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If you are of a certain age, you may be plagued by the impactful memory of a 1976 Emmy-nominated made-for-TV movie starring Michael Landon, “The Loneliest Runner.” The project was of particular importance to Landon – who wrote and directed – because the story was autobiographical. The way his mother’s character handles her 13-year-old John Curtis’ chronic problem is textbook bad mamma – she hangs his stained sheets in front of the window, so everyone coming home from school can witness his shame. In an attempt to circumvent the pee show, John Curtis runs home as fast as he can to tear down the sheet. The race home instills a love of running, and he joins the track team to deal with his anger. The movie flashes forward to a decade later when it is revealed that Curtis has become a marathon runner and an Olympic Gold medallist.

Bedwetting in children under the age of 7 should only be considered normal and part of the maturing process. In other words, bedwetting happens because of immaturity. Children learn to control their bladders during sleep at their own good time (but usually before the age of 7). Not wetting the bed anymore is actually the last stage of the often-challenging process of potty training. In the United States, it’s estimated that seven million children regularly wet their beds. In the U.K., bedwetting is considered normal under the age of 5. One in seven U.K. children aged 5 and one in 20 children aged 10 wet the bed. There is, in fact, an organization, a childhood continence charity in the U.K., founded in 1988, called “ERIC,” (Every Child Has The Right To Go, website www.eric.org.uk) which operates as a support group and provides information for parents and adults who suffer from bedwetting.

While bedwetting resolves in time with most, for some it becomes a challenge. Bedwetting is actually a complex process that involves the coordinated action of the muscles, nerves, spinal cord, and brain.

There are two recognized forms of bedwetting:

Primary – Primary bedwetting refers to children or those who have never had control of their bedwetting. This form, primarily, stops when maturity and the ability to control the urination process are outlined above.

Secondary – Secondary urination refers to a relapse – that is, a child has been “dry” (no bedwetting) for six months when there is suddenly a recurrence.

Underlying conditions for secondary bedwetting may include:

• Psychological stress
• Major life changes (moving, starting a new school, or parents’ separation)
• Heredity – it runs in families
• Small functional bladder capacity
• Food sensitivities – these include citrus, caffeine, carbonated drinks, and other foods

Medical Causes of bedwetting include:

• Obstruction of the urinary tract
• Constipation or irregular bowel movements
• A low level of hormone that controls how much urine is produced during sleep is called “high-urine production”
• Bladder infection
• Kidney infection
• Diabetes
• Bladder or urinary abnormality.

If a child who is five or older wets the bed more than two or three times a month, the child’s pediatrician should be contacted.

Parents should never place blame due to bedwetting – it is not done intentionally and not done to get attention. It can be as simple an issue of a heavy sleeper who is unable to wake themselves up when their bladder is full. Some parents have noticed that their child doesn’t wet the bed when he/she sleeps somewhere other than home. Doctors speculate that a strange location makes heavy sleepers sleep more lightly and they are able to wake themselves up.

It will help the child’s doctor if the parents keep a journal over the course of a week, chronicling the bedwetting and addressing the following:

• When did it start?
• Is the child a heavy sleeper?
• Has it improved, worsened, or stayed the same since the onset?
• How frequently does night-time bedwetting occur?
• How effective are your solutions – protective undergarments? Bedwetting alarm?

In the meantime, don’t worry, as it is a situation that is solved by most. Never punish a child or compare him/her to another child (everyone’s development is different), and don’t restrict fluids (but let them drink water, rather than other kinds of drinks). Work with your child and discuss goals of treatment and alarm use, don’t focus on accidents.