I recently heard from a mother who has a seven-year-old son who is having issues with bedwetting. She says that her son potty trained at three and wore Pull-ups® at night until he was about five. Finally, he was dry all night long for two years. Then, out of the blue, he started wetting the bed. She is wondering if this is normal or if she should take her son to the pediatrician.
Most parents know that boys take longer to potty train than girls. The average age for daytime dryness for boys is three years old. That means there are some boys who are 2 ½ years old and others who are 3 ½ years old who are still working on using the toilet. The process can be painfully slow for parents but it is important to be patient because boys don’t have control over their bladders until they are older.
Most boys don’t stay dry all night long until they are closer to 4 years old. This mother’s son was within the normal range for nighttime dryness. Once boys stay dry at night, they usually don’t regress. Her son, however, did regress and she wants to know what’s up.
Enuresis is the term used for wetting. Children can have daytime enuresis or nighttime enuresis, and the causes can be different. When a child never stays dry during the day or night, he has primary enuresis. This is quite common. In fact, 16% of five-year-olds, 13% of six-year-olds and 5% of ten-year-olds have primary enuresis.
If, however, a child potty trains completely and stays dry for a period of time and then begins wetting again, he has secondary enuresis, as this mother’s son had.
Many different things can cause secondary enuresis and below are some of the most common:
• Urinary tract infection – It is important to go to the doctor and get a urinalysis on your child to see if there is any sign of infection.
• Overactive bladder – Often enuresis is caused by a bladder muscle which is overactive. There are exercises and medication that can help with this.
• Constipation – Often children who have chronic constipation will get urinary tract infections and this will cause daytime or nighttime wetting
• Disturbed sleep – If children have poor sleep quality (sleep apnea, snoring, etc.), they can experience enuresis.
• Underlying medical problems like thyroid disease, diabetes or sickle cell disease. These are problems that your physician would detect.
• Neurological injury – If a child has had an injury to the nervous system, this can cause enuresis.
• Trauma – If a child has been traumatized by abuse (particularly sexual abuse) enuresis can occur.
If a child has been dry for a long period and then begins wetting, it is important to take him to the pediatrician for a thorough physical exam and preliminary evaluation for other problems. Once the cause has been found, it can be adequately treated. Sometimes, however, no cause is found and the child simply needs help retraining.