Bed Wetting Causes

Dear Dr. Greene, My eight year old son has wet the bed consistently (about every other night) for as long as I can remember. He feels terrible about it and I feel like a failure as a parent. My mother says it is because he has emotional problems. What is the real cause of bed-wetting? Does anybody know? Please don’t indicate where this question came from, but please get back to me if you possibly can.

Bed Wetting Causes

Dr. Greene’s Answer:

Children who can control their bladders during the day, but who have never been dry at night for at least a six month period, have what is known medically as primary nocturnal enuresis (PNE), the most common form of bed-wetting. Over five million school-age children in the US alone have PNE.

Sadly, most children with PNE feel that there is something wrong with who they are that causes their problem. Many of them feel that it’s the result of either bad thoughts or bad actions. They feel that somehow bed-wetting is a punishment.

Similarly, many parents feel that their children’s bed-wetting is a result of a defect in their parenting. This feeling is heightened by well-meaning friends and relatives who bring up questions of emotional instability as the cause of bed-wetting.

In a recent survey of 9,000 parents of kids ages 6 – 17, 22% stated that they thought the reason their child wet the bed was laziness (survey conducted by ICR Survey Group from July 10, 1996, through August 6, 1996). I am happy to tell you that this could not be further from the truth! Primary nocturnal enuresis is a common developmental phenomenon related to physical and physiologic factors. It does not come from emotional stress, poor self-esteem, or emotional immaturity.

Children with PNE have two things in common. First, they need to urinate at night. Not all children do. During the first months of life, babies urinate around-the-clock. Most adults, however, don’t need to urinate at night (although a small percentage of the population will need to urinate at night throughout life). Sometime in middle childhood, most individuals make the transition from urinating around-the-clock to only urinating during waking hours. There are three reasons why individuals continue to need to urinate at night:

  1. There is an imbalance of the bladder muscles. For example, the muscle that contracts to squeeze the urine out is stronger, at moments, than the sphincter muscle that holds the urine in.
  2. They have bladders that are a little too small to hold the normal amount of urine.
  3. They make more urine than their normal-size bladders can hold, for several reasons:
    • They may drink too much. Drinking in the two hours before bed increases nighttime urine production.
    • They may be consuming a diuretic medication, a substance that directly increases urine output. Usually these are not prescribed medications, but caffeinated cola drinks or chocolate.
    • They may make more urine in response to a chronic disease such as diabetes or a chronic urinary tract infection.
    • They may make more urine than average because of their hormonal regulatory systems. Babies make about the same amount of urine around-the-clock. Most adults make less urine while they sleep. The reason for this is thought to be a nighttime surge of a hormone called Antidiuretic Hormone (ADH). The levels of ADH found in the blood are higher beginning in the evening. One study looking at ADH levels in bed wetters, compared to controls, found that there was a constant low level of ADH in the bed wetters. The nighttime surge did not happen. Perhaps this is a reason bed wetters tend to make more urine at night.

If an individual consistently has to urinate at night, one or more of the above three reasons is the cause. The second thing children with PNE have in common is that they don’t wake up when they need to urinate. When infants need to urinate, there is no signal that goes from the bladder to the brain to wake them up. This is wonderful, since they are not yet able to walk to the bathroom and use the toilet! On the other hand, when an adult’s bladder is full at night, there is a signal that goes from the bladder, through the nervous system, up to the brain. This initiates a dream about water, or more specifically, about going to the bathroom. The dream alerts our reticular activating system, which awakens us. We can then get out of bed, walk to the bathroom, and use the toilet. This signaling mechanism comes into play sometime in middle childhood.

For many years, parents of bed-wetting children have claimed that their children were deep sleepers. Physicians have usually disagreed with this, citing evidence from sleep EEGs showing that bed-wetting children went through the same stages of sleep as other children, at the same frequency, and that bed-wetting can occur at any stage of sleep.

I have never heard a parent come in and say, “My child spends too much time in stage four sleep.” They just say that their children are deep sleepers and are difficult to wake up. About a decade ago, researchers in Canada performed a simple, but powerful, study where they put headphones on children in a sleep lab. They began the study by allowing the children to get used to sleeping with the headphones on. Then they began introducing tones through the headphones. They measured the minimum volume it took to wake each child. The study showed that the children in the bed-wetting group were dramatically more difficult to wake up than normal controls — confirming what parents have known for years!

Children who wet the bed at night both need to urinate at night and do not wake up when their bladders are full. These are the only children who wet the bed.

Understanding the causes of bed-wetting can help remove its stigma. You are also now better equipped to evaluate the suggestions people make to you. Effective therapy is aimed at the underlying causes. Most children can be completely dry within 12 weeks.

