?

If the child is still wetting the bed after six or seven years of age and it is becoming a nuisance or problem to him or her.

If the child has persistent daytime wetting.

If the child has been dry at night for more than a year and suddenly starts to wet the bed.

What treatment might help?

Various things can be done to help the child feel better. If there are emotional problems, some form of counselling will be desirable. Other treatment that might help:

THE BEDWETTING ALARM: With this apparatus, a pad is put under the bottom sheet or a tiny pad is placed in the child's pyjama pants to detect the presence of urine. The pad is connected to a bell which rings when urine is passed. The bell is intended to wake the child, who turns it off. The method works best with older children who want to stop wetting and about 80 per cent of them will stop within two weeks of starting to use the equipment. Some may have to use it again later because of relapse.

MEDICATIONS: Certain medications are effective in some children and occasionally give long term control after they are withdrawn.

HYPNOTHERAPY: This might be of value for some children.

REMEMBER: Bedwetting happens during deep sleep. It disappears naturally in most children and is not usually associated with any physical or emotional problem. There are various ways in which the child can be helped.

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