One GOODNITES® GoodMorning Club^TM reader is concerned because her 8-year-old son wets the bed at home but not during his extended stays with his grandmother who lives out of state. Another reader wonders why her 10-year-old stepson wets the bed when he stays at her house but not at his biological mother's house. According to Dr. David Fay, a family physician and associate director of the Waukesha Family Practice Residency Program in Waukesha, Wis., bedwetting in separate homes is fairly common. Managing the issue requires communication and cooperation among all parties.

There is no single "cause" that has been identified as being responsible for bedwetting. Genetics are a major factor, as is bladder capacity. Many experts also believe bedwetting may be part of a sleep disorder. Dr. Fay believes the combination of bladder capacity and emotional upset can trigger bedwetting in kids who live at more than one address.

"Most kids who wet the bed have limited bladder capacity to begin with so their ability to control that has little reserve," says Dr. Fay. "As a result, any stressful situation can cause them to regress and begin wetting again."

Children who wet the bed in one home but not another can be divided into two basic categories:

• Children who have wet the bed all along and have already been evaluated, undergone treatment, shown some improvement and have begun wetting again.
• Children who have never wet the bed and have started to do so in one home or another.

In the first case, Dr. Fay says that for some reason, the child's perception of the household where he wets the bed is different than his perception of the other home. It may be that in one household the parent is diligent about limiting fluids before bedtime, taking the child to the bathroom several times a night and generally sticking to whatever routine they have established to help the child keep from wetting the bed. This routine may not be adhered to in the home where the child wets. The way to solve this problem is for the adult parties in the two homes to compare their routines and make sure they are as alike as possible.

In the second scenario, Dr. Fay says the reasons could be emotionally driven. That means the child is so upset by whatever is going on in his or her life that one manifestation of the upset is bedwetting.

As for the sleep component, Shelly Morris, director of the Enuresis Clinic of America, says in a household where a child doesn't sleep as well or as soundly, he or she may not wet the bed.

"It's the same situation as when an adult is in a strange bed, such as a hotel room," says Morris. "When you're in a different place, you just don't sleep as well. If a child doesn't get into that deep sleep, he or she may wake more easily to go to the bathroom."

"Morris explains that this is often the reason children who wet the bed sometimes do not do so at a sleepover or the first few days of camp. It can also apply, however, to a child who visits a relative for overnight stays or who splits his or her time between divorced or separated parents.

"The keys to solving the problem are cooperation, communication and consistency between the two households. When the two parties can communicate and are willing to work together, there are a number of strategies for managing bedwetting, including motivational therapy, absorbent products, sleep and bladder conditioning and medication. These approaches are discussed in detail on the GOODNITES® Web site.

Frank, from Strasburg, Penn., says his daughter wets the bed both at his house and at her mother's house. He feels that his daughter, age 6, is old enough to stay dry at night, but his ex-wife refuses to address the situation. Meanwhile, his new wife thinks he should do more to solve the problem on his own, including confronting his ex-wife. Frank is afraid any confrontation would cause even more bitterness and make the problem worse.

It's well known that divorce can be bitter and that children can be caught between two parents. Emily Bouchard, a blended family coach and counselor, says if one parent really digs in his or her heels and refuses to admit there's a problem, the best strategy is to back off.

"If your ex-spouse is adamant that they don't want to deal with the situation, don't take it personally," says Bouchard. "Rather, try to understand where they're coming from so that you can understand what your child is experiencing at their house."

Beyond that, it's important to get the child's point of view. If he or she thinks the bedwetting is not a problem and is comfortable wearing absorbent underpants to bed, then it's best to just deal with it very matter-of-factly. Habits such as making sure the child uses the bathroom before bedtime and taking him to the bathroom one last time before you go to bed may help prevent possible accidents.

In addition, the bedwetting child may be able to help get the other parent on board. But it's important that this not be done in a confrontational way, says Bouchard. Perhaps start just by helping the child visualize staying dry at your home and giving her a small reward when she's successful. Another good idea is an incentive chart with stickers that she receives for staying dry. It may be possible for the child to then take the incentive chart to the other home.

The important thing is for everyone involved to think of the best interests of the child. Managing bedwetting in a way that's best for the child and your family, or solving the underlying problem that the bedwetting may indicate, will result in a happier child and a happier family.