N.B. As I stated in my earlier answer titled, “Is bed-wetting genetic?”, there is help for children who wet the bed! The biggest hindrances to getting help are the absence of a skilled, empathetic physician, and shame — parents and children are ashamed to bring the subject up with someone who can help. It is up to you to take the first step! Talk with your doctor. If you find that for some reason she or he is not able to get your child dry quickly and effectively, I would call the closest Children’s Hospital to find out who treats bed-wetting issues.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. mumu

    i am 21 years old girl . i do not understand my situation at all , during the day i can sleep even five hours and when i wake up i find nothing {no wetting my self out} but only night hours when i sleep even just one hour i got my self in a situation of bed wetting heavily. i have tried many ways like tradition medicines of many kinds or like to stay awake may be until 2;30 and when i sleep same thing happen so it doesn’t matter which time i sleep BUT amazing thing is usually around 4 o’clock if it happen i wake up and change the clothes and go to toilet then sleep gain i have never wet the bed till even 8 o’clock .. hence it is only at any time i sleep till around 3;30
    I feel so awful to my self and grief always like am i born to suffer this way.. please help me out

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    • mrs.svl

      My daughter has ten years old.she still bed wetts. She is in deep sleep she didn’t wake up.please give me some suggestions to help my daughter. This my humble request.

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      • At ten years of age, an alarm might be a good choice for your daughter. Dr. Greene has written extensively about bed wetting alarms. You can read more here –> Bed Wetting Alarms.

        Hope that helps,
        @MsGreene

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  2. AnonymousGuru87

    There are demons amongst us. Evil and temptation, amongst others. These demons enter our body without our knowing. You are the select few that maintained this gift that God has blessed all of us with… to rid and cleanse your body of this demon. Most have lost this. This process, which almost all of you would find embarrassing, is the only process for removing this evil.
    Almost every single one of us has been given this gift from birth. This is why children are the most innocent. Not because they don’t know better, but because their removal of this evil is more frequent. Look back into your life, and remember the last time you “wet the bed.” Ask yourself, is this the last years of your life that you remember being innocent.
    Furthermore, it is my belief that the demons who’ve entered our bodies have tricked us into being impatient, lazy, disgusted, and materialistic. Impatient, not being resolved enough to deal with the “bed wetting” situation. Lazy, not wanting to clean the “mess.” Disgusted, thoughts of abnormality and “nastiness.” Most of which, materialistic, not wanting to replace our bed and or bedding. All things that we have come to believe are just and need not of a second thought. Demons have used these three simple evils to influence us to teach our children how not to “wet the bed” (Cleanse our body of evil).
    In conclusion, AFTER the surprise or reactions that you may get for “wetting the bed,” do you notice a brief moment, maybe even an elongated moment, of a calmness amongst your storm? Also, for the non-believers; Are you really making your own decision, or is the Hiden-Demon whispering one, if not all, of the four evils I have mentioned above? After all, urinating is our bodies natural cleansing method. Please, do think about this, and allow your body to cleanse the evil.
    Hopefully some methods to help you cope and or deal with the cleansing. For the impatience, simply leave the “mess” for just a moment to take a shower, or a bath if desired, (calmly of course) and re-dress. If you’re still not feeling up to cleaning, this is laziness. Recognize this, because laziness is a fatal flaw for all of us. Try doing at least 10 or more jumping jacks and or push-ups; not too much; just enough to get your blood flowing. Afterwards, you should feel the laziness dwindling. Proceed to stripping the sheets, and decide whether or not you want to wash them immediately or later. There is no pressure to wash the sheets immediately. Disgust… for this, the solution is simple. Just like “Tinker Bell” would say, “think happy thoughts.” Think of all of the things that make you happy, and maybe even one of my favorites, recite to yourself stupid little jokes that are so silly, you can’t help but giggle. Maybe even some laughter in your VICTORY over the demon for possession of your body. **Doing this from the moment you realize that you have cleansed your body, will help you throughout the challenges all of the other evils throw at you.** Materialism; “The big kahuna.” Things you might think to yourself, amongst others of course…. Oh my God. My sheets are ruined. I just bought them. What the “heck?” My bed. What am I going to do? My bed is destroyed. I can’t afford to replace anything. This is unsanitary. I can’t clean all of this out. Everything has to be replaced. (Shaking my head)
    Just think to yourself; is this really the end of days? Is your life suddenly and physically going to end, or will time press forward, and will all this just be a simple memory faded into your vast collection of memories. Memories of importance are only important because you made them so. Go easy on yourself. You did something great today. Remember the greatness, and don’t cloud it with misjudgment. Lift your head high, because YOU were in a battle for possession of YOUR body, and YOU are victorious!!!!

