Bed wetting, also called nocturnal enuresis (night wetting), is common in young children and occurs in more than 10 percent of five year-olds and 5 percent of 10 year-olds.
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There is often a history of bed wetting in family members.
This may be due to a small bladder capacity, immaturity, deep sleepers and sometimes constipation.
Wetting both day and night is called diurnal enuresis and whilst common in young children this problem needs a different approach and comprehensive medical assessment.
For children who wet the bed your family doctor will take a history and perform a physical examination to exclude medical causes of enuresis.
The only routine investigation needed is a urine test.
The only effective cures are time or the use of an alarm.
The child needs to be keen, motivated and usually older than seven years-old to use the alarm.
The battery-operated alarm is pinned to the front of the pyjamas and a sensor is placed between two pairs of undies.
If the child wets, the alarm hopefully wakes the child who then turns the alarm off, goes to the toilet and helps with changing undies and bed sheets.
Over a period of six weeks there is a two in three chance of a cure.
The second line treatment but not cure is a hormone tablet DDAVP (Minirin), naturally produced by the body, which reduces urine production overnight and is especially useful for sleep-overs, camping and family trips.
This is a safe treatment in the correct dose and the child should not drink before bedtime.
Other treatments such as hypnotherapy, herbs, acupuncture, diets, fluid restriction and star chart rewards and especially punishments do not work.
Parents need to be supportive.
It is not the child's fault and bed wetting can cause low self-esteem and embarrassment.
