DEAR DR. DONOHUE: My son, who is 11 1/2, has a bed-wetting problem. If he doesn’t drink fluid after 6 p.m., he’s OK. One doctor wants to prescribe medicine. Another says not to worry, for the problem will go away. We are still worried and confused. We would appreciate your help. – A.T.

ANSWER: Every bed-wetting child and every parent of a bed-wetting child is worried, confused and distraught. You are approaching this in the right way – without any hint of punishment or implication that the child is at fault. He isn’t. As many as 4 percent of children around age 11 wet the bed. By age 18, only 1 percent must still deal with the problem. Maturity, therefore, does cure most children.

One reason why children fail to achieve control is a small bladder size. Your son might try to hold off urinating during the day for up to 15 minutes or more each time to stretch the bladder. Another reason is immaturity of the nerves that send signals to the brain that the bladder is full. Time generally takes care of that problem. A third possibility is overactive bladder-wall muscles. And a fourth is a slight deficit in the production of a hormone – antidiuretic hormone – that slows urine production during the night.

The third and fourth causes respond to medicine. However, they also respond to time. Since your son gets through the night successfully when he doesn’t drink after 6, that bodes well for time to eventually keep him dry. If there are special occasions that might give rise to a loss of control, then the boy could use medicines for those times. Antidiuretic hormone is available as a nasal spray or a tablet. It’s called DDAVP, and he doesn’t have to use it every night.

I’m not sure your son would benefit from other remedies for enuresis, as this problem is called. There are devices that sound an alarm when the first drop of moisture hits a sensor in the underwear. Whenever the bed-wetting topic appears, writers tell me of successes with their children when certain foods are eliminated from the diet: Dairy products and citrus fruits are always mentioned.

Why not let your son make the choice about medicine use?

DEAR DR. DONOHUE: I am the stepmother of five adult children who have signs of fetal alcohol syndrome. There were born to an alcoholic mother and alcoholic father. Does the father have an effect on the problem? Please make people aware of the handicaps brought about by this syndrome. – P.H.

ANSWER: Fetal alcohol syndrome is a tragedy that can be prevented only by pregnant women abstaining from alcohol. Alcohol and its byproducts are transferred from the mother to the developing embryo and fetus during pregnancy. Since the amount of alcohol necessary to cause changes isn’t precisely known, the only safe policy for a woman is to not drink any during a pregnancy.

The manifestations of the syndrome are many. A fold of skin can cover the nose side of the eye. Teeth might be small, poorly formed and deficient in enamel. The jaw is often excessively small. Body growth is impaired. Joints can be affected. Holes can form in the wall that separates the left and right sides of the heart.

The most significant and most devastating effects of the syndrome are impairment of brain development. Affected children can be left with lifelong learning disabilities, sometimes of great severity, and they can suffer profound personality disorders.

The father’s sperm does not contribute to the syndrome.

DEAR DR. DONOHUE: I have never seen an answer to my question. My diastolic pressure is 58, but my systolic pressure is 159. Is the lower pressure good or bad? – J.C.

ANSWER: The lower pressure is good, but it doesn’t cancel the effects of a high first number – the systolic pressure. Neither does a low first number cancel the effects of a high second number.

The blood pressure report answers common high blood pressure questions in detail. To obtain a copy, write: Dr. Donohue – No. 104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.