Bedwetting is a common problem but an upsetting one for both parent and child. It is so common that an entire industry has grown up around the problem including books, equipment and even medications that offer cures.

Research turned up the following practical and compassionate article on bedwetting from the website of Dr. Sears (Ask Dr. Sears.com), which is reprinted in its entirety.

William Sears, MD and his wife Martha Sears, R.N. come by their knowledge not only from 30 years practicing pediatric medicine but raising 8 children of their own.

Millions more have sought their advice through the 40+ pediatric books, articles in parenting magazines, and appearances on more than 100 television programs such as 20/20, Good Morning America, Oprah, CBS This Morning, CNN, NBC’s Today Show and Dateline.

Myths about Bedwetting

• Bedwetting is not a psychological problem. It does not mean that your child is too lazy to get up, is using bedwetting as a control issue, or is manipulating the family.

• Misunderstandings about bedwetting have kept it from being viewed as a legitimate medical problem. If the lungs malfunction, the child is medically and sympathetically treated for, say asthma. If the bladder malfunctions, the child is thought to be lazy, stubborn, and immature. You would certainly be sympathetic to an asthmatic child who wheezes at night because his lungs aren’t filling with enough air.
• Think of bedwetting as any other medical concern in which an organ of the body is malfunctioning. Bedwetting is a malfunction of the bladder-brain communication system. The child sleeps so deeply that bladder-overfilling and spilling occurs.
• It’s a myth that children don’t care. Really, what child would want to wake up in a wet, smelly bed every morning, and start each morning stripping the bed and carrying wet sheets to the washer?

Facts About Bedwetting

1. The medical term for bedwetting is “enuresis,” which refers to bedwetting that is not due to an abnormality of any portion of the urinary tract. Primary enuresis means the child has never been dry, whereas secondary enuresis is the term used for a child who has previously been dry but then starts wetting his bed. Bedwetting is sometimes referred to as “nocturnal enuresis” or “nightwetting.” Sometimes it’s called “sleep wetting,” since some children may also “nap wet.” Bedwetting really should be called “sleep wetting” because it occurs during sleep.

2. Fifteen percent of five-year-olds or around three to four children in a first grade class, are not dry every night. Eighty-five percent of children eventually outgrow bedwetting without treatment. In the teenage years, only two to five percent of children, or one child per class, continue to wet their bed. Bedwetting boys outnumber girls by a ratio of 4 to 1.

3. Bedwetting is not an emotional or psychological problem, nor does it reflect a dysfunctional family. It is a problem of sleeping too deeply to be aware of bladder function.

4. The genetics of bedwetting are similar to that of obesity. If both parents were bedwetters, the child has a seventy- percent chance of being a bedwetter. If only one parent was wet at night, the child will have a forty-percent chance of following his parent’s nocturnal habit.

5. It helps to first understand how children usually achieve bladder control. In early infancy, bladder-emptying occurs mostly by the bladder-emptying reflex. When the bladder reaches a certain fullness and the muscle has stretched to a certain point, these muscles automatically squeeze to empty the bladder. Sometime between 18 months and 2½ years, most children have an awareness of bladder fullness, the first step toward bladder control. Next, the child becomes aware that he can consciously inhibit the bladder-emptying reflex and hold in his urine. As a result of his urine-holding efforts, his bladder stretches and its capacity increases. When the child can consciously inhibit the bladder-emptying reflex, he achieves daytime bladder control. Nighttime control occurs when the child can unconsciously inhibit the bladder-emptying reflex.

6. Think of bedwetting as a communication problem: the bladder and the brain don’t communicate during sleep. The bedwetting child literally sleeps through his bladder signals. Delay in bladder control can occur if there is a delay in awareness of bladder fullness, a small bladder, or the bladder-emptying reflex continues to be strong well into later childhood. These components of bladder maturity occur at different ages in different children. Bedwetting is simply a developmental lag in the mastering of a bodily skill. There are late walkers, late talkers, and late dry-nighters.

7. Bedwetting is a sleep problem.

New insights into the cause of bedwetting validate what observant parents have long noted: “He sleeps so deeply, he doesn’t even know he’s wetting the bed.” These deep sleepers are not aware of their bladder sensation at night, let alone how to control it. In addition to bedwetters sleeping differently, the hormonal control of urination may act differently in some children.

8. Some bedwetters may have a deficiency of ADH (anti-diuretic hormone), the hormone that is released during sleep and concentrates the urine so that the kidneys produce less of it during sleep and the bladder doesn’t overfill.

