Hi K.W. – the majority of children who wet the bed have nothing medically wrong with them. While doctors and researchers have been able to identify some known causes, there is still an air of mystery surrounding some aspects of bedwetting. Contributing factors include a small bladder capacity, genetic predisposition to the condition, and the absence of ADH (antidiuretic hormone) – children without ADH produce four times the amount of urine as those who have the hormone and are therefore at a greater likelihood of exceeding their bladder capacity overnight. In general, we find that children stop wetting the bed when their bodies become better able at storing the urine overnight or they learn to wake-up on their own in response to a full bladder. Researchers have shown that while deep sleeping certainly plays a role in bedwetting it is not the primary cause of why it happens in the first place. Children who are particularly deep sleepers fail to wake in response to the message sent by the bladder to the brain saying it is full and requires emptying. The bladder then attempts to either store the urine or it empties while your child sleeps. The many known (and unknown!) causes of bedwetting go someway toward explaining why we experience such variable responses to the range of treatments available. Conditioning alarms are currently the safest and most effective means of treating bedwetting. There are a number of different styles available so it is best to meet with a continence advisor first to discuss your individual needs. It is important that you do not try and go it alone as the more support and guidance you receive during the treatment phase the greater the likelihood of success. In the meantime it is important that your reassure your daughter that this is in no way her fault and that with time she will become dry overnight. Build her self-esteem by focusing on all those things that she does well, and minimize any focus on her bedwetting.

Regards,
Dr Cathrine

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