clear which aspects are most affected. More studies are needed to understand the impact of nocturnal enuresis on parents. Causes Bedwetting children are often normal emotionally and physically, although enuresis can be caused by other health conditions. Primary nocturnal enuresis can have multiple causes, which can make approaching a course of treatment more difficult. Enuresis can be caused by one or more of the following: Caffeine consumption Caffeine is a diuretic, which means that it increases urine production. Reports from those who have failed enuresis treatment say that they were not recommended to limit caffeine and that they mostly consume 2 to 4 mg/kg/day. Pattern and volume of fluid intake A pediatric day can be categorized into 3 periods: 7 AM to 12 PM, 12 PM to 5 PM, and after 5 PM. Children with enuresis are usually dehydrated and drink the most after 5 PM. This can be remedied by having the child drink 40% of daily fluid requirement before noon, 40% from noon to 4:30 PM, and 20% in the evening. Lower functional bladder capacity Children with enuresis have lower functional bladder capacity than healthy children. This means that their bladders hold less urine, often over 50% less. Dysfunctional voiding Both bladder voiding and storage problems may be present with dysfunctional voiding and may be present at any age. It is characterized by an obstruction of the bladder as a result of a non-neurogenic cause, which is due to the muscles controlling urine flow that do not completely relax. Symptoms may include daytime wetting, night wetting, urgency, a feeling that the bladder is always full, and straining to urinate. Urinary tract infection It is uncommon for nocturnal enuresis, in the absence of other symptoms, to be caused by an infection. Pinworms have also been linked with sudden onset enuresis in young girls. Delay in maturation and development Mastering urinary control during sleep time is a normal part of childhood development and may be delayed by stress and social pressures. The risk for enuresis increases threefold for children who experience stress, demonstrated by the higher prevalence of enuresis in lower socioeconomic groups. Anxiety experienced by a child between ages 2 to 4 also increases the risk for enuresis because this particular time period is sensitive for the development of nighttime bladder control. Nocturnal enuresis has been found to be more common in those with developmental delay, physical or intellectual