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  3. Amy

    I just want to thank you all for sharing your stories. I was beginning to believe I was the only one out there with these problems. My step son for 2 years has peed pretty consistently every night. I can only recall this one time where he didn’t pee for 4 days straight. His father and I do believe he is lazy and just doesn’t care, but then other times when you do try and catch and wake him, it’s like he is catatonic and doesn’t know what’s going on. We have tried everything from no drinks after 6, to waking him up every 2 hours, to putting pull ups on him. We have also gone to his doctor and he is no help at all and tells us he will grow out of it. Hopeless parent looking for suggestions. Thank you all for reading and sharing your stories.

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    • How frustrating, Amy. Have you tried bed wetting alarms? They are a huge commitment for the parents, but given enough time and consistency (usually three months of consistent work, every night before you see results) they can work.

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  4. Some guy

    Im 17 and i wet the bed….i thought it was because i drank too much. So i had an experiment…..i was to drink absolutely nothing for a whole day and go too bed. I did and i woke up in wet sheets! So i did another experiment…..i was to drink four gallons of water at twelve in the afternoon and at the end of the day, go to sleep. And again WET SHEETS! Is there a medication i can take in order to stop this!?…. It would save me alot of sanity and my moms detergent… Please help!… (-_-)

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    • Hi Some Guy,

      Yes, there are medicines that can help, but the key is to figure out the core reason and get the best treatment for the cause. Most pediatricians can help you figure it out, but if your doctor isn’t helpful, you can ask him or her to refer you to a urologist who specializes in bed wetting.

      Don’t give up. There is help!

      @MsGreene

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  5. Steve Miller

    Great post. There are many alarms available today. In addition to the two sites Dr. Greene mentioned, there is a new site I found – http://onestopbedwetting.com
    It has a large selction of bedwetting alarms and comes with personalized advice from specialists.

    Steve

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  6. Anonymous

    Well am 16 and I am still bedwetting. I don’t know what to do. I am fed up. My mom always thinks am just too lazy, so am irritated😤😠 Someone pls help me😂😂😂😂😂

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    • How tough. What have you tried so far?

      @MsGreene

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    • tiff

      Im 14, got da same problem. Im pretty sure its from drinking soda and eating chocolate (for me at least) so unfortunately i have to limit myself on those from now on XD

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  7. CHUKS

    I FRIEND OF 24YRS WHO USE TO BED WET WHEN EVER SHE IS STRESSED UP HER SELF. PLZ DO U A TIP OF SOLUTION ON HOW IT WILL CALL IT A STOP?

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  8. Unknown

    Hi I’m 14 and I’m a bed wetter I don’t pee all the time but most of my life yes this week it only happened once it use to be an everyday thing for many years for the past two years or so it’s not that rare but I don’t really do it anymore my mom told my doctor and well they said is she happy at home , not all the time I’m not always happy today I cried and stuff bc well it’s personal and well when I peed 2 days ago I was next to a fan w the windows open was it bc I was cold ? And usually my mom gets mad at me and we’ll she never like supported me throughout this she usually just gets mad at me and we’ll I just want to know why ? It gets me so scared to even sleep over at my cousins house bc what if I pee ? I told my cousin once and she even offered me a diaper . And well I didn’t pee that night so idk but I just wish it would stop

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  9. SampsonDog

    Although, some websites like WebMD and this one will tell you that this condition is not related to anxiety or stress, they are wrong. I wet the bed constantly from 1st grade to 8th grade. I fully believe my bedwetting was emotionally linked and linked specifically to the anxiety and stress that came with extreme, daily bullying at school. I find it extremely ironic and interesting that there is a picture of a school bus in this article because that is where the majority of the bullying took place. The day I finally took my last step off that bus knowing I would be attending another school (the end of my 8th grade year) I NEVER WET THE BED AGAIN. If you are in a bad place and are a bed wetter and are being bullied at school; please message me on Facebook. I know that there are hundreds of kids who commit suicide each year because of this and I fully believe that all these school shootings we hear about now are linked to bullying. Please I want to let anyone know that you are not alone.

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    • Thanks for speaking up, but so sorry about what you went through.

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  10. Private

    Hey, I’m female and 15 years old. I’ve wet the bed my whole life. I usually do it 4-7 times a week! And I’m honestly sick of it, especially in winter. Do you have any tips or advice to help with my condition? Any referrals, just anything in general to help!?! It would be muchly appreciated!!

