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Dr. Cathrine answers some of your questions.

My 7 year old son is in DryNites at the moment – every morning they are wet. We have tried to go without, but he just wets the bed and doesn’t even wake up. I couldn’t have that so back into Pull-Ups – At this point I am thinking of an alarm – could you recommend which would be the best and is it likely to wake my 2 year old that shares a bedroom with him. The alarms are the most confusing – if I am going to spend the money I would like to get the right brand.

The enuresis alarm that you refer to is a device that awakens your child from sleep when he wets the bed – they are currently the most effective treatment for bedwetting with cure rates around 70-75%. Enuresis alarms have two basic parts: a wetness sensor that detects urine and an alarm unit that buzzes after your son wets the bed. Some models vibrate when they go off – this benefits some children who are more likely to wake up if they feel a vibration at the same time that the alarm starts to buzz. Some alarm systems can be placed inside children’s underpants and can be worn with absorbent pants while others are fitted to the bed. When your child wets at night, the urine turns on the alarm, while the alarm wakes your child so he can go to the bathroom and finish urinating in the toilet. After weeks of hearing the alarm, children learn to pay attention to their bladder signals and wake up before wetting the bed. Although effective, the enuresis alarm will require a lot of effort and commitment will involve frequent waking up at night and can take months to work. Treatment options vary depending on your child’s age, the frequency of wetting, and any symptoms that may be associated with the bedwetting. The most important aspect of treatment is ensuring your son is motivated to become dry. If by chance he is not then I would hold-off until he is ready. Ideally your selection of product should be done with the help of a GP with bedwetting experience or a continence nurse advisor (you can ask your GP to refer you to your closest continence clinic). Alarm systems are not always the best option for every child and family (particularly if you find it disturbs your younger child at night), and it may need to be paired with other treatments like dietary control or bladder therapy.

I would just like to know at what stage I should get medical help re: my son’s bedwetting. He is 5-1/2 and has always been wet in the morning – sometimes soaked through. I have held off taking him as I don’t want him to be embarrassed by it and thought he would just grow out of it, although we do discuss it with him.

There is some debate about the age and frequency at which bedwetting becomes a medical issue. While some experts consider bedwetting normal until age 6, others recommend seeking medical attention once your child has reached 5 years of age. Most cases of bedwetting will stop by themselves as children’s bodies mature although some children will need extra help to achieve dryness. It is difficult to determine which children will outgrow the problem by themselves, although some experts agree that the frequency of bedwetting plays an important role – that is, children who wet the bed less than 2 to 3 times a week typically stop without treatment, while more chronic sufferers tend to need some assistance. Children, who wet the bed, frequently have a parent who also wet the bed as a child – interestingly these children often become dry at about the same age as their parent did! If your GP does not know a lot about bedwetting you can ask him to refer you to a professional who has experience in treating bed-wetting. It is important to get a urine test first to rule out any possible underlying medical condition – although these are rare and account for only about 1% of bedwetting cases. There are a variety of treatments available with different approaches suiting different children. I understand your concerns as it is very easy for children to feel embarrassed by their bedwetting and to feel they are the only one’s with this problem. How your child adjusts to the problem is largely dependent on how we as parents handle it. It is important to provide lots of reassurance and encouragement and remind him that he is not alone – there are probably at least two other kids in his class that still wet the bed!

My son has a problem when he sleeps. He’s a very very very deep sleeper. We tried with the waking during the night to put him on the toilet, but we found we couldn’t wake him enough to use the toilet. I was wondering if that will make his bedwetting even harder to stop?

As your son is still only four. I wouldn’t be overly concerned about the fact that he is still wetting the bed unless of course it is upsetting him. Reassure him this is perfectly normal and very common among children his age. It is quite common for parents of children who wet the bed to comment that their children seem to be very deep sleepers although being a ‘deep sleeper’ is typically not the cause. My eldest child was such a deep sleeper that she would fall out of bed without waking up – and has remained dry at night since age 3. While you may be able to reduce the number of wet beds by lifting your son onto the toilet during the night – this method won’t help him to independently wake and empty his bladder on his own. As his body matures he will learn to respond to the sensation that his bladder is full and wake on his own. Some children’s nervous systems just take a little longer to mature – the majority of children at this age will outgrow bedwetting on their own without the need for treatment. In the meantime you can encourage a healthy bladder by making sure your son drinks plenty of water during the day, eats lots of fresh fruits and vegetables and limits fizzy drinks – particularly before bedtime. Given the frequency of his wetting you might want to consider using an absorbent pant like DryNites Pyjama Pants – you could continue using these until he starts to have a few dry nights each week and then discuss with him whether he would like to try undies – of course if the idea of lots of wet beds does not appeal to you, you can continue using DryNites until he has achieved night time dryness. The speed at which children achieve night time dryness can vary considerably some do so in a few weeks while others will take months. It is important to stay positive, as even after he has been dry for a while accidents are still common.

