Dr Catherine
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Girl
4-7 years

Hi, My son has always had a wet nappy and he is 6 (April 2013). How do you know if it’s genetics, underdeveloped neurological signals or lack of Production of the hormone? Our daughter who is 4 has been out of night nappies for 2 years and our son is very embarrassed that he still has to wear a nappy to bed. Thanks Anna

Dear Anna, the tricky and often frustrating thing about bedwetting is that we don’t always know what is causing it and it becomes even more challenging for older siblings when their younger sibling achieves nighttime continence before them! The most important thing is to reassure your son that his bedwetting is not his fault and really not something he has a lot of control over. Some children who wet the bed do so because their nervous system is slow to process the feeling of a full bladder, which is why you 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 your kidneys produce overnight. Some children produce more urine than normal because their body fails to produce sufficient ADH hormone, a hormone which 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 you would most likely urinate frequently throughout the day. Most children your sons age will outgrow bedwetting on their own as their body matures and becomes better able at storing urine overnight. I would recommend however that you have him checked by your GP just to rule out any possible underlying physiological or medical factors. Given his feelings of embarrassment I would also use this opportunity to discuss more formal treatment approaches to help him to stop. All the best! Kind Regards, Dr Cathrine