Almost all can be helped by their GP or a continence adviser. Very few physical or psychological problems.

Nocturnal enuresis is the most common form of incontinence in children. At age 5 years, 15% of children are wet at night, but this number drops to 5% by 10 years and 1% by 15 years.

It occurs more in males than females. Most children who are incontinent are only wet at night but there is

A small percentage that are wet during the day past the age they are expected to be dry. As they get older, the majority of children will become dry, and it is not normal to treat a child for bed-wetting until they are at least five to seven years old.

Enuresis is the involuntary passage of urine beyond the age at which voluntary control is usually acquired.

Primary enuresis: Urinary incontinence that has not been preceded by a period of consistent dryness (i.e. has never achieved consistent dryness).

Secondary enuresis: Urinary incontinence that occurs after previous successful training and dryness for a period of one year or more.

Nocturnal enuresis: Wetting that occurs at night.

Diurnal enuresis: Wetting that occurs during the day. Some children may have both diurnal and nocturnal enuresis, in which case they are most likely to have Primary enuresis.

There is no single specific cause for enuresis in children past the age of expected control of the bladder. The following factors are known to contribute to enuresis in children.

Delayed development (Maturation) Just as some normal children are later than average in crawling, standing, walking or talking, some are late achieving bladder control, apparently for developmental reasons. This condition may have a genetic basis (run in the family).

Urinary tract infection (Bladder infection) May cause wetting, and this possibility should be eliminated by doing a urine test when the child is first assessed by a health professional.

Emotional Factors There appears little or no connection between primary enuresis and emotions. In contrast emotional disturbance is nearly always linked with secondary enuresis. Treatment should be directed at identifying and if possible relieving the causative stress.

Physical Disorders It is rare for physical or structural defects to cause enuresis.

Most training programmes for children are not successful until the child wants to be dry. In other words when it becomes a problem for the child, this is usually after the age of seven.

Support Explaining to children they are not alone and that it will get better in time often helps. It is important to try not to be angry or anxious, children often feel the same way! Try to relax them and reassure them they are not 'babies', and that you understand that it is not a deliberate act or laziness which is the cause.

Seek help from your GP, or further assessment by a Paediatrician, and/or Continence Adviser ( a nurse or physiotherapist with special experience n continence management).

When you visit a Paediatrician or Continence Adviser a history will be taken to establish the type of incontinence, and a programme developed which is most suited to the child and their family.

Fluids - It is not a good idea to stop children drinking before bed - they should drink as they wish, within sensible limits. However, some drinks can irritate the bladder, and it is worth cutting these out to see if it makes a difference. Tea, coffee and cola all affect some children.

Rewards - a system of stars or other rewards for achieving manageable goals over a certain period of time can be helpful sometimes just keeping a record of the dry and wet nights is enough. Both children and parents can benefit from regular support from a suitably qualified health professional.

Retention training - (may be helpful if investigations have established the child has a small bladder for their age.)

The purpose of this is to increase the amount the bladder can hold by stretching it a little at a time. The training is best done by giving extra drinks in the day and encouraging them to 'hold on' and go to the toilet less often, thereby gently 'stretching' the bladder and gradually making it easier to 'hold on' to larger volumes. Regular measurement of urine volumes passed will help monitor the progress of the training and give the child encouragement.

Enuresis Alarm (bed buzzer) - Alarms can be a very effective method of treatment for children who do not respond to simpler measures and continue to wet the bed after seven years of age. There is a high success rate with this form of treatment, but families need to be taught how to use them correctly, and in a supportive manner to benefit the child. The child and parents often require regular support from a suitably qualified health professional.

Medication - There are medications that can be used to assist in the management of enuresis. Children who are on medication may become dry, but can revert to wetting when the medication is stopped. This form of treatment must be closely monitored by the paediatrician or GP. There are side effects with some of these drugs which would be explained by your doctor should this form of treatment be chosen.