9. Normally, bladder fullness works like supply and demand. The bladder fills with just enough urine at night so that it does not overfill and demand to be emptied. Bedwetters may overfill their bladder so the supply outweighs the demand, but because they are sleeping so soundly they just don’t tune into their bladder fullness.

10. A small number of children have small bladders that are more easily overfilled.

The following article is reprinted with the permission of Kelly Palmatier as it appears with the title of Volunteering with Children on the site, compassionatekids.com

Volunteering with children is a great way to help them learn about giving back. Children learn valuable skills while “on the job.” Home schooled students, who may have more time available for volunteering, could also enjoy the additional socialization opportunities presented through volunteering. Another benefit of volunteering is children learn about the concerns of the organization and what need it fills in the community. Consequently, the children also have an opportunity to remember what they have to be thankful for.

Work Together

It’s important to work side-by-side when volunteering with your child, since leading by example has been shown to be the most effective form of teaching. Children who see their parents volunteering are much more likely to believe in the value of working to help others.

Naturally, working side-by-side with your child will allow you to assist him/her when necessary, ensuring the child’s presence is a help, not a hindrance to the organization’s staff and other volunteers.

An additional benefit of working with your child as a volunteer is the bonding that occurs when people work together as a team. Also, when people are focused on a task, it sometimes fosters deep conversations that may not have occurred with more direct eye contact.

Consider the Right Opportunity

When choosing a volunteering opportunity, it’s important to consider the following:

• Your Child’s Interests
• Your Interests
• Your Child’s Abilities
• Your Abilities
• Location, Frequency, & Duration
• Staff Attitude

Your Child’s Interests

If your child is clearly interested in a subject, it may be possible to use that interest as a springboard into volunteering: Children who construct a lot of forts or buildings with blocks may enjoy helping out a construction organization such as Habitat for Humanity; children who love animals my enjoy volunteering with animal organizations such as the Humane Society.

Your Interests

It’s also important to consider your own interests. Children look to their parents to help them discern how to respond to new stimuli. If you are bored while volunteering, your child will associate boredom with volunteering. Alternately, if you are passionate about your actions, your child will respond to that passion.

Your Child’s Abilities

If your child is very young, it can be challenging to choose a volunteering opportunity that he/she can actually help with. Fortunately, there are opportunities available that even very young children can do with a little parental guidance.

I started volunteering with my children when they were three and six years old. My older child could follow basic directions well with a small amount of supervision. However, my three-year-old was an energetic little boy with a young child’s motor skills and attention span.

We were able to be successful volunteering at a local food pantry, where his sorting and counting skills worked quite well with close supervision and direction from me. I gave simple tasks such as taking two boxes of macaroni & cheese from a shelf and putting them in each grocery bag. He was able to complete these tasks easily, while I added all the remaining groceries.

Your Abilities

Just as your child will learn from your passion for volunteering, he/she will benefit from seeing you work well in your element. For example, if you are especially skilled at home renovations, you may find a community restoration project to work on. This would allow you to share your skills while demonstrating the relevance volunteering has to many different careers and interests.

Location, Frequency, & Duration

Of course, it’s important to consider the basic logistics of any volunteering opportunity. If the opportunity is close by, a commitment to help out on a weekly basis may be fine. If it’s farther away, you may need to commit to helping on a monthly basis instead. It’s fine to increase your volunteering later, after you’ve tried it out and you know it works well for you, but be careful not to over-commit initially. Remember your child is already learning work ethics from this experience. You’ll want to ensure you arrive in a timely manner when you’re expected, only canceling or rescheduling when you truly have valid reasons and can give plenty of notice.

Consider, too, the duration of each volunteer session. Older children may be fine with a few hours or more. However, younger children may need sessions to be kept short.

We found our one-hour volunteer session at the food pantry each week worked well during the first 30 to 45 minutes of fast-paced grocery bag-filling. However, the remaining 15 to 30 minutes of shelf-restocking were slow-paced enough that the three-year-old had trouble staying focused. It was an invitation for chaos. We handled it by simply leaving earlier until he was a little older and better-able to handle a full hour of volunteer work at a time.

Staff Attitude

The last item to consider is the attitude of other volunteers and the organization’s staff. Most people will appreciate your instilling a volunteer ethic in children at a young age, but you may find a few “sour apples” who focus more on the decibel level or other potential distractions. (In fact, many organizations may prohibit children under a certain age.)

To some extent, the mission you’re on is more important than any individuals who may not appreciate your child’s input. However, be sure to consider the effect others’ attitudes have on your child. If a child feels like a hindrance, volunteering will end up seeming like a chore rather than a joy.