Our son is 7, and a bed wetter. Our daughter is 5 and also a bedwetter. Both would probably wet the bed approx 4/5 days a week. Both my husband and I were bed wetters. (one of my brothers until he was around 14) We make no fuss of either of the children if they do or don’t wet the bed. If they do, they tell us so I can change their sheets. It also doesn’t seem to bother the children that they wet the bed – it certainly doesn’t bother us, as long as they are happy. When we go away, they wear ‘night pants’ and it also doesn’t phase them. We would like to continue like theis until it begins to bother one or the other child – what do you think?

It sounds like you have the situation totally under-control! Typically we suggest that once a child has reached school-age and is still wetting the bed on a regular basis you should get them checked out by a GP to rule out any possible underlying medical causes. However, given that there is a strong family history with both you and your husband having wet the bed I would guess that the main underlying causes is genetics! It is well known that children with one or more parents who themselves wet the bed do take longer to achieve night time dryness. We also suggest that parents seek additional support when the bedwetting becomes a cause of frustration, results in feelings of hopelessness or elevated stress. This is clearly not an issue for you – you are clearly at ease with the situation and it doesn’t seem to bother either child. It is true that children who wet more frequently find it more difficult to achieve dryness without any form of treatment – but if it is not a concern for either you, your husband or your children I would leave it until you are all ready and in the meantime they may just stop!

My son has not long turned 5 & we have attempted on a few occasions to get him trained at night. He currently wears pull ups to bed & is wet 6 out of 7 nights. The times we have tried jocks, he was dry the first night & we gave him heaps of praise, but the next 4 nights were wet, so we went back to Pull-Ups. The problem is he just doesn’t wake up to go, he’s a heavy sleeper & I’m just wondering at what age should he really start to wake by himself & go to the loo. I’m not overly concerned at this stage, but the year is quickly slipping by & ideally i would like him to be able to wear jocks at night before he goes to school next year.

It is not uncommon for 5-year-olds to wet the bed with approximately 15% of children continuing to do so, the greater proportion of these being boys. One reason for this is that their bodies often take a little longer to mature. Typically they have a nervous system that is slow to process the feeling of a full bladder and as a result do not wake up in time to reach the toilet or do not wake at all! It is not unusual for either parent to have wet the bed – if so you may like to remember at what age you became dry at night? It is quite common for parents of children who wet the bed to comment that their children are very difficult to wake although being a ‘deep sleeper’ is typically not the cause. Most children at this age will outgrow bedwetting on their own without the need for treatment. If you son is still wetting the bed once he starts school or it becomes a problem for either him or yourself then it may be time to speak with your doctor or an incontinence advisor about different treatment options. I would not be overly concerned at the moment. You may also like to switch from using pull-ups to DryNites as these are specifically designed to hold larger amounts of urine. They are designed to look more like a pant than a nappy and appeal to older children.

My son is 5 1/2 and wets every single night. I haven’t taken him to the doctor yet. I have tried a star chart within the past 4 months and he did do well at one stage during this where he didn’t wet his Pull-Ups for 1 week straight. We praised him etc and rewarded him with a toy which he chose. I would like some advice please on how I can try & get him to not wet at night. He has been out of day time nappies since he was 11 months. It is just at night. It is now very very rare for him to wake up with a dry nappy. His nappies when he wakes up a rather saturated.

Given your son was day trained at such an early age I can see why you may be feeling a little bewildered that he continues to wet at night. Enuresis is much more common in boys, with 7% of boys compared to only 3% of girls continuing to wet the bed at night at age 5. While many children do outgrow the problem, some – particularly those like your son who experience a higher frequency of bedwetting – need additional intervention or support. It is generally recommended that once a child reaches school-age and is wetting the bed on a regular basis (i.e., say twice a week) or the bedwetting is causing stress to either your child or yourself, you should meet with your GP or an Incontinence Advisor. They will have a better idea about what may be causing his enuresis and what the best forms of treatment may be as these can differ depending on the child. There is some debate surrounding the use of incentives and rewards for achieving night time dryness. One of the main reasons a reward system doesn’t work as well for night time wetting compared with toilet training during the day is that the actual bedwetting is not directly under your child’s control. Many parents have however combined the use of incentives with say an alarm-based treatment. When using rewards it is important that you set realistic goals and keep things simple – given that your son wets every night you should not initially aim for dryness as he is most likely to fail and feel even worse about himself. Reward behaviours that he can directly control like going to the toilet before bedtime or helping to dispose of his DryNites Pyjama Pants in the morning. You can discuss with him what his initial goals may be and write these onto a chart. Immediate reinforcement typically works best, you may like to use stickers which can be accumulated and ‘cashed-in’ for a larger reward. You will need lots of patience as a dry bed won’t happen over night – be prepared for setbacks but be comforted in the knowledge that one day this will all be just a distant memory!

