Q: What causes a child to be a bedwetter?
Bedwetting of the primary type does seem to run in families. So whatever the cause is, it is likely that children who are bedwetters have some sort of genetic reason. It's also possible one or both of their parents wet the bed.
The most popular theory is that bedwetters have a slight delay in maturation of their nervous system. When the bladder is full, the sleeping brain has to send a message down to the bladder not to pee. If your child's nervous system is a bit underdeveloped, the message might not get through.
Another theory is that children who are bedwetters are very deep sleepers. They are sleeping so soundly their brains don't tell their bladder to hold it.
Some experts also think that bedwetters may simply make more urine at night than other kids, and their bladder can't hold it all. Others hypothesize that their bladders have a smaller capacity to hold in the urine compared with kids who stay dry.
Q: What should be done about bedwetting?
The first step is to talk about it with your pediatrician, which many parents don't do because they (or their child) are embarrassed. But it's crucial to do so because the first step in assessing a bedwetter is to rule out any medical causes.
A urine test could reveal a urinary tract infection or excess sugar in the urine as a cause. A physical examination might demonstrate constipation, for instance, which could push on the bladder and cause the bladder to release urine at inappropriate times. A sleep history may reveal that a child has a sleep disorder called sleep apnea, in which breathing stops for a brief time. Urine can escape during those episodes.
Sometimes, secondary bedwetting can occur if a child is psychologically stressed or if he has lived through a disaster recently, such as a hurricane or fire. Those children may need some counseling or other help.
Most of the time, however, your child will naturally outgrow bedwetting as he gets older. To help your child outgrow bedwetting, you can try a number of behavioral strategies outlined below.