A bedwetter can stress the whole family

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If your child can stay dry all night, be sure to give him plenty of praise.

Bedwetting is the third-highest stress factor for families -- right behind divorce and arguing -- according to the National Association of Pediatric Nurse Practitioners and the Dysfunctional Outpatient Voiding Education Center at The Children's Hospital of Philadelphia. As stressful as it may be, neither parent nor child are to blame.

WHAT WE KNOW ABOUT IT

Known medically as enuresis, there are two types of bedwetting, according to WebMD:

-- Primary is the most common type and occurs when a child five or older has not yet had six or more months of dry overnights while wetting the bed three or more nights a week.

-- Secondary enuresis is bedwetting that restarts after a period of dry overnights.

-- Bedwetting is not an uncommon condition, with five to seven million children affected each year according to the DOVE Center at the Philadelphia children's hospital. Most children outgrow bedwetting at a rate of 15 percent per year which breaks down like this: 40 percent of three-year-olds; 20 percent of five-and-six-year-olds; three percent of 14-year-olds and one percent of older teens still bedwetting several times per week.

-- More boys than girls wet the bed, the DOVE Center says. While no one is to blame, there is an 80 percent chance that a child inherited the condition; it generally runs in families.

-- A bedwetter is not wetting the bed voluntarily. What doctors pinpoint is uncomplicated: that the bedwetter's bladder is not fully developed yet. Combined with the likelihood that your bedwetting child is a deep sleeper, the signal the brain sends that says, "Time to get up and use the bathroom," is ignored.

-- There is no connection between bedwetting and potty training. The two do not impact each other. Again, no blame.

WHAT WE CAN DO

-- First step is to get your child a physical. Ask the doctor to check for urinary tract infection, diabetes, allergies, ADD, ADHD and sickle cell anemia where appropriate. If your child has a sleep disorder, tell the pediatrician. Rarely is an emotional situation at the root of the problem, but if your child has extenuating stress, inform the doctor.

-- Assure your child that he or she is blameless and that you will work together to fix the problem. Assure them they are not alone. There is a chance that some of their friends share the problem but are not talking about it. If you do know of another child with the problem, do not reveal the name without that parent's permission.

-- Have you been a bedwetter in the past â€" or perhaps another family member was? Sharing your experiences and perspective as an adult will show your child there is a light at the end of the tunnel.

-- Work together with your child to retrain his or her brain. Stories are told of bedwetting children staying dry overnight at a relative or friend's house, making possible the belief that your child can control the bedwetting by putting his mental powers to work. Ask your child to visualize a dry overnight before going to sleep.

-- Also ask your child to practice "holding it" for a longer time during the day. This might help in increasing the bladder muscles as well as retraining the brain.

-- Make liquids a no-no past a certain hour before bedtime. Eliminate caffeine. Direct your child to use the bathroom before bedtime.

-- Your doctor may recommend a sensing alarm that attaches to your child's overnight underwear and wakes him when he is wet.

TIP FROM THE PARENTING TRENCHES

Praise your child when he or she is dry several nights in a row. Set up a reward system; this will encourage your child to try harder.

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Doreen Nagle is author of "But I Don't Feel Too Old to Be a Mommy" (HCI, $12.95). She welcomes your parenting tips and concerns at doreennagle@hotmail.com. Follow her on Twitter, @ParentingDoreen.