Beyond a certain age, bedwetting goes from an extra-load-of-laundry inconvenience to an embarrassment that creates tension between you and your grade schooler. You just don't know what to do or how to talk about it with him. But before you let your frustration—and guilt—get the better of you, consider this: An estimated five to seven million kids in the United States wet the bed. About 20 percent of 5-year-olds and 12 percent of 6-year-olds have the problem, says the American Academy of Pediatrics. Yet bedwetting, or nocturnal enuresis, is seldom discussed due to its embarrassing nature and the stigma attached.

Why does it happen? Some children have smaller bladder capacity, others produce more urine at night than in the daytime, and some kids don't arouse well at night even when their brain is screaming "get up and go." Ultimately, you both need to know that it's not your child's fault. "A lot of parents believe that a child would be dry if he wanted to be," says Howard Bennett, MD, a clinical professor of pediatrics at the George Washington University School of Medicine in Washington, DC, and the author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting. "They think, If you didn't drink so much water before bed, or if you weren't lazy, you would be dry. And this is incorrect."What to do? If you show more interest in your child's overcoming bedwetting than he does, he's simply not ready. In the meantime, make your life easier by encasing his mattress in a waterproof cover and having him wear disposable, absorbent underwear at night. Also have him use the bathroom at bedtime, then wake him to go again before you go to bed (see "Daytime Duties" for more tips).When your child is ready to make the effort to stay dry, he'll probably tell you or say that wetting the bed is frustrating. "A child upset about wetting is a child motivated to get dry," says Dr. Bennett. He advises talking to your pediatrician before your child is 6, though he may not be mature enough to start a program until he's 7. When he indicates he's ready, keep a calendar of wet and dry nights to motivate him, and use a bedwetting alarm, which senses moisture and wakes him (find one at bedwettingstore.com). Alarms are about 75 percent effective, says Dr. Bennett, adding that staying dry takes a motivated child and parent several months and lots of practice. If preventive strategies don't work, talk to your doctor about medications.While it can be hard to understand why an older child can't control himself at night, remember that this is a normal part of development for many kids and that he'll get past this over time. Meanwhile, suggests Dr. Bennett, have him give his bladder a positive message at bedtime, such as "You are going to hold all my pee inside tonight!"   

Daytime Duties

Good habits by day may help keep your child drier by night, says Dr. Howard Bennett. He suggests:

• Drink more during the day. This way she'll stay hydrated and won't have to drink as much at night.
• Don't hold it in. Paying attention to her body during the day will make it harder for her brain to ignore her bladder while she's sleeping.
• Go on poop patrol. Make sure she's producing at least one bowel movement a day. Constipation can put pressure on the bladder and cause bedwetting.