Bedwetting: Answers to Parents’ 6 Top Questions

Parents share secrets and strategies with each other about how to deal with fussy eaters, colicky infants, and tantrum throwers. But bedwetters?

The problem of bedwetting is still shrouded in embarrassment despite the fact that it's very common. As a matter of fact, one in five 5-year-olds is a bedwetter, according to the American Academy of Pediatrics.

To understand why kids wet the bed, we talked to WebMD's pediatric expert, Steven Parker, MD. He shares the six most common questions parents ask him about bedwetters -- and what he tells them.

Q: Why is my child bedwetting?

Before I answer, I need to know a few details. Has your child consistently wet -- that is, never had dry nights -- or has your child been dry, and the bedwetting is a recent problem?

Those are two very different situations. Most of the time, the child was never dry, a problem known as primary bedwetting (or by the medical term, primary enuresis).

A much smaller number of children has what we call “secondary” bedwetting or enuresis. In this case, the child was dry for a long time, maybe a year, and then becomes a bedwetter. That is more unusual, and there is more likely to be a medical cause or a trigger, such as psychological stress or trauma. But that's true in less than 10% of cases.

Most of the time, a child has primary bedwetting, and after a thorough physical examination and examination of the urine, no medical reason is found. In that case we rarely figure out the cause. But I say to the parents: one in five kids at age 5 has this. How abnormal can that be?

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. I think delayed maturation is probably the better explanation. And that perhaps if you are slow in maturation, you may also have a different sleep pattern.

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.