Preschool Bedwetting

Bedwetting may require professional evaluation if it is associated with: fever, painful urination; excessive thirst, loss of bowel control, or sudden onset with great frequency.

If your child is worried about her bedwetting, your pediatrician can probably reassure her. Consult your pediatrician in private first, without your child. That way you will spare your preschooler's feelings and you can let your doctor know that it's your child, not you, who is concerned about the problem.

Bedwetting is a common problem among preschoolers. Indeed, it should not even be considered a "bad habit," because your child cannot control it. Although bedwetting may persist through (or even beyond) your child's fifth year, most children grow out of it during the early years of school.

If bedwetting occurs only occasionally, don't worry about it. In fact, consider yourself (and your child) blessed. But habitual bedwetting (which your pediatrician calls enuresis) is seldom a cause for concern. In nine out of ten cases, enuresis results from a delay or slowness in development. Only a handful of cases result from an emotional cause (pressure from parents to toilet train too early, for example) or a physical cause (a urinary infection or a bladder abnormality). If, despite these reassurances, you still have any concern about your child's bedwetting, you should, of course, discuss them with your pediatrician.

Whatever the cause of your preschooler's bedwetting—and no matter how frequent—it's certainly not her fault. So regardless of how tired you are or how angry and frustrated you feel at having to change the bed for the fifth time this week, try not to blame your child for her bedwetting. Have patience. Your child will probably stay dry both day and night by age five or six.

A sudden rise in the frequency of bedwetting may indicate stress in your preschooler's daily life. The causes of a preschooler's stress are many: the arrival of a new baby, an extended or unanticipated separation from you or your partner, getting lost in the department store, an illness or hospital stay, a death in the family, and so on. If you recognize the source of stress, talk to your child about it as kindly and openly as possible. If you pamper your child for a while, chances are that the bedwetting frequency will revert to normal.

If you want to do what little you can to cut down on the frequency of bedwetting, try the following:

• Encourage your child to use the toilet right before she goes to sleep at night.
• Cut down on your child's fluid intake before bed. Although this may achieve some short-term success, it may have little or no long-term impact (besides being somewhat inhumane).
• Take your child to the bathroom before you go to bed yourself. Though this tactic may cut down on the times you have to change the bed, it will not in any way affect the overall problem of bedwetting. Nor does it really address the cause of bedwetting. Indeed, because taking your child to the bathroom at midnight may not even wake her up, this strategy might actually encourage her to urinate in her sleep.

The best approach to bedwetting is to treat it as no big deal. Accidents do happen, and habitual bedwetting usually signals late development, not illness. Your child will eventually outgrow it, but again, it might not be until she's six or seven years old.

So praise your child when she wakes up dry in the morning (without making too big a show of it), but don't chastise her for a nighttime accident (or a daytime accident for that matter). Strong parental disapproval only makes the problem worse.