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Four-Year-Old Wets the Bed

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My four-year-old son wets his bed every night and sleeps right through it. It seems not to bother him. My husband and I even try to wake him up to go to the bathroom, but it does not work. What else we can do?

A: Don't feel alone! Your son is nearing the age when many families usually become very frustrated and would welcome a quick fix. Unfortunately I don't have that, but I can offer some possible suggestions to supplement what you're already appropriately doing. I am assuming he does fine during the day and has never been totally dry at night. It is true that bedwetting runs in families, but it can still occur even without that history. Remember there usually is nothing "wrong" with his body and one out of five children still wet the bed at least monthly at age five.

I suspect this is bothering your son just as much, so together success can hopefully be achieved. Once your child is interested in overcoming his bedwetting, two guiding principles apply: work with him and protect his self esteem. A child has to learn either to sense a full bladder during sleep and contract the muscles which hold in urine, or to wake from sleep, find the bathroom, and pee in the toilet. No small task for the average five-year-old!

Discuss specific training methods with your pediatrician. Initially the goal is getting up at night and using the toilet. Discontinue diapers or pull-ups. Use a plastic mattress cover. Enlist your child's help in cleaning up and changing the bed. Avoid punishing or criticizing. Limiting fluids may not have much of an impact. One successful method uses an alarm, which is set off when a sensor, worn in the underwear, gets wet. Medicines are used only in special circumstances. Whatever your method, be patient and plan on keeping in close contact with the pediatrician for guidance and reassurance.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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