Adam is your average 10-year-old - well, almost. He loves playing soccer, he's a whiz at computer games, and he's got a wide circle of friends. But he's never been on a sleepover, and there's a compelling reason.
Adam still wets the bed several times a week and wears nappies every night. It's having an increasingly serious impact on his life. Next week he's supposed to be going on an overnight school camp where he'll have to share a dorm with three other boys, and he's terrified his secret will be exposed.
A Danish research study carried out in the late 1990s examined the level of stress created by bed-wetting, or nocturnal enuresis, and concluded that for children, its impact can be devastating. 'It ranks as the most upsetting after parental divorce,' says paediatrician and nephrologist Mark Chan Kwok-ho. 'It's worse than getting bad results at school, it's worse than being teased for being short. The research showed enuretics [those who wet the bed] were more fearful, anxious and impatient, and had more feelings of inferiority.'
It's extremely distressing for everyone concerned, says Adam's mother, Therese. 'You're constantly having to cover up for your child, make excuses as to why he can't join in on sleepovers or slumber parties,' she says. 'It's also not the sort of thing you can talk about to other mothers. It's humiliating both for you and your child. I always thought he'd grow out of it, but I definitely think we've reached the point where we have to seek medical help. I just don't want to make Adam feel any worse than he already does.'
Bed-wetting is more common than most people think - or talk about - and it's hard to know just what constitutes 'normal'. Is it five-year-old Sean, who has a sodden, heavy nappy five mornings a week? Two-year-old Susie who toilet trained herself, and stopped wearing day and night nappies all at once - she's never wet the bed? Or seven-year-old Katie, who has a couple of accidents a week, but is old enough - and embarrassed enough - to change the bedsheets herself?
The short answer is that there is no 'normal', and all children develop at different rates. But as a rough guide, statistics show that a surprising 15-20 per cent of children still wet the bed at the age of five, and while by 10 years old they should be dry, 5-10 per cent may still be wet. By the age of 15, the incidence rate drops to somewhere between 0.5 per cent and 2.5 per cent. Chan says that being dry at night is the last stage of toilet training, and that a child has to be developmentally ready to achieve it.
