Many parents are concerned when their child continues to wet their bed at night past the age of three years old. Since most children begin to stay dry through the night around three years of age their concerns are valid. However, child and adolescent psychiatrists stress that enuresis is a fairly common symptom and not a disease. Occasional accidents may occur, often when the child is ill. Parents need to be understanding particularly if the child has been able to have a majority of dry nights. Some facts parents should know about bedwetting:

• Approximately 15 percent of children wet the bed after the age of three
• Many more boys than girls wet their beds
• Bedwetting runs in families
• Usually bedwetting stops by puberty
• Most bedwetters do not have emotional problems

Persistent bedwetting beyond the age of three or four rarely signals a kidney or bladder problem. Bedwetting may sometimes be related to a sleep disorder. In most cases, it is due to the development of the child's bladder control being slower than normal. Bedwetting may also be the result of the child's tensions and emotions that require attention.

• There are a variety of emotional reasons for bedwetting. For example, when a young child begins bedwetting after several months or years of dryness during the night (secondary enuresis), this may reflect new fears or insecurities. Often, this may follow changes or events which make the child feel insecure, such as: moving to a new home, parents divorce, losing a family member or loved one, or the arrival of a new baby or child in the home.

Parents should remember that children rarely wet on purpose, and usually feel ashamed about the incident. Rather than make the child feel ashamed, parents need to encourage the child and express confidence that he or she will soon be able to stay dry at night. Parents may help children who wet the bed by:

• Limiting liquids before bedtime
• Encouraging the child to go to the bathroom before bedtime
• Praising the child on dry mornings
• Avoiding punishments
• Waking the child during the night to empty their bladder

Treatment for bedwetting in children usually includes behavioral conditioning devices (pad/buzzer) and/or medications if behavioral interventions are unsuccessful. In rare instances, the problem of bedwetting cannot be resolved by the parents, the family physician or the pediatrician. Sometimes the child may also show symptoms of emotional problems--such as persistent sadness or irritability, or a change in eating or sleeping habits. In these cases, parents may want to talk with a child and adolescent psychiatrist, who will evaluate physical and emotional problems that may be causing the bedwetting, and will work with the child and parents to resolve these problems. Early supportive intervention will help minimize the potential emotional impact of persistent bedwetting on the child.