Enuresis overview – So what is bedwetting?
In New Zealand children, voluntary control of urination is usually evident by the age of five. Nevertheless, nocturnal enuresis (at least twice a week) is present in at least 16.6 percent of otherwise healthy 5 year-old children, 6.6 percent of healthy 7 year-olds, 6.6 percent of healthy 10 year-olds, 3.3 percent of 12 to 14 year-olds and 1.6% percent of teenagers at age 15. Bedwetting happens more in boys (almost up to three times more so) than in girls and happens more often in the first born child. Bedwetting often is often genetic, so if you or your partner wet the bed as a child there is a good chance your child has inherited this trait.
There are different types of bedwetting that may occur, including the following:
- Diurnal enuresis – wetting during the day.
- Nocturnal enuresis – wetting during the night.
- Primary enuresis – occurs when your child has never been toilet trained at night.
- Secondary enuresis – occurs when your child did have a period of dryness, but then returned to having accidents at night.
We understand that the formative years that your child goes through are some of the most difficult and challenging times that you as parents will face and that they as children may experience. There are a myriad of different medical problems that are bound to crop up as your child grows up and enuresis is just one of these. It may be a very uncomfortable and sensitive issue to deal with, but on the whole is considered relatively minor.
Why do Kids Wet the Bed?
Medical professionals don’t know for certain what causes bedwetting or why it stops. However, it is often a normal part of normal development and most children grow out of it. The majority of the time, bedwetting is not a sign of any deeper medical or emotional issues. Most children have urine control problems only while they’re sleeping, so clearly, they do not deliberately wet the bed.
Studies suggest that bedwetting may be due to a nervous system that is slow to process the feeling of a full bladder. Consequently, these children do not wake up in time to relieve themselves. As mentioned above, doctors don’t know exactly what causes enuresis, but the following factors may influence the likelihood that a child will develop some kind of enuresis:
- Hormonal problems
- Bladder problems
- Trouble sleeping
- Medical conditions (such as Diabetes or urinary tract infections)
- Stress such as divorce or death in the family
One research paper found that 23-36% of parents had used punishment as their main means of dealing with bedwetting. Bedwetting is not due to laziness on the part of the child, so remember to give your child the care and support you know they need and stay positive during this tough time. If you make a minor issue from a bedwetting incident then your child will also feel it’s not such a big deal.
Behavioural Modification is a process that helps lessen the severity of the bedwetting taking place, some of these tools for bedwetting solutions include: bedwetting alarms, positive reinforcement and bladder training programs. In more advanced or longer term cases, medications can be used to manage the enuresis. If you feel this is something you want to find out more about, talk to your medical professional.
The best solution for bedwetting is usually just time. Bedwetting, will most likely go away on its own, but until it does, it can be embarrassing and awkward for your child. It’s vital that you offer support and maintain a positive outlook during the times that your child wets their bed. Reassure your child that bedwetting is a regular part of growing up, and that it’s not going to persist forever. It may soothe your child to hear about other members of the family who also struggled with it when they were children. We all want to know that we are not alone in times of trouble so stories can help a child understand that bedwetting happens to other people too.
Try some simple changes that may reduce the amount of times your child wets the bed, for example, remind your child to go for a wee one final time before bedtime. Try to have your child drink more throughout the day and less at night, especially before bedtime. Try to ensure that fluids given later in the day don’t have caffeine or sugar in them.
What can parents do to help their bedwetting children?
As a parent, with a million things going on, it’s often hard to know exactly what is causing your child to wet the bed. Bedwetting is not a behavioural problem so try to remind yourself of this when it happens.
Most children will develop no ongoing issues as a result of bedwetting, and it is important to be supportive and not critical even though, as a parent, it can be challenging dealing with this stage.
