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What could be causing my son's bed-wetting?

 Bed-wetting is a common problem - at least one in twenty children, more often boys, still wet the bed by the age of ten.

Children gradually learn to recognise the sensation of a full bladder and learn to 'hold on' in the day. They learn to wake up in the night to find a potty or toilet.

Despite much research we do not know why some children develop night-time control of their bladders later than others, but it is not due to laziness or lack of will power.

This type of bed-wetting has usually been going on since your son was little and is called primary enuresis. It can be hereditary meaning that your son is somewhat more likely to wet the bed if you or your husband did so when you were children. The outlook is good and usually improves with the measures described below.

You ask about artificial food colourings. These are not known to be associated with bed-wetting. However caffeine is present in many foods and drinks, being present in tea, coffee, cola drinks and some fizzy fruit flavoured drinks, chocolate and cocoa.

It is a diuretic; this means that if your son has drinks containing caffeine towards the end of the day or at bedtime he will produce more urine overnight making him more likely to wet the bed.

If your son was previously dry at night and has recently started wetting the bed he needs to be thoroughly checked by his doctor. This type of bed-wetting is called secondary enuresis and may be due to an underlying problem such as urine infections or diabetes which will need treatment.

Whatever type of bed-wetting your son has, his first step, if he has not already done so, is to see his doctor who will check your son does not have a physical cause for his bed-wetting. The doctor will also check his urine does not contain glucose (a sign of diabetes) or protein or blood (signs of urine infection or kidney problems) all of which could make him wet the bed.

Your son is probably like the vast majority of children of this age who wet at night but have nothing wrong with their urinary system. It is essential that you find out how keen he is to be dry at night before you seek further help as his own motivation is the key to success.

If he is not bothered by his bed-wetting, frustrating as it may be for you, it is better not to pressurise him to be dry at this stage. Perhaps over the next few weeks get him to talk about what things would be good about being dry.

Once he really wants to be dry at night his doctor can refer him to an enuresis clinic - your son may already be attending such a clinic. The word 'enuresis' means wetting and 'nocturnal enuresis' means bedwetting.

The clinic is usually run by a nurse or health visitor trained in helping with enuresis. He may be given an alarm which is a common aid offered at this age. The alarm helps your son to wake up to the sensation of a full bladder and to eventually 'hold on' when he gets the sensation.

Your family as a whole need to be motivated and committed for a period of up to three to four months. The success rate tends to be about 70 per cent, although ten to 20 per cent relapse at least once but respond much quicker after a break to a second period of using the alarm.

Medication can be helpful if your son's wetting need to be stopped reliably and immediately, for example a school trip, holiday or sleep-over at a friend's house. The commonest medication used these days is a drug called desmopressin. It reduces the amount of urine produced overnight and works in about 70 per cent of patients.

Some children use it continuously for a limited period, usually about six to eight weeks. There is no limit on the number of courses tried should he wet again. Desmopressin is available as tablets or a nasal spray.

Also consider using night-time protection pants to give your son discreet overnight protection against bed-wetting so he can wake up to dry sheets. The pants are plain white and look and feel like normal underwear being hardly noticeable under pyjamas. They can be very helpful if he is sleeping away from home.

For further advice and help including details of specialist enuresis clinics in UK, write to the Enuresis Resource and Information Centre (ERIC), 34 Old School House, Britannia Road, Kingswood, Bristol BS 15 2DB, call them on 0117 960 3060 or visit their website on www.eric.org.uk

We recommend readers seek personal medical attention in appropriate circumstances.