When a child suffers from the inability to exercise full control of the bladder, especially at night, but sometimes during the day, he or she has what is called enuresis . It is generally characterized by repeated voiding of urine into the child's bed or clothes (whether involuntary or intentional) and is usually accompanied by the presence of clinically significant distress or impairment in social and/or academic functioning.

The diagnosis is not made until the child is age five or six.

Factors and causes of enuresis can be either environmental or physical. Some known causes are a child's anxiety about such events as the birth of a sibling or the loss of a family member; a delay in the development of the nerves and muscles involved in bladder control; stress during toilet training and pressure to toilet train too early; or simply a child's failure to learn to respond to his need to urinate while asleep. Enuresis is exceedingly frustrating for both the parents and the child. While children usually appear unaffected by their wetting, most children are actually intensely embarrassed or ashamed of it. These negative feelings may be intensified by isolation from peers and caretakers as the child will likely be teased or ostracized by classmates and viewed as infantile by some adults. To make matters worse, many parents punish or disgrace their child in a misguided attempt to correct the problem.

Parents' frustration may also lead to their verbal or physical abuse of a child; next to crying, incontinence is the most commonly stated reason for parental assault of children. If you are the parent of an enuretic child, remember:

The way you react to the child's problem can deeply affect his self-esteem, progress in school, and the ability to make friends. Remain patient, calm and understanding when responding to accidents. Encourage your child and show faith that he will soon be able to stay dry.

Most children do not wet intentionally. Toilet training is a common difficulty in childhood and is usually not a sign of deep-seated personality problems. Talk to your child's teacher about his problem so that allowances can be made.