By being prepared, it will make things easier when your child is woken in the middle of the night, trying to deal with a wet bed. Some preparation tips include:
- Make sure you have spare sheets or old towels easily accessible. Small bedwetting accidents can sometimes just be covered by a thick towel
- If it is cold, make sure spare blankets are accessible in case required
- Having soft lighting, especially if other children are around, can help keep the rest of the family sleeping through the night
- Make sure you have spare pyjamas and a cloth close by. Clean your child as much as possible with a warm damp cloth before changing them into the dry pyjamas
- Reassure your child while doing all of the above and settle them as quick as possible
- Put all the dirty linen and pyjamas into the laundry, don’t leave them lying on the floor as a reminder
- Do not leave them in a wet bed or wet pyjamas
Stay positive, supportive and patient and return to bed.
When to seek medical care
Bedwetting that begins unexpectedly or is accompanied by other symptoms might just be a sign of another problem, so talk to your medical professional. Your doctor may check for signs of a urinary tract infection, constipation, bladder issues, diabetes, or stress.
If you can’t see any particular reason for a relapse into bedwetting, for example starting at a new school or family stress, it might be a good idea to get a second opinion by visiting a health care clinic or family practice. Some signs to look out for from your child are:
- If the child unexpectedly begins to wet the bed after being consistently dry for at least six months, with no really significant events occurring in your little ones life
- Starts to wet his or her pants during the day
- Complains of a burning or painful sensation or discomfort when urinating
- Has to urinate more frequently than in the past
- Has swelling of the feet or ankles
The doctor might start out by enquiring about your child, including when they first learnt to use a toilet during the day and whether or not anyone else in the family has had the same bedwetting issues. The doctor will usually then examine your little one, measuring their height, checking their spine, abdominals and reflexes. If the situation calls for it, the doctor may request a urine sample in order to rule out an infection or cystitis. At the clinic a record of your child’s blood pressure and possibly a blood sample might be taken, if he or she suspects kidney disease is to blame for the bedwetting. Your doctor is a trained health care professional, it is important that he or she is consulted earlier rather than later should you suspect anything abnormal about your child’s bedwetting. You could also consult with a continence advisor, who are usually experienced, qualified nurses who have undertaken specialist training to help people with this type of problem.
Bedwetting and Self-Esteem
It is important that your little angel understands that bedwetting is not something they should feel uncomfortable or humiliated about. Tell your child you know it’s not his/her fault and let them know that lots of their friends probably also have problems developing the muscles needed to stay dry all night. Respect your child’s privacy when it comes to the bedwetting problem. Try not to talk about wet sheets and related issues in front of the rest of the family, and encourage other relatives to treat the bedwetting subject with compassion and respect. When a child wets the bed and has a brother or sister that does not, teasing often happens. It’s not unusual for the non-bedwetting younger brother or sister to have already achieved night time bladder control.
Don’t allow enuresis to become the centre of your interactions with your child, instead focus your attention on all the other things that make them a special and fantastic person.
Tips for improving your child’s bladder control
Having a healthy bladder can help to manage your child’s enuresis. Read on for more tips on how to help maintain a healthy bladder:
- Ensure your child has 6-8 drinks each day. Preferably water or milk. Limit sweet and bubbly drinks, especially ones containing caffeine such as cola and chocolate.
- Encourage drinks (mainly water) at regular intervals during the day, spread it out evenly.
- Avoid dairy products at night until the nocturnal enuresis subsides then gradually increase these products back into diet. These include products such as milk, ice cream, cheese, puddings that contain dairy etc
- Avoid citrus juices late in the day/early evening as the citric acids can aggravate the bladder contributing to urinary nocturnal enuresis.
- Stop ‘just in case’ visits to the toilet (i.e. before going out). Contrary to popular belief, it is good for children to ‘hold on’ so the bladder learns to store larger amounts of urine.
- Increase fibre, vegetables and fruits in their diet to prevent constipation and straining as this can affect how the bladder functions.
- Don’t lift children when asleep to take them to the toilet when you go to bed or during the night. This can slow the development of the bladder/brain connection in your child.
- Encourage your child to be active and healthy. Exercising has benefits for all parts of their life.
- Provide a well balanced and healthy diet for your children.