Resources for Finding Volunteer Opportunities

There are many ways you can learn about volunteering opportunities, including the following:

• Check with Keep America Beautiful or other local organizations for community clean-up days.
• Consider raising vegetables or starting a canned food drive for your local food pantry.
• Check with local nursing homes for “toddler days.”
• Take on home baking projects for fundraising bake sales or meal delivery services.
• Ask your local Chamber of Commerce for information about local organizations that may have volunteer opportunities.
• Call non-profit organizations you like and ask what you can do. They may have needs/volunteer opportunities that you haven’t even thought of.
• Check for opportunities listed in national volunteer website databases such as VolunteerMatch.org (has a designation for kid-friendly opportunities) or Idealist.org (has designations for teen opportunities and under-age-12 opportunities).

As with most parental/educational pursuits, there are many factors to consider regarding volunteering with children, but a little effort can provide a lifetime of benefit for both the kids involved and for society.

During his preschool years, my younger brother would bite his brothers and sisters. He bit us when we wouldn’t give him what he wanted. Unfortunately for my parents, he also would bite the neighbor’s children, kids in the playground, and just about anyone  when he didn’t get his own way.

In those days, a biter was considered a troubled child whose parents did not know how to control him.  By the time he was three he had a reputation in our neighborhood. As he would approach the playground with my mother, other mother’s would grab their kids and move to a different play area.

My parents were mortified by his biting and at a loss to get him to stop. Our pediatrician was called into the situation and was also at a loss to know why this bright, friendly, otherwise likeable boy would resort to biting.  All kinds of behavior modifiers were tried, including making his brothers and sisters bite him back. Nothing worked. Then, he stopped. Just a month before he started Pre-K…he stopped biting and he never bit anyone again!

The other day I came across an article by Dr. Som, a pediatrician, whose posts I’ve referenced in past blogs. My mother and father would have been so relieved to have read her article about preschoolers and biting.

So…for all of you who may be worried about a preschooler who bites here is an excerpt from Dr. Som’s post that will put preschool biting in perspective and hopefully put your minds at ease.

Biting is very natural and all children around the age of 12 months begin to experiment with biting Mom or Dad. Then they might try biting siblings or friends. The behavior peaks around 24 months and then declines. Three year old children rarely bite because they have gained social competence and the language skills to mediate frustration.

Please know that all children bite. No matter how you handle the behavior, your child will outgrow it by three years old. How you react may affect how quickly the behavior stops.

To nip it in the bud

• A simple, “biting hurts” will do. Nobody should be called bad. No shouting.
• Give affection and attention to the child that was bitten.
• Briefly ignore the biter. Time out may not be necessary as ignoring the child sends a clear message that biting is an antisocial behavior.
• Let the biter say sorry or hug the person he has hurt.
• Anticipate biting and offer distraction or offer words that the child can use instead.
• If the skin is broken, see your doctor about the need for antibiotics or a tetanus shot. Usually soap, lots of water, and maybe a cool compress are all you need.
• Choose a daycare with good staffing ratios, at least one adult to four children for toddlers. A quality provider engages the children, minimizes boredom, recognizes fatigue and understands that biting happens.

Biting is almost never a sign of abnormal development in an otherwise normal child.

Visit Dr. Som’s site at   www.pensivepediatrician.com/

I came across an article by Kay Kosak Abrams, a psychologist, that I am reprinting because it has a message for every parent who has ever had to explain why we must say goodbye to something or someone that means a great deal to us.  Dr. Abrams shares her thoughts on the necessity of saying goodbye as a child moves towards adulthood. I hope reading her article will make it a little easier for you the next need to help your child with saying goodbye.

Sometimes we try to protect our children from sadness and loss in ways that result in increased fear and anxiety. It is a common misperception that to ignore “saying goodbye” might alleviate painful feelings.

By middle school, most children have experienced the loss of a friend, pet or relative. Separation, loss and reattachment are common and necessary experiences in life. Infants separate and reattach when they nurse and when they sleep. Our children practice separation when they go to a friend’s house or when they go to school. Sleepovers and summer camp are also times to practice emotional and physical separation.

As they grow up, our children move away from dependency in order to master independence over and over and over again. I often remind parents that parenting is about attachment, separation and “letting go,” from the time our children are born to the time we are saying goodbye as they leave for college.

If a child shows signs of regression, such as reverting to bed wetting or clinging with fear when a parent attempts to leave, it is time to step back and think about how to help him or her regain a sense of emotional security. It is never too late to go back in order to rethink a “goodbye” ritual to help your daughter or son adjust to loss.

Here are some tips that may help in preparing children in saying goodbye to a beloved caretaker.