My son is 5 years old he has been really good. He hasn’t wet his bed for over a year. However, the past week he has wet his bed every day. What’s going on? What do I do?

This must be really frustrating for both you and your son. Bedwetting is typically broken down into two distinct categories: Primary Nocturnal Enuresis (these children have never achieved night time bladder control) and Secondary Nocturnal Enuresis which is the category your son falls into. With Secondary Nocturnal Enuresis (SNE) children have achieved night time dryness for a period of at least 6 months then begin to wet the bed again. While urinary tract infections are often the most common cause, psychological factors such as a traumatic experience like being bullied or family stresses like divorce may also result in a return to bedwetting. When children return to bedwetting after a significant period of dryness it is important to first have a thorough physical exam to rule out anything health-related. At the same time it is worth thinking about what has changed? Your son was dry at night and now he’s not. Has anything changed in the home environment? Is something upsetting him at school? It is not unusual for children to begin wetting the bed again around the time they start school as they are faced with many new and potentially stressful experiences. If you think stress may be the cause you can help him by talking to him about anything that may be worrying him – remembering that young children can find it difficult to verbalise their feelings. In these cases creative play and physical activities can be great outlets for stress!

When should I expect my son to be dry at night? He wets the bed at least 5 out 7 nights now and he’s 5 years old.

Different children develop the neurological and emotional capacity to control their bladders at different ages. At age 5, about 15% of children continue to wet the bed on a regular basis. The incidence of bedwetting drops significantly with age, so by age 15 only about 1-2% of adolescents experience bedwetting. As children get older bladder capacity increases, an overactive bladder may normalize, or your child will learn to recognize the signal that it is time to void. Your son is often the best one to determine whether the bedwetting is a problem. Does the bedwetting bother him? If it does then it is time to make an appointment with your GP to discuss treatment options.

Do you have any tips on what I can tell my 7 year old son who wets the bed every night when he asks me why he wets and when will he stop. I don’t want to fill him with false hopes yet I want to give him hope.

Most children with enuresis seem to be normal, physically, intellectually and emotionally. While the majority of children will grow out of it by age 5, a small percentage of children will continue to wet the bed if left untreated. Reassure him that this is much more common in boys and that there is probably at least one other boy (or girl) in his class at school that also wet the bed. Talking to your son about the problem can sometimes uncover particular fears or anxieties – is he afraid of the dark? You can explain to him that not all children are good at everything – while he may be very good at maths and not need much help from his teacher, other children seem to be better at not wetting the bed and were able to achieve dryness without the help of their parents or a doctor. Enuresis is typically associated with a combination of factors including heredity – if both parents were bed wetters, 77% of their children will be, while 44% of children suffer from bedwetting if one parent was a bed wetter. Other factors contributing to bedwetting include small bladder capacity, a tendency to produce too much urine at night, and the inability to recognize a full bladder while asleep. It is important to help your son feel in control of the situation – bedwetting often results in feelings of helplessness, lowered self-esteem and a lack of control. Do make an appointment to discuss this with your GP but in the meantime you can talk to you son about different behavioural approaches that might help (like drinking more during the day, holding on for longer periods of time, reducing the amount of caffeinated drinks consumed). Make sure you give him lots of support and encouragement and until the wetting stops he may want to use Drynites Pyjama Pants to help reduce the number of wet beds and the frustration and discomfort associated with this and allow him the freedom to go on sleepovers without the concern of being embarrassed in front of his friends.

Is it considered normal for kids to wet the bed at night until they are 5 or 6? My son (6) has not had a dry night wet and my sister keeps telling me to take him to the doctor.

At age five the incidence of bedwetting is between 5-20% and it is much more frequent in boys than in girls. A general rule of thumb is that about 15% of children achieve night time dryness each year after age 5. At age 5, enuresis affects 7% of boys and 3% of girls. By age 10, it affects 3% of boys and 2% of girls. Typically we suggest that you consult with a GP if your child is still wetting the bed by age 6 as only about 15% of these children are able to achieve night time dryness without treatment. Remembering that treatment may consist of something as simple as helping your child to train their bladder to hold on to more urine by increasing the amounts of liquid drunk during the day or holding-on for longer periods throughout the day. It is important first to meet with your GP so that you rule out any possible medical reason before embarking on a behavioural treatment programme.