Bedwetting, medically called nocturnal enuresis, occurs when a child urinates involuntarily during sleep. It’s important to understand that this happens during sleep—your child isn’t choosing to wet the bed, and it’s not something they can consciously control.
The real issue is a developmental gap in the brain-bladder communication system. In children who stay dry, the brain and bladder communicate effectively during sleep. When the bladder gets full, it sends a signal to the brain, which either wakes the child up or sends a message back to hold the urine until morning. In children who wet the bed, this communication system hasn’t fully developed yet.
Key point: Bedwetting is a skill that hasn’t been learned, not a character flaw or behavioral problem.
The medical community typically considers bedwetting a concern after age 5 or 6, but I actually have a different perspective on this.
Age matters less than impact.
If your 7-year-old is wetting the bed but it’s not causing emotional distress, not affecting their social life, and your family can manage it without excessive stress, then it may not be a “problem” that requires immediate intervention.
But if your 7-year-old (or 8, 9, 10, 11-year-old) is feeling ashamed, missing sleepovers, declining invitations to overnight activities, or losing confidence, then it’s worth addressing—regardless of whether they’ve reached some arbitrary age threshold.
The real question isn’t “How old is too old?” but rather “What is this costing my child emotionally and socially?”
More common than you might think:
So if your child is wetting the bed, they’re definitely not alone—even though it might feel that way to them.
Yes, there’s often a genetic component. If one parent had bedwetting as a child, there’s about a 40% chance their child will too. If both parents had bedwetting, that increases to about 70%.
But here’s what’s important: Even when there’s a genetic predisposition, the brain-bladder connection can still be taught.
Genetics might explain why your child is wetting the bed, but it doesn’t mean they can’t learn to stay dry.
The most common cause is a developmental delay in the brain-bladder communication system. But bedwetting can also be related to:
Physical factors:
Important: Before starting any bedwetting treatment, I recommend ruling out physical causes with your pediatrician. This might include:
Once physical causes are ruled out or addressed, we can focus on teaching the brain-bladder connection.
Most children will eventually stop wetting the bed without treatment—about 15% per year spontaneously resolve.
But here’s what that “wait and see” approach doesn’t account for:
The emotional and social costs of waiting:
Yes, your child will probably outgrow it eventually. But what does “eventually” cost?
For many families, addressing bedwetting proactively is worth it—not just to get dry beds, but to restore confidence and enable full participation in childhood.
It is really more about motivation than age.
In general, I have found that Keeping the Bed Dry® is appropriate for children as young as 8 years old as well as adolescents.
Kids under 8 years of age are often not bothered by not being dry, as they are typically not going to sleepovers or sleep away camps. Having said that, of course, there is the occasional child who is 6 or 7 years old who is eager to be dry at night, and older kids who are not yet ready.
For this type of approach to work, the patient, and not just the parent, has to be motivated.
The language is intentionally designed to be simple so that children, adolescents, and adults alike can easily grasp the concepts and be able to quickly implement them.
Our program uses medical hypnosis, cognitive behavioral therapy techniques, and motivational strategies to teach your child’s brain and bladder to communicate effectively.
Here’s the process:
Step 1: Parent watch all videos (1-1.5 hours)
I recommend you watch the full program so you understand the process and can provide technical help when needed. There are some great tips for parents to help you in the process. We’re building a team of support for your child and you need to understand the whole picture.
Step 2: Child watches one video each week (5 min – 25 min)
Each week for 4 weeks, your child will login to Keeping the Bed Dry® to watch the weekly video and download the homework. It is best to find a consistent time this can happen each week so your child knows what to expect and when.
Step 3: Homework and Practice
There is downloadable homework each week. Your child can expect about 10-15 minutes per day, which includes practicing the visualization technique 2-3 times daily. The homework and practice are key components to success.
Step 4: Start enjoying dry nights!
Most kids will see improvement within a couple weeks. It will take time and part of the program is celebrating each step to success. You have lifetime access to the videos so your child can go back and practice with the video as many times as they need.
Let me break down the key differences:
Medications (like DDAVP):
Bedwetting Alarms:
Our Program:
The fundamental difference: Most approaches manage symptoms. We teach the skill. When your child learns this skill, it’s theirs forever—no ongoing medication, no alarm, no external interventions needed.
Medical hypnosis (also called clinical hypnosis) is a focused state of attention and heightened suggestibility. Think of it as very focused concentration—similar to being absorbed in a good book or movie.
What it’s NOT:
What it IS:
During medical hypnosis, your child is always aware and in control. They can open their eyes and stop at any time. We’re simply using this focused state to teach their brain and bladder how to communicate effectively.
Safety: Medical hypnosis has been used safely for decades and is recognized by the American Medical Association and American Psychological Association as a legitimate therapeutic technique.
This varies by child, but here’s what we typically see:
Important caveat: Progress isn’t always linear. Some children improve dramatically right away. Others have slower, steadier progress. Some have “two steps forward, one step back” patterns.
All of these are normal and can lead to success.
What I tell families: Give the program 3-4 months of consistent practice. Most families see enough improvement in that time to know the approach is working.
Success really does depend on following through.
Here’s what doesn’t work:
Think of it like learning an instrument. You can’t watch one piano lesson and expect to play a concerto. You need consistent practice, patience, and positive expectations.