• When we experience a sudden or mysterious loss, we are more thrown off than if we had been able to prepare. This is true for young children as well. When babies experience a sudden or extreme change in circumstance, you may see greater insecurity manifested in fussiness and poor adaptation. Some babies and young children show changes in sleep patterns, appetite and general mood, just as we do when we experience significant change or loss.

• When we feel vulnerable and uncertain, just after “the rug is pulled out from under us,” we engage in dependent behaviors that might increase our sense of security. For example, your child may be “clinging” because now he or she is afraid that another person that he or she depends upon will disappear. Increased crying, whining or “baby talk” might secure more care as well.

• In addition to behaviors that secure dependency, we need to work through feelings of sadness and loss, and we might engage in efforts to protect ourselves from further vulnerability of loss. Your child might become bossy and controlling in an effort to ward off any vulnerability. If he or she “mans the ship,” so to speak, he or she can feel in control of who comes and who goes during playtime.

• In order to promote healing and to begin moving forward, start with a simple conversation addressing the caregiver’s departure. You can bring out a photo of  the caregiver to help your child with conscious recall. Addressing the truth gently, but directly, is best. Tell your child that the person who left had to go but they still love and will miss him or her.

• If there is a way to communicate with the caregiver by phone, through a visit or sending letters, this will help your child, as will having your child draw a picture and send it to the person.

• Once you have gently and directly addressed the fact that the caregiver will not be coming back, but that he or she is well and can exchange letters and packages, your child will be able to move forward. The significance of a caregiver’s absence will recede with a peaceful, rather than fearful, feeling.

Growing up involves making friends and losing friends. Most parents will need to depend on alternative caretakers at some point prior to preschool. Children benefit from attachment to extended family members, as well as to caretakers. However, when someone they love is leaving, young children need to understand their experience of loss.

Saying goodbye helps us to attach, separate and reattach, thereby making new relationships while holding onto beloved friends who are no longer with us. It is parents’ job to help their children with the transition. Learning how to say “goodbye” is a lifelong skill and a priceless gift we teach our children.

Kay Kosak Abrams is a psychologist in private practice in Garrett Park, Md. Visit www.kayabrams.com for more information.

Chef Ed Cotton, Executive Chef at Plein Sud,http://www.pleinsudnyc.com in NYC is a new contributor to Kid-healthy recipes for “Can Do” Street. Chef Cotton graduated from the Culinary School of America, has held executive chef positions at several upscale restaurants across the US  and was a final contestant in Season 7’s Bravo’s Top Chef in Washington D.C. in Sept of 2010.

The first recipe Chef Cotton shares is for a Chicago style dish deep pizza, made with all fresh, healthy ingredients.

It  is a perfect recipe for a mom or a dad who like to share the cooking “from scratch” experience with a young child who is interested in cooking. It  is a great opportunity a child to work with dough and see his or her creation turn into a favorite…pizza!

Chicago Style Deep Dish Pizza

Dough Recipe

Approx. 2 1/2 cups whole wheat flour

1 pkg. fast rising yeast

1 tsp. salt

1 tsp. sugar

1 cup of very warm water

Toppings

1 package Health Choice/ low fat brand shredded cheese

2 cans whole tomatoes

A generous handful of fresh basil leaves, chopped

Cracked black pepper, salt and oregano to taste

4 or 5 large cloves of fresh garlic, sliced thin

2 -10 oz. packages of frozen spinach, thawed

1 fresh ripe tomato, thinly sliced

2 teaspoon dried oregano

Directions – Crust

• Combine the yeast, salt, sugar, 1 cup of the flour and the cup of warm water
• Mix thoroughly
• Since you aren’t proofing the yeast first; the water needs to be a bit hotter than usual
• Add enough of the remaining 1 1/2 cups of flour to form a soft dough
• Knead it for a few minutes, then put it back in the bowl, cover and set aside to rise
• When the pizza dough has more or less doubled in bulk (usually in less than an hour) punch it down.
• Lightly spray a 10 inch spring form pan with cooking spray
• Press the dough into the pan and up the sides.

Toppings

• Squeeze the moisture out of the thawed spinach
• Break up the tomatoes slightly and set them in a sieve to drain.
• Spread the shredded cheese over the crust
• Top with the tomatoes which have been mixed with the basil leaves, season with salt, pepper, oregano.
• Sprinkle the sliced garlic over the tomatoes and top with the spinach and then arrange the sliced tomato decoratively on top.
• Bake at 425 in the middle of the oven for about 45 minutes or so.  Since it’s so thick, it takes quite awhile for the filling to heat all the way through.

Note: The pizza makes a great presentation when you remove the ring from the spring form pan.

To learn more about Chef Ed Cotton, go to Facebook and enter his name.