When discussing nocturnal enuresis, your child's doctor will want to take a detailed history and may want to perform a focused physical exam. Though rare, there are some symptoms and physical findings which suggest a medically treatable condition (these children usually aren't totally dry during the day or, if they are, now surprisingly begin wetting themselves). Social stresses do not routinely cause primary bed-wetting, so don't blame yourself because of that recent divorce, change of job, or move across the country. The fact that your child is dry during the day and even some nights, shows he can do it with time and patience.
Once your child is interested in overcoming nocturnal enuresis, apply two guiding principles: work with him and protect his self esteem. A child has to learn either to sense a full bladder during sleep and contract the muscles which hold in urine, or to wake from sleep, find the bathroom, and pee into the toilet. No small task for the average five-year-old!
Discuss specific training methods with your pediatrician. Initially, the goal is getting up at night and using the toilet. Discontinue diapers or pull-ups. Cover the mattress with a plastic sheet. Enlist your child's help in cleaning up (older children can change the bed by themselves). Avoid punishment or criticism. One successful method uses an alarm which is set off when a sensor, worn in the underwear, gets wet. Medicines are only used in special circumstances. Whatever your method, be patient and plan on keeping in close contact with he pediatrician for guidance and reassurance.