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When Kids Wet the Bed

Why kids wet the bed

It helps to understand how children achieve bladder control. Infants urinate in response to the bladder-emptying reflex: When the bladder has stretched to a certain point, it automatically releases the urine. Sometime between 2 and 3 years of age, most children become aware of bladder fullness, and learn that they can consciously inhibit the bladder-emptying reflex and hold in their urine. At this point they achieve daytime bladder control.

Nighttime control occurs when a child can unconsciously inhibit the bladder-emptying reflex. So think of bed-wetting as a communication problem: The bladder and the brain don't "speak" during sleep. The child who urinates in his sleep literally sleeps through his bladder's signals and fails to wake up to go to the bathroom.

Steps to dry nights

As a 5-year-old, Ben rarely had dry nights. His mom didn't worry much about it, but when he turned 6 she became concerned and brought him in to see me. Bed-wetting isn't at all unusual for a boy under the age of 6 (in fact, boys with the problem outnumber girls two to one), but by this age Ben was tired of waking up wet and his mom was tired of all the laundry. Besides, Ben was eager to be able to spend the night at friends' houses and didn't want to be embarrassed by an accident.

I suggested that Ben's mom follow the method I've recommended for 25 years. It's a time-tested approach that I estimate works for at least 70 percent of my patients. While it often takes all seven steps, the problem may be solved even sooner and most children begin to experience dry nights within about a month.

Before you start, however, make sure your child's bed-wetting isn't caused by a medical condition or by stress from a life event that may need to be dealt with.

Once you've ruled out an emotional or serious physical cause, you'll also want to be sure that the problem truly needs to be addressed at this point. Ask yourself these questions:

  • Is your child 6 or older? (If not, it's best to wait for him to outgrow the bed-wetting.)
  • Is your child bothered by his repeated bed-wetting? Does he really seem to want to stop?
  • Are you so tired of coping with the problem that it's worth the effort to make your child stop bed-wetting?

If the answer to any one of these questions is yes, you'll have a much better chance of success.