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The dreaded wakeup call of a child who has wet the bed is not a good way to start the day. Bedwetting, also known as enuresis, is urinating while asleep after the age when most children are expected to be dry through the night. Most children are dry well before the age of 5. However, by age 7, a few kids still wet routinely.

Boys are more at risk for bedwetting, as are children with attention deficit hyperactivity disorder or a parent who wet the bed as a child. If your child still wets the bed often despite being older than 7; begins to wet the bed after having been dry through the night for a few months; has painful urination, pink or dark urine, excessive thirst or hunger, or chronic constipation; or snores loudly at night, it’s time to talk with your child’s doctor. The physician may perform a urine test to rule out infection, diabetes and other abnormalities. It’s rare, but on occasion imaging tests may be ordered if an uncommon structural abnormality in the kidneys or bladder is suspected.

How can you help your child? Consider these possibilities:

• Limit the amount of fluid your child drinks after supper, unless your child plays sports in the evening.

• Avoid drinks with caffeine, which is a bladder stimulant and irritant.

• Be sure your child urinates before bedtime, and consider waking him or her later in the evening when you yourself are ready for bed.

• If your child is constipated, discuss with your doctor a recommended treatment regimen.

• Watch for irritant rashes that can occur when your child is wet at night.

Your physician may recommend a nighttime moisture alarm. In my experience, these work well although they require patience. It may take two to three weeks to see initial effects and three to four months to see resolution.

Medications are sometimes prescribed and effective, including DDAVP (the trade name for desmopressin), a hormone that reduces nighttime production of urine. There’s little or no evidence that alternative therapies such as hypnosis, acupuncture, chiropractic therapy and homeopathic herbal remedies are effective. For more information or specialist advice, please visit mercy.net/lnbedwetting.

The most important therapy is support and understanding. Your child is not wetting the bed voluntarily, and this is often very embarrassing for him. Be supportive. This too shall pass. [LN dingbat]

Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day.

Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day.

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