Managing Bed-wetting In Children

January 27, 2010

By system

Bed-wetting, otherwise known as nocturnal enuresis , can be a very embarrassing problem for children, and an equally distressing one for parents. It can potentially affect the self-esteem of a child if not managed properly. Generally, bed-wetting before the age of 6 to 7 isn’t a cause for concern. In early childhood, night time bladder control may simply not have matured. There may be a hereditary component, and is generally more common in males .

Enuresis can be classified as:
Primary Enuresis – in which there has never been a dry night from the beginning.
Secondary Enuresis – in which the child was dry for at least 6 months before the onset of bed-wetting again.

Most children overcome bed-wetting as they get older , typically resolving by the age of about 5 years. However, it may persist for some beyond then, and it can occasionally be a cause for embarrassment and shame . The important thing for parents to understand, is that a child rarely bed-wets on purpose, so scolding or other forms of reprimanding are usually not helpful .

Causes of Bed-Wetting:
The small bladders of children very quickly get filled up .
Often, young children do not realize when their bladders are full.
The urinary sphincter muscles, whose job is to stop the urine from leaking out of the bladder, is generally not very mature in children, thus occasionally losing control, especially during sleep, when the conscious mind is at rest.
Young children may fall into very deep sleep and this may cause unconscious emptying of the bladder.
Stressful events such as starting school or becoming an elder sibling may trigger bed-wetting.
Some kids don’t produce enough anti-diuretic hormone. This hormone tells the kidneys to release less water.
Medical conditions such as diabetes, urinary tract infections, chronic constipation, brain and spine conditions eg. Cerebral palsy and spina bifida.

Bed-wetting was previously believed to be a chiefly psychological issue, and many children were made to see counsellors and psychiatrists for treatment. However, psychological treatment has been found to be ineffective in most cases. It is now known that the majority of bed-wetting children do not have a primary psychological problem. As such, parents and caregivers should not reprimand a child who wets the bed, but rather give positive re-inforcement and encouragement when he or she remains dry.
It is important to remember that bed-wetting is usually not done on purpose, so it is not the child’s fault, and he should not be made to feel guilty.

Treatment:
Treatment is generally unnecessary for bed-wetting in children less than 7 years of age. Most will learn to control their bladder with time, even without treatment.

However, in a child older than 7, who wets the bed at least 2 times a week for at least 3 months, professional help may be sought. The child should also see a doctor if it starts to affect the child’s self-esteem, homework and peer relationships.

Treatment would generally focus on positive re-inforcement, a moisture alarm and behaviour therapy. Medical problems, if present, will have to be managed. Occasionally, medication may be prescribed.

Steps you can take to help bed-wetting :
1.No late night drinks.
2.Make it a habit to empty bladder just before bed time
3.May have to wake child in the middle of the night to pass urine.
4.Positive re-inforcement for dry nights
5.Seek medical help if the problem persists.

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