When to Treat Bedwetting

Deciding when your child is ready to work on achieving nighttime dryness can be a trying experience. Since there is no specific recommended time, you might consider the following factors:

• Your child's temperament. Some children naturally worry more than others. They worry that there is something wrong with them or that they are different from their peers. Earlier intervention and greater reassurance is helpful for the "worrier." Other children are more easygoing and easily make accommodations for their condition. As a parent, you know your child's temperament better than anyone.

• Family stressors. Taking these steps to dryness requires effort from both parents and children, so it's helpful to choose a low-stress time to begin. High-stress times may be: immediately before holidays or family vacations, at the beginning of the school year, when your child is starting a new sport, following a sibling's birth, following a close family member's death, during or following a divorce, and during or following moving. Try to choose a time when the child is settled into a familiar daily routine.

• Your child's goals or obligations. Your child might voice a wish to sleep over at a friend's house without worry, or go to an extended summer camp. These are often very realistic goals and indicate high levels of motivation.

• Your child's age. Each child of course develops at a different rate, but the average child is dry at night by the age of six. There is a wide variation: some five-year-olds are very motivated to become dry, whereas some seven-year-olds are not.

• Whether they have had any dry nights. If a five- or six-year-old is having dry nights about half the time, supportive treatment may be all that is needed to encourage development. However, a six-year-old who has never had a dry night is less likely to get to dryness without intervention. In an older child of age 10 or 11, wetting even a few nights a week is too much. Intervention to get to complete dryness is warranted. Remind your child that there are treatment options available to make things better.

• Although 97% of bedwetting children who are dry during the day have no medical reason for their bedwetting, a thorough medical history and examination is recommended before starting treatment. Medical conditions that make achieving dryness more difficult include urinary tract infections, diabetes, constipation, and sleep apnea. These can be ruled out by your health care provider, clearing the way for effective treatment.