If the child has been reliably dry for a couple of years and is now wetting the bed, I'd rule out medical issues first (those urinary tract infections are a headache, especially for girls), then look to emotional upsets. (I'm sure you'd know if there's a new sibling in the house, but there may be something at school.) And don't overreact to an occasional accident, which is easy for me to say, since my kids are grown and not using my bedding anymore.
— Maureen Hart
"Bed-wetters of all ages suffer more than their parents or pediatrician may know," says clinical psychologist Lyle Danuloff. "Children as young as 5 often live with feelings of fear of discovery, shame, low self-esteem and feeling different."
So address the issue, by all means. But address it with care and patience.
"Bed-wetting is not anyone's fault," says Danuloff, who works as a consultant with the Michigan-based Enuresis Treatment Center, a facility that helps patients overcome chronic bed-wetting through sleep studies and other exercises. "Our findings point to a deep sleep that prevents the brain from responding to the bladder's signal."
Danuloff and pediatrician Jennifer Trachtenberg recommend these steps:
Call your doctor. "I always recommend visiting a physician for evaluation," says Trachtenberg. "Medical issues including urinary tract infection, diabetes and constipation may be the cause."
Understand the brain's role. "In 99 percent of all bed-wetting cases — based upon our research of tens of thousands of documented cases — the root cause is sleeping so deeply," says Danuloff. "The bladder sends the signal to the brain that it wants to empty but the brain fails to either wake you up or send the signal to the bladder to stay closed. The signal gets sent, but it doesn't get received."
Root out possible causes. If the bed-wetting is happening after months or years of nighttime dryness, the deep sleep could be brought on by life stressors — trouble at school, a new sibling, an illness, says Danuloff. You may not be able to eliminate the source of stress, but knowing what's triggering the change in sleep patterns can give you some idea whether the bed-wetting needs medical attention.
Comfort your child. "When a bed-wetting incident occurs, this is a time when the child will most likely feel embarrassed and down," says Trachtenberg. "It's important for parents to keep up a positive attitude, as this will help keep their child's self-confidence and self-esteem up."
Skip the lectures. "All you need to say to your child is 'Let's get you up and change the sheets and make sure you don't go to school stinky,'" says Danuloff. "Don't criticize your child. Don't shame your child."
Seek treatment ... If the problem persists and no underlying medical issue, such as a urinary tract infection, is identified, you may want to enlist the help of a treatment center, such as Danuloff's (nobedwetting.com), which works with patients all over the world.
… or ride it out. "It's been found that 5 to 7 million children over the age of 5 still wet the bed," says Trachtenberg. "That number continues to decrease by about 15 percent each year without any real intervention."
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