    Thanks

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    • By now you’ve probably tried a lot of things. What are they and what was the result? Did some of them work temporarily?

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    • Jesse

      You are getting cold in the winter and probably in the summer due to air conditioning, your body is warming itself. I used to be the same way. Once the urine gets cold I would wake up, even had dreams I was on the toilet. I don’t know why it works but the elders swore by it, eat raw potatoes and drink less at night. Good luck and you will grow out of it.

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  11. ann

    My boy is Ten years and still wet his bed every night. He said he doesn’t feel it when he is full. It’s been so from when he was 8 years. I’m worried

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    • Unknown

      I’m just saying I’m the same way my mom always gets mad at me for not getting up at night when I have to pee but I swear I never ever feel it and I’m sure your son doesn’t either . Go seek a doctor he might be shy or embarrassed but it’s best for it talk to multiple doctors maybe go just here the respond

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  12. Kristan

    Hello,
    So I have a 7 year old little girl. She is my second child of 3, and all have been completely potty trained since the age of a year and a half. No bed time wetting or daytime. About a year and a half after I had my third baby my lil girl started wetting the bed every night. I have tried everything. How can she go 4 and a half years . If I do, would that help? The prescribed nasal spray didn’t work. I don’t know what else to do.

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  13. Stephanie

    Help!!!
    My son is six years old, he is autistic (high functioning) he had been potty trained for a year and a half before the bedwetting started. I heard flonase could help…is this true???? Why has this started out of the blue and what should I do?

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  14. JaChelle

    Please help me understand. I used to wet the bed from tge ages 6- 13. And then it stopped. Now I’m 16 going on 17 it just now it came back. Im not stressed out or anything I just don’t understand what’s going on. I don’t know if I left a wet towel on the bed or not because my pants are dry except on the side I was lying on. I don’t know if I had a wet dream or not but I just need some answers because this is starting to get out of hand. PLEASE HELP!!

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  15. mayat

    hi dr greene….am 19 years old
    i do wet the bed sometimes at night only…i don’t know what to do about it..i can’ t talk to anyone about it because i am embarrased…it affects my social life because i am in the university and i find it difficult to stay in the hostel or spend a nite out at a friend’s place…i really need help to know what exactly is wrong with me because it is really affecting my life

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  16. Elizabeth

    Hello,
    My son has been fully potty trained for over four months, night and day, He had been keeping his pull up dry during nap and night time, I started putting him in underwear at night and he did well. I noticed this past weekend he would wake up in the morning soaked. This seemed unusual to happen all of a sudden. He is not sick, nor does he seem to be coming down with anything. His dad lives away monday through friday for work, and comes home during the weekends,I am not sure if the cause of this has something to do with that ,I do not really know if its an emotional factor or what? Please help!

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    • sj

      I’m not sure if it will solve this, but after my daughter goes to sleep at 8, I get her up when I go to bed, usually around 10pm, to go to the bathroom. This helps empty her bladder of anything she drank at dinner time or just before bed. Obviously, she goes to the bathroom before she falls asleep at 8 to, but I find she usually has a relatively full bladder at 10 when I have her go. Good luck!!!

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  17. zel

    My child never peed in bed, but now, when he turns 3, he does, but not at our home. It’s just when we go sleep somewhere else. What is the reason?

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  18. kakoli mondal

    Hi Dr. I am a staff nurse, my son is 8 years running, wets hardly once or twice in a month at night as well as day time in coaching class. His abdomen is enlarged than other boys since infant period, gripping teeth at night. We all take tab albendazole 6 month interval as we live in worm infested area. Family history of enuresis up to 10 years present. Milestones are normal. He suffered from throat and cough, fever, spread redness after DPT vaccination. What can I do to stop bed wetting?

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  19. Concerned Grandparent

    I’ve unsubscribed to this newsletter, because I have not received a response.

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    • I’m sorry you weren’t able to find the help you need at DrGreene.com. I suggest you log on to HealthTap and post your question there. They have a large number of doctors answering questions and may be able to help you.

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  20. Concerned Grandparent

    My daughter recently got engaged to a man whom has an 8 year old daughter. My daughter has 2 sons, 3 & 1 1/2 years old. The 8 year old has had many issues growing up.

    Her biological mother abandoned her very early on. She has had 2 women live with them over the years and one other step-mother. The 8 year old still wets the bed and herself during the day. She has stolen from her father, a store and I caught her trying to steal from me. Now she is stealing food from the pantry and storing it in her room. She has done this before.

    She no longer has friends at school. I’m not sure exactly why, but she never meets a stranger. When she gets upset she screams and jumps up and down, like a tantrum. I’ve never seen an 8 year old do this before, but she does it very often.

