Genetics seem to play a role – a family history of bed wetting significantly increases the chance of a child having enuresis as well.
Thyroid dysfunction, medication use, pain on defecation, and emotional stressors may all play a role.
Psychological factors like stress at school or home are sometimes involved (though most kids with enuresis are psychologically normal).  Caffeine, medications and developmental or congenital abnormalities are the underlying cause for a subset of kids.

Reassure your child that bedwetting is a normal part of growing up and that it’s not going to last forever. I have seen some children whose enuresis worsened with exposure to environmental antigens or toxicants, others who improved with adrenal-supportive treatments.  Diseases like diabetes mellitus or insipidus, urinary tract infections, and sickle cell anemia are all less common, but concerning causes. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend’s house or at camp.

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