Usually occurring in children under the age of 6 years who are having difficulties controlling their bladders at night.

What to look for

It is not abnormal for young children to wet the bed at night - even when they have learnt to use the toilet during the day. However there may be a need to be concerned if -

• your child is older than six and has never been dry at night

• your child suddenly starts wetting at night after a period of having been dry through the night.

The most important thing to remember about bedwetting is that it is not a wilful act. Do not whatever you do, become angry or make the child feel guilty or ashamed as this will make the problem worse.

Don't be unduly concerned about bedwetting unless your child is older than six. Before then, your child's body may not have developed enough to control bladder actions at night. Time usually heals the problem: Most children resolve any difficulties on their own by the age of seven.

Causes

It is not fully understood why bedwetting occurs. It is thought be a stage whereby the child has not fully developed his or her bladder control mechanisms fully for use at night. Very rarely is it an infection, however, if you are concerned it is a wise idea to take your child to a doctor for a check up.

The child may be consuming too much fluid before going to bed which could exacerbate the problem.

Any new, stressful situation may cause a child to revert to bedwetting, as can being overtired or sick. Once your child adjusts to the situation, the problem should resolve itself. If your child does not improve, the treatments listed here may help. In addition, you may want your child to talk through his/her fears.

Traditional Treatments

It is wise to go to a doctor who may perform numerous tests to ensure the problem is only minor and is not disease-related.

There are three primary ways to treat bedwetting in an otherwise healthy child…

1. Waiting for spontaneous resolution,

2. Employing behavioural conditioning, and

3. Undertaking drug therapy.

Waiting, though often the preferred course, may make your child anxious. However, if he/she is old enough to benefit from counselling, this may be of benefit to him/her and the whole family.

Using a device with a sensor that detects wetness and sets off an alarm has proved very effective. The child begins associating bladder distension with being awakened and in time "learns" to awaken before losing control.

Drug therapy is considered less effective because most children relapse after stopping medication. It has its place, however. For short-term help when your child sleeps at a friend's.

Alternative/Natural Treatments

Exercise - Bladder-stretching exercises may help your child increase bladder capacity. Bladder-stretching exercises may help your child increase bladder capacity.

Homoeopathy - There are several Homoeopathic formulas available which are usually beneficial. These include - causticum, pulsatilla and equisetum. There are several Homoeopathic formulas available which are usually beneficial. These include - causticum, pulsatilla and equisetum.

Herbal Remedies - Small does of tea made from St. John’s Wort or Cornsilk can help.

Mind/Body Medicine - Hypnotherapy has been helpful for some patients.

Dietary Considerations

Sometimes bedwetting is associated with food allergies. Try eliminating milk products, citrus fruits, and chocolate foods most frequently linked to allergies from your child's diet.

Personal Care

Allow the child to wear new pyjamas to bed each night and to make his bed with fresh sheets everyday. This will make him/her feel it is his/her responsibility to keep the bed linen and himself clean and fresh. Also it will give him/her a sense of independence in that he/she does not have to rely on you.

If you are using an alarm device for behavioural conditioning, avoid heavy sheets and pyjamas which can cause sweat, and can set off the alarm.

Prevent the mattress from getting wet by using a plastic-lined mattress cover (which may cause the child to sweat) or, better yet, provide him/her with a smaller, rubberised, felt-covered pad that he/she can place over the wet area on the bed after an accident.

When to seek further professional advice

• your efforts to help your child learn to stay dry through the night are not working, or your child wants additional help in managing the situation.

• your child is wetting the bed and has frequent or painful urination, dark brown urine (a sign of bleeding), abdominal pain, or fever; these symptoms may indicate a urinary tract or bladder infection.

• your child experiences side effects from any medication he/she is on for bedwetting