Beating the Bed-wetting Blues

WebMD Live Events Transcript

Is your children one of the 10% of all children over the age of 6 who has serious bed-wetting problems? Coping with this problem can be difficult and expensive. Pediatrician Steven Parker, MD joined us on Aug. 3, 2005 to answer your questions.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, Dr. Parker. Thanks for joining us today.

PARKER:
Thank you, it's great to be here.

MODERATOR:
At what age should we become concerned about a child wetting the bed?

PARKER:
There is no set age. In this country at least, we know that by 3, about three-quarters of children are dry at night but one out of four aren't and they're perfectly normal children. Every year after that about one in five or one in six begins to achieve nighttime dryness without any treatment at all.

Usually bed-wetting is not a sign of a medical or psychological problem so there is no real time we need to be concerned. I think the question is more when we decide to try to do something about it and help the child to achieve dryness at night.

MODERATOR:
Is it more prevalent among boys or girls or does gender not matter where bed-wetting is concerned?

PARKER:
Everything is always more prevalent in boys and bed-wetting is no exception. Boys are usually two to three times more likely to not have achieved nighttime dryness compared to girls for some reason.

MODERATOR:
So if you have a child who is six years old, getting ready to start kindergarten and is still wetting the bed, what would be the first steps you should take?

PARKER:
I think in all cases where you are concerned about bed-wetting going on too long, whether it's at night or during the day, the first order of business is to make sure that there isn't a medical cause. That means that your child should see his or her pediatric provider who can do a thorough physical exam to make sure there is nothing physically wrong. Also it's always essential to obtain a urine sample and make sure there's no infection or sugar or something else that might be going on that is causing the child to continue to wet -- that can only be diagnosed through an examination of the urine.

The first order of business is to make sure there's no medical problem, which is usually the case; usually kids are perfectly healthy. In fact, we don't know why they are still wetting the bed except that probably it runs in some families and the child is just slow in maturing in the areas that allow kids to be dry at night.

"I almost never think that bed-wetting is due to 'laziness'. Almost any child is going to stay dry when they can -- it's such a sign of maturity and being a big boy or girl."

MEMBER QUESTION:
My son was dry for almost a year at age 3 but started to wet the bed after a primary care taker passed away. He is dry all night -- he pees as he is starting to wake up. Could this just be laziness or do you see him as an actual bed wetter? My son is now 7.

PARKER:
That's a really good question and makes one important point. There's a difference in children who have never been dry at night, which is called primary enuresis, and children who are dry for a long time and then begin to wet the bed again; that's called secondary enuresis.

When there's primary enuresis, which was not the case with your child, usually we don't have concerns about a medical problem or stress causing it, but rather it's a problem with immaturity of the nervous system.

On the other hand, if there is secondary enuresis and the child has been dry for a while, we know that he or she is capable of being dry and wonder what might be causing the recurrence of the wetness. In that case it's especially important to look for a medical problem. Stress can also be an inducer for the enuresis to recur.




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