Nocturnal enuresis or bedwetting, is defined as unintended urination at night by children past the age of 5 years. The bedwetting may be ongoing or occasional, but the dry bed times are unpredictable. Bedwetting is a very common condition affecting an estimated 6 to 7 million children nationwide. Boys are more commonly affected than girls are. Bedwetting can negatively affect the relationship between child and parents, child and siblings, and child and classmates. Seeking remedies and dispelling myths about bedwetting are important to keep any psychological damage to a minimum.

While all the causes of bedwetting are not completely understood, bedwetting does often tend to run in families. The reasons may fall in the fields of nutrition, phychology, medicine, genetics, habits, and more.
A recent finding indicates that a lack of a common mineral prevents the full extension and elasticity of the bladder.
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Most children will eventually outgrow bedwetting. Each year about 15% of the bedwetters will stop bedwetting. By the age of 18, about 1% is still wetting the bed.

Questions to be answered include how the bedwetting is impacting the family, what treatments have failed to work and what routines the family goes through to deal with the problem. Parents and the bedwetting child need to know that bedwetting is a medical problem and a very common one that likely will go away in time, with or without treatment. The child must not have guilt about having bedwetting nor should the parents have guilt about their ‘failure’ in child rearing and toilet training.

The fears and misunderstandings of brothers and sisters can also affect the bedwetter - usually displayed through teasing or ridicule.

Bedwetting usually occurs during a critical stage in a child's life, when he or she is establishing relationships with peers and siblings--relationships that are critical for social development. If bedwetting is not treated, a child's self-image can be crushed.

Mishandling of bedwetting can make the situation worse for the child - often seen in poor school performance and antisocial behavior, such as declining to participate in group activities or "acting out".

If the family and wetter decide treatment is appropriate, a full description of the plan must be given to the entire family. Without the proper motivation and understanding of the plan, it will probably fail.

The child must be assured that bedwetting is common - he or she is not the only child who wets the bed. The child must understand the treatment plan. After all, the treatment is for the child.

Parents need to know that treatment can take a while to work - possibly weeks or months. The parents must be encouraged to follow the treatment plan and to be patient, understanding, and devoted. The child may wet the bed again after a period of dryness - the parents should be discouraged from scolding or punishing the child for wetting the bed. The parents should ignore the wet bed, but not their child.

There are various treatment options available for treating bedwetting.

Alarms - Wet-bed alarms are moisture-sensitive and ring when the child wets. This wakes the child so that he or she can go to the bathroom. Initially, the child awakens after or during voiding; the child then learns to associate bladder fullness with a conditional response (i.e., awakening and avoiding bedwetting).

Pharmacologic: Imipramine hydrochloride and DDAVP Nasal Spray

DDAVP Nasal Spray (desmopressin acetate) acts by decreasing the production of urine during the night.

DDAVP is actually a hormone called anti-diuretic hormone or ADH. It is delivered in the form of a nasal spray that is used at night. DDAVP has almost an immediate effect of reducing urine output and therefore reduces bed-wetting. Success rates are high, but most children experience a return to bedwetting as soon as the drug is discontinued. DDAVP is effectively used for special occasions, like camp or sleepovers, when a dry night is very important to the child. Practice once or twice at home with the nasal spray beforehand.

Imipramine was initially used as an anti-depressant medication. This drug is thought to relax the bladder muscles, allowing for greater filling and with less bladder sensitivity to filling. Imipramine may take a week or longer to start working and has the side effects of decreased appetite, irritability, headaches and constipation. These side effects go away when the medicine is stopped.

The use of hypnosis or related therapies are very effective in subconsciously training the body to be alerted to wake and go to the bathroom even from deepest sleep. If you can find a well recommended hypnotechnician in your area, it will usually take a single session, preferably at the home, to train the prompting of the full bladder to awake the child and then completing the job of going to the bathroom.

Restricting fluids, except for a mild fluid restriction as bedtime approaches, does not help develop better nighttime bladder control.

Rejection, shame, and punishment because of bedwetting does not help stop bedwetting. It does increase the child's anxiety and lowers the child's self esteem. Parents must realize that bedwetting is not deliberate or controllable by the child.

Questions Parents Ask

Is there something physically wrong with my child?

While bedwetting can be a symptom of some underlying condition, such as an infection of the urinary tract, most children with bedwetting do not have a serious physical aliment. Recent research shows that, in some children, bedwetting may be related to a lack of nighttime increase in antidiuretic hormone (ADH) - the hormone responsible for the regulation of urinary output - resulting in nighttime overproduction of urine.

Should my child be allowed to participate in overnight activities, such as camp, sleepovers, and family vacations?

Absolutely! The same age when children wet their beds is a very important time to be involved in activities with peers and siblings.

There are ways to "protect" the child at overnights. For example, have the child bring his or her own sleeping bag. Use nappies, or diapers. It is important that the child feels secure enough so that he or she will not lose sleep for fear of wetting the bed. Sometimes DDAVP is used for special occasions like sleepovers, or camp, to ensure a dry night when it is most important to the child.

While parents should not punish or blame the child, they should teach the child to take responsibility for remaking the bed and changing into dry pajamas and hanging the sheets out to dry. A wet bed can be ignored, but a child cannot.

Are there safe and effective treatments available?

Yes, and a first step is to try the remedy recently discovered. Send for the free report by clicking here.

Here are some practical tips:

Don't drink liquids close to bedtime
Use the bathroom just before going to bed

Try not to get discouraged, even if there are recurrences of bedwetting after a dry period.