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| |    The Basics of Bed-Wetting by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Some children stay dry all night soon after (or even before) they are dry during the day. Some don't master dry nights until into their teens. The range of what's normal is wide. Doctors usually will not make a diagnosis of enuresis (bed-wetting) until age four for girls and age five for boys. So many children below those ages still have wet nights that it doesn't make sense to consider it a disorder. No one knows why girls, on average, learn to stay dry sooner than boys. (Girls mature faster than boys, on average, in many areas.) A matter of learning Learning to stay dry at night is like learning to ride a bicycle: Both are a matter of the brain taking control over a set of muscles in a new way. The key muscles involved in staying dry work by squeezing off the outlet of the bladder. Imagine holding the neck of a water balloon so that the water doesn't spray out. Some children find it easy to control these muscles, just as some learn to ride a bike easily, while others take a long time to feel comfortable doing it. How soon a child gains control depends on physical and neurological maturation, as well as on motivation and persistence. Why staying dry is important What makes staying dry at night different from riding a bicycle, of course, is that parents care very much when their children can learn the skill, whereas they rarely get upset about delayed bike riding. Children care, too. They take great pride in the ability to control their bodies, and not having the control can undercut their self-esteem. And children are often embarrassed by their problem. They think they are the only people to have it. As a pediatrician, I know that there is a very good chance that there is at least one other child in the same classroom who wets the bed. Naturally, that child isn't announcing the fact publicly! Children who wet often fear that they will always wet. As a matter of fact, for any given child with a wetting problem, there is about a one-in-seven chance that he will attain dryness within the next 12 months without any specific treatment. When a school-age child comes to me with a bed-wetting problem, I ask if he has already learned to ride a bike. If he has, I want to know if he could always ride a bike or if he had to learn. Of course--he learned! So, I point out, learning to stay dry at night is really the same thing: a matter of teaching your brain to be in charge of your body.
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