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Fast Fact

Contrary to popular opinion, bed-wetting is a very common problem. It affects somewhere between five and six million children.
Bed-wetting, or nocturnal enuresis, can be divided into two types: primary nocturnal enuresis and secondary nocturnal enuresis. These two types are very different in their causes and treatments.
In primary nocturnal enuresis, children have never achieved complete nighttime control - always wetting at least two times a month.
Secondary nocturnal enuretics are completely dry at night for a period of at least six months and then begin wetting again.
In secondary enuresis, the key is finding out exactly what has changed. There might be a new psychological stress such as a divorce, a move, or a death in the family. It might be something physical: the onset of a urinary tract infection or diabetes, for example. It might be a situational change - perhaps altered eating, drinking, or sleeping habits.
The great majority of bed-wetting children are primary enuretics. For primary enuretics, the cause is decidedly NOT stress or behavioral concerns.
In a 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!
Research has shown that primary nocturnal enuresis is often inherited. If both parents were bed-wetters, 77% of their children will be. If only one parent was, 44% of their offspring will. If neither parent wet the bed, only about 15% of their children will wet the bed.
With primary nocturnal enuresis one almost always finds another relative who was a bed wetter. This corresponds to what is called an autosomal dominant inheritance pattern.
In recent years, researchers have identified an association with bedwetting and two genes named ENUR1 and ENUR2. In studying certain families with primary nocturnal enuresis, researchers discovered that members who wet the bed were more likely to have the ENUR1 or ENUR2 gene than those who did not. More recently, the possibility of a third primary nocturnal enuresis-related gene (ENUR3) on chromosome 22 has also been uncovered. Presumably these genes affect either whether children will need to urinate at night or how easily they can wake up when their bladders are full.

see Fast Facts about Bed Wetting »

Potty Training

10.15.2001 Add new comment Send to friend Print this article

I am just three years old and I really want to get potty trained, but can't quite do it. Any suggestions?

Ryder - Hillsborough, California

Dear Ryder, You are obviously a very smart little boy to be Surfing the Web, and I really appreciate the fact that you want to be potty trained. I'm sure that very soon you'll be able to use the potty every time you need to. The fact that you want to will make it very easy for you! I'm including some ideas to help your parents help you with the process, so call them over to the screen . . .

Dear Ryder's Dad and Mom, You have an adorable son! Most children are ready to tackle the challenge of potty use somewhere between age 2 and shortly after their third birthday, with boys generally at the latter end of this range. Letting you know when their diapers are dirty is an early sign of readiness. When they start to let you know just before they need to go, it is time to begin.

Experts tout many different methods of potty training. Each of them work for some children, or they would not have become popular. By understanding the underlying forces that surround this issue, you will be able to identify which of the many suggestions out there are most likely to work for your child.

The first force is the intrinsic powerful urge in children to grow and develop. The quest for mastery unfolds naturally. Closely coupled with this is the strong desire to imitate those they care about and admire. You can capitalize on this by reading aloud together as a family one of the outstanding books that describe potty use as a part of growing up. My favorite is Toilet Learning by Alison Mack. Illustrations of fire fighters, doctors, baby sitters, and parents all going to the bathroom will delight and educate your son. There are countless other potty-related books and videos that can help get your child interested. Watching the same-sex parent or older sibling in the bathroom reinforces this process. Buying him fun new underwear can further encourage him. Allowing him to pick out a potty seat and using non-food rewards for potty use can also make the process fun.

If these were the only forces affecting potty training, there would be no problem. Fear often plays a major role: fear of failure, fear of disappointing one's parents, or fear of the potty can derail the process. Potty training tends to come at an age when children's fears are most intense. De-pressurize the situation.

If your child seems to be afraid of the toilet itself, then gradually acclimatize him to the potty. Have him sit on one of the little potties fully clothed for a few minutes each day while you read to him or tell him a story. When that becomes old hat, take his diaper off so he can sit on it just like Dad and Mom. Eventually this will become old hat, too. Begin putting the contents of his dirty diapers in the potty so he can see what happens. Then give him the opportunity to run around bare-bottomed so he can try to go on the potty if he wants.

If your child is afraid of failure, it is paramount that when he does make a mistake your response is not an exasperated or a punishing one. Instead say something like, "Oops, there it went. Someday soon they're all going to land in the potty. We'll try again." Encourage him that accidents are okay, and that he will ultimately succeed.

The desire for approval is another strong motivating force that impacts potty training.