Question: My child is out of diapers but continues to wet the bed. Why are we still having the problem? How can we get this under control?

Think about it: Bedwetting has come out of the closet and is now recognized as a common childhood problem. Twenty percent of 5-year-olds and 10 percent of 6-year-olds routinely wet their beds. This behavior is purely a symptom of an immature bladder system, and for most children, the problem will disappear when they get a little older. The following ideas may help speed the process along.

If your child is 5 or younger the easy solution is to allow your child to wear disposable padded underwear to bed. These disposable pants are readily available and can be purchased where diapers are sold. Let your child put them on and off by himself, and tell him that when he’s ready to wear underwear to bed to just let you know. The more low-key you are about this issue the easier it will be for your child to make the step to underwear. Many young children sleep very deeply and simply don’t wake up to use the toilet.

If your child is over 5, the first step is to arrange for him to have a complete physical. Let the doctor know in advance what your concern is so that your child isn’t embarrassed at the doctor’s office. If there are any health problems your doctor can identify them and help solve the problem. Ask your doctor about PNE (Primary Nocturnal Enuresis) which is caused by a hormone deficiency that causes bedwetting and can be treated with a prescription nasal spray.

Make a plan: Your child is most likely embarrassed by this situation and really wants to control it. Empathize with his feelings, and offer to put together a plan to solve the problem. Some ideas are to limit fluids after dinner, use the toilet twice immediately prior to going to bed, keeping a night light on to light a clear pathway to the bathroom, using a plastic mattress cover, keeping clean pajamas and a sleeping bag near the bed for accidents. Allow the child to take responsibility for the problem by showing him how to change the bedding and launder the wet sheets. During this time, you may want to “double-make” the bed. Put on a clean sheet, cover with a plastic mattress cover, and then put another clean sheet on top. If an accident occurs, your child can simply peel off the wet sheet and mattress cover and have a fresh sheet ready to sleep on.

Use an alarm pad: If your child is older than 5, has no health-related issues causing the bedwetting, and clearly wants to eliminate the problem, talk to your doctor or hospital about purchasing a bed-wetting device. This is a pad that that is connected to a buzzer that wakes your child up at the start of an accident so that he can use the bathroom. Typically, after a few weeks of use, a child becomes used to waking up to a full bladder and will do so without the pad.

Don’t obsess about it: Don’t make bed-wetting a primary issue of the family. Take steps to control it and eliminate it, but don’t focus too much energy on it. Try to be patient. It will take time and maturity for your child to get this part of growing up under control, but it will happen.