Research on medical hypnosis and cognitive behavioral approaches for bedwetting shows 60-80% of children achieve complete or near-complete dryness.
Most families who complete the program see significant improvement. Some children become completely dry every night. Others go from wetting every night to occasional wet nights (maybe once a week or less).
Important factors that affect success:
What I can tell you: Families who “follow the program”—who practice consistently, maintain positive expectations, and give it adequate time—almost always see improvement.
I can’t guarantee specific results because every child is different. But I can tell you that this approach has helped hundreds of families in my practice over more than two decades.
Online video program (Keeping the Bed Dry®): $197 for lifetime access to all four videos and supporting materials.
Is it worth the investment? Consider what you’re getting:
Most families tell us it’s one of the best investments they’ve made in their child’s wellbeing.
To learn more about seeing Dr. Lazarus via telemedicine, please complete this form and schedule a free consultation phone call.
No, payment is due at the time of purchase. Reimbursement for the purchase depends on your specific insurance plan. Some plans cover my services under behavioral health benefits, while others don’t.
I recommend calling your insurance company and asking whether they cover “clinical hypnosis” or “behavioral therapy” for nocturnal enuresis.
Even if insurance doesn’t cover it, many families decide the investment is worth it given the emotional and social costs of continued bedwetting.
Our online video program ($197) is generally not covered by insurance but is significantly more affordable than ongoing medication costs or long-term therapy.
First, let me be clear: Success requires following through with the program. If you watch one video or practice inconsistently, it’s unlikely to work.
But if you follow the program consistently and don’t see improvement after 3-4 months, here’s what I’d recommend:
What I won’t do: I won’t string you along for months with false hope if the approach isn’t working. If I don’t think I can help your child, I’ll tell you honestly and help you find other resources.
At this time, the program is not available in DVD format. The program is accessed through the website using the login and password created at check out. With your purchase, you have unlimited access for viewing.
Our program tends to work best for:
Children who are:
Families who are:
Our program might NOT be the best fit if:
I hear this all the time, and it’s a completely valid concern.
Here’s the honest answer: Most approaches families try first are symptom management, not skill-building.
Medications, alarms, fluid restriction, scheduled wake-ups—these manage the problem but don’t teach the brain-bladder connection.
Our program is fundamentally different because we’re teaching the actual skill that’s missing.
Think of it this way:
If you tried training wheels, a bell, and a helmet to help your child ride a bike, and none of those “worked,” would you conclude your child can’t learn to ride?
No. You’d realize that what they need is to learn the actual skill of balancing.
That’s what we do. We teach the skill that’s missing.
Many of my most successful families are ones who tried multiple other approaches first—because they’re motivated, committed, and when they finally find an approach that teaches the actual skill, they see dramatic results.
Motivation matters, but it’s not as black-and-white as you might think.
What I’ve found: When children understand they’re learning a skill (not fixing a flaw), most become quite motivated. They want to feel capable and normal. They want to go to sleepovers and camps. They want to stop wearing pull-ups.
The key is reframing bedwetting as a skill to be learned rather than a problem to be ashamed of.
That said, if your child is completely resistant or has no desire to change, that makes success more difficult.
Keeping the Bed Dry® includes two videos and worksheets that specifically address motivation. These are powerful techniques to enhance motivation.
As it happens, it seems that at any age, the harder we push, the harder people push back. This is true whether you’re 5 years old or 95 years old!
If your child has any sports or hobbies he or she enjoys, you could gently suggest that, just like soccer, or piano, or dancing, the more you practice, the better you get at it. And the more you practice, the easier it gets. And the more you practice, the faster you get at it. Just like any other skill or sport, more practice means better results! This connection is often helpful for kids to see the visualization practice in a different way.
Again, the harder we push, the harder people push back. And there is a chance your child may not be ready to put in the time, yet. Motivation of the child is one of the most important factors for success with the program. This is a process and is different for every child.
I understand this concern. Many children carry significant shame about bedwetting.
But here’s what I’ve found: Talking about bedwetting in an empowering, skill-focused way actually reduces shame.
When we reframe it as “Your brain and bladder are learning to communicate” instead of “You’re wetting the bed,” children feel relieved. They realize they’re not broken—they’re just learning something new.
The approach we use is:
Most children leave our sessions feeling more confident, not more embarrassed.
Absolutely not! This is completely normal and expected.
Progress is rarely linear. Some common patterns include:
All of these patterns can lead to complete success.
A single wet night (or even a few) after progress doesn’t mean the approach isn’t working. It might mean your child was extra tired that night, or they drank a lot before bed, or they were stressed about something.
What matters is the overall trend over weeks and months, not day-to-day fluctuations.
Here’s what I recommend:
Frame it as learning a skill:
“Your brain and bladder haven’t quite figured out how to work together at night. But that’s something we can teach them! Dr. Lazarus has helped lots of kids learn this, and we’re going to work with him to teach your brain and bladder how to communicate.”
Focus on the benefits:
“Once you learn this skill, you’ll be able to go to sleepovers whenever you want! And you won’t have to wear pull-ups anymore. How great would that feel?”
Avoid shame or blame:
Don’t frame it as “fixing” your child or solving a “problem with you.” Frame it as learning a skill that will make their life better.
Build excitement:
“I’m really excited about this! I think you’re going to do great. And I’ll be here to support you the whole way.”
