Hi M.L – there are a number of possible reasons why children wet the bed. Some do so because their nervous system is slow to process the feeling of a full bladder, which is why they do not wake up in time to go to the toilet. Others wet the bed because their bladder has yet to mature to a point where it can store the amount of urine their kidneys produce overnight. Some children produce more urine than normal because their body fails to produce sufficient ADH hormone, a hormone that is designed to reduce the amount of urine the kidneys produce. Others wet the bed because they have a small bladder capacity – if this is the case children tend to also urinate more frequently throughout the day. Anxiety is not generally a contributing factor in primary bedwetting however it would definitely heighten the stress and negative feelings associated with his bedwetting. There is also a number of underlying medical causes so it is very important that you make an appointment with your doctor and have this investigated further. The two most common medical causes of bedwetting are chronic constipation and urinary tract infections. Symptoms of constipation may include abdominal pain or cramps, nausea, pain when going to the toilet, frequent urination, soiling and occasionally vomiting. Once your doctor rules out any underlying medical cause then it is definitely time to think about introducing some form of formal treatment. Conditioning alarms are typically your best option although I would discuss this with your doctor first. The drinking program that your friend refers to is designed to increase bladder capacity. Drinking water regularly throughout the day is certainly a very good habit to encourage so long as he does not try and hold on as this can lead to accidents. It’s good practice to drink water approximately every 2 hours tapering off in the evening – he should be consuming approximately 1.5 litres per day. It is not unusual for children to drink very little during the day while at school and then consume the majority of their daily fluid intake in the afternoon, placing additional pressure on the bladder at night. Children who drink insufficient water are also at higher risk of becoming constipated. In the meantime try and avoid any comparisons between him and his siblings as this will only add to his anxiety. It is important to focus on and celebrate all those things in his life that he does well – children tend to feel good about themselves when they succeed in areas that are meaningful to them and that they value. Help him to put his bedwetting in perspective, this is just one very small part of himself that he has no control over and with time his bladder will learn to get better at storing the urine his body is producing!

Regards,
Dr Cathrine

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