    She has researched the internet for pictures of nude men (boys). When my grandson goes to the bathroom, she tries to peek in. It’s very disturbing to me.

    She has ADHD and is on meds for that. She has also seen a psychiatrist for these other issues, but she would only see her once a month and nothing is happening with her getting better or them accessing her and determining what is wrong.

    At first I thought she is just doing these things for attention, but now it’s just getting old and she doesn’t care that she gets in trouble for doing bad things. My daughter has tried loving her and giving her extra attention. She would fix her hair for school and it would look so cute and then the 8 yr old would just pull it all out right before school.

    I know her father has spoiled her some, since he has been on his own with her from an early age, but I think she may be bipolar. Should we seek a professional that will do a more extensive evaluation quicker?

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    • Carla

      As a former foster parent, this sounds very much like the 8 yr. old was sexually abused or observed sexual activity at an earlier age. I would suggest she get a physical and into therapy.

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  21. Hope

    My daughter is 7 years old. Her father is very sporadic with seeing her and recently (6 months ago) lost the ability to see her without supervision due to drug use and a court order. He only calls her about once every 2 weeks, sometimes less than that. I’ve noticed a connection with her bed wetting and those phone calls. She only has accidents on nights after he has called her or when she has been asking about why he hasn’t called her. She had far more frequent accidents when she was seeing him regularly, but that hasn’t happened for almost a year.

    I read how stress can be a cause of bed wetting, as well as your other post on sexual abuse. When she did have visits with her father, she would always come home subdued and quiet. Often times even wetting the bed several nights in a row after a long weekend with him. She would tell me stories about how her daddy would tell her to tell him if anyone touched her down there because he would hurt them if they did. When I was still married to him he was abusive to me and I even had a DVO against him. She has never had bruises when coming home from him, but I know he was verbally abusive to me as well. Should I be concerned?

    I have brought as much as I can forward to the judge on our case and there is an order for her father to only get 1 hour supervised visits, but then what? Should I take my daughter to a specialist for bed wetting? Or do I need to find her a counselor to speak with? If I should be concerned with him, I only have so much time before he has unsupervised visits again. He always plays the victim at our hearings. Claiming he just wants to see his child. I always speak to her safety, but only after he was arrested was I able to get a stop to his overnight visits. This has been a battle for the past 6.5 years.

    I want my child to be safe and happy, but I don’t know what to do about the bed wetting and her estranged father. Any advise you have would be greatly appreciated. Thank you.

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  22. mrs flisher

    My 8 year old daughter keeps wetting the bed. Some time she wets 3 or 4 times a night and she will be sick as well. I took her to my doctors, but they have not suggested anything. Please can you help at all? I have tried everything I can think of.

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  23. Jamie

    Dr. Greene, I am a bit older (19) and have never considered myself a bedwetter aside from several accidents when I was between 5 and 8. I’d be dry for several years, but then out of the blue I’d have an accident. I’m sure one or two accidents a year don’t make you a bedwetter, but what would be the cause of this? Even stranger, and lucky for me, is that they seem to be incomplete accidents. In other words I’m jolted awake 1-3 seconds after I feel myself start to pee in my dream, where I am surprised that I have no more urine to pass, so I don’t even need to hold anything or run to the bathroom. You said bedwetters wet when their bladders are full and released while sleeping. If my bladder isn’t full how can I be having small accidents like that?

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  24. DryBuddyEZ

    Good post! I would advice parents to never use any form of punishment for your bedwetting child. Also, use a bedwetting alarm to help their kids learn how to wake up when wetting is occurring.

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  25. Katherine Anthony

    I have a baby boy after 10 years. He’s going to be 1 year next month, I went through Caesarean section, but I cannot lose my baby weight after my delivery. I’m breastfeeding my baby since delivery. I was thin before my pregnancy. What is the reason and what I should do to reduce my weight? Thank you.

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  26. sara mc

    Hi Dr, Greene, my 9 yr old daughter is a bed wetter and now is getting horrible looking rashes on her inner thighs? Hydro cort is not working…what do you think this could be?? Thanks – you are the best!!!!!!!

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  27. kerron cummings

    i still dont understand why im wetting the bed
    im 14 years old
    im overweight
    i wet the bed everynite

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    • Alan Greene

      Kerron, wetting the bed every night can be discouraging. If it’s always happened (PNE, as described above) it’s the intersection of two things: needing to pee at night, and not waking up when needing to pee. This happens for around 1-2% of all 14-year-olds. It’s worth seeing a doc who treats enuresis to see what can be changed to solve this.

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