How to handle a tot’s sudden bed-wetting

Your 5-year-old is suddenly wetting the bed at night. Is this cause for concern?

“Bed-wetters ... suffer more than their parents or pediatrician may know,” says clinical psychologist Lyle Danuloff. “Children as young as 5 often live with feelings of fear of discovery, shame, low self-esteem and feeling different.”

So address the issue with care and patience. “Our findings point to a deep sleep that prevents the brain from responding to the bladder’s signal,” says Danuloff, who works as a consultant with the Michigan-based Enuresis Treatment Center.

Danuloff and pediatrician Jennifer Trachtenberg recommend these steps:

Call your doctor. “I always recommend visiting a physician for evaluation,” says Trachtenberg. “Medical issues including urinary tract infection, diabetes and constipation may be the cause.”

Understand the brain’s role. “In 99 percent of all bed-wetting cases, based upon our research of tens of thousands of documented cases, the root cause is sleeping so deeply,” says Danuloff. “The bladder sends the signal to the brain that it wants to empty, but the brain fails to either wake you up or send the signal to the bladder to stay closed.”

Root out possible causes. If the bed-wetting is happening after months or years of nighttime dryness, the deep sleep could be brought on by life stressors: trouble at school, a new sibling, an illness, says Danuloff. You may not be able to eliminate the source of stress, but knowing what’s triggering the change in sleep patterns can give some idea if medical attention is needed.

Comfort your child. “When a bed-wetting incident occurs, this is a time when the child will most likely feel embarrassed and down,” says Trachtenberg. “It’s important for parents to keep up a positive attitude.”

Skip the lectures. “All you need to say to your child is, ‘Let’s get you up and change the sheets and make sure you don’t go to school stinky,’ ” says Danuloff.

Seek treatment ... If the problem persists and no underlying medical issue, such as a urinary tract infection, is identified, you may want to enlist the help of a treatment center, such as Danuloff’s (nobedwetting.com).

... or ride it out. “It’s been found that 5 (million) to 7 million children over the age of 5 still wet the bed,” says Trachtenberg. “That number continues to decrease by about 15 percent each year without any real intervention.”