Doctor Betti
Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children."


Question: My 13-year-old son has not been able to grow out of his bedwetting problems yet. I have taken him to doctor after doctor and they haven't been able to help. They tell that there is nothing wrong with him and he is in perfect health. Nothing they refer me to do seems to work. They even had me setting alarm clocks to get him up to go to the restroom, but that didn't work. Veronica

Answer: "Enuresis 'or bedwetting, can be very frustrating to both child and parent! It occurs more frequently than is admitted. Wetting at night accounts for about 85% of all cases of enuresis. Causes of enuresis can be caused by any number of factors including maturational delay, small bladder capacity, deficiency of a hormone that balances fluids in the body "antidiuretic hormone," and something that is extremely important -- family history.

If neither parent has a history, chances are about 15% that a child will get enuresis. If one parent has a history, 44%, and if both parents have a history of bedwetting, 75 to 80%!

Generally, the physical examination is completely normal. Of course, infection, constipation, diabetes, etc., are all potential causes. These would be ruled out by your child's pediatrician at the office.

I hear many parents tell me that "my child sleeps like a log" and "nothing will wake him!". Deep sleepers have a more difficult time responding to their body's cue. Small bladders also run in some families. Daytime frequency is usually noted in these cases.

Have a diary ready to show your child's doctor? This will be very helpful for future treatment. Treatments include alarms, restriction of fluids prior to bedtime, hormone replacement and positive reinforcement. Potential consequences of enuresis include parent-child conflicts (resulting from the frustration), behavior problems, low self-esteem, etc. Your child feels bad about the situation. He needs all your support.

The environment should be supportive with the child taking a good portion of the responsibility for bladder control without resorting to punitive measures. Remember to only use positive reeinforcement. Failure to respond to conventional measures at home may indicate referral to a specialist. Consult with your child's pediatrician.

Dr. Betti

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    This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.