|Bed-wetting in Children - Bright Tots - Information on child development - Autism information. www.brighttots.com
Approximately 15% of all elementary school age children wet their bed, and continued bed-wetting (enuresis meaning urinary
incontinence, especially during sleep) past 5 years old. Nighttime bed-wetting, clinically diagnosed as primary nocturnal enuresis,
is a common problem affecting an estimated 5 to 7 million children in the United States.
All children with wetting problems, especially those who wet during the day, need a medical evaluation that includes testing for
infections or other physical problems. Most children wet only at night, and only about 1 out of 20 has a medical condition that
requires treatment. bed-wetting prevents the child from spending the night away from home, and these children usually want to
Most children begin to stay dry at night around three years old. About 66% of children who wet their bed are boys. These
children are not lazy, and they have to be told that bed-wetting is not their fault. Parents often feel responsible for their child’s
bed-wetting. This is seldom the case, and parents need to be at ease not feel guilty.
Reasons for bed-wetting
Waiting for the condition to go away on its own is a misconception some parents have about bed-wetting. About 1 out of every
8 children who wets the bed will be dry a year later on their own. It can take more than 3 years for bed-wetting to stop without
treatment. Waiting for a child to outgrow the problem is not usually a good idea, because the child’s self-esteem will suffer. bed-
wetting is hereditary and has been confirmed by the identification of a gene marker.
Effective treatments are now available. Physicians emphasize that bed-wetting is not a disease, but a symptom, and a rather
common one. In most cases, it is due to the development of the child's bladder control being slower than normal. Parents should
remember that children rarely wet on purpose, and usually feel ashamed about the incident. Instead of making the child feel bad
or embarrassed, parents need to support the child and communicate the belief that he/she will soon be able to stay dry overnight.
Helpful Tips for bed-wetting:
• Restrict liquids before bedtime
• Make sure the child uses the bathroom before bedtime
• Compliment the child on dry mornings
• Refrain from disciplining for bed-wetting
• Wake the child during the night to empty their bladder
Facts about bed-wetting:
• About 15 percent of children wet the bed past 3 years old
• More boys than girls wet their beds
• bed-wetting does run in families
• Generally bed-wetting ends by puberty
• The majority of bed-wetters do not have emotional problems
Possible Causes for Bed-wetting
bed-wetting may sometimes be related to a sleep disorder. bed-wetting may also be the result of the child's worries and emotions
that need attention. There are different types of emotional reasons for bed-wetting. For example, when a young child begins bed-
wetting after several months or years of dryness during the night, this may represent new fears or insecurities. bed-wetting may
follow changes or events which make the child feel vulnerable such as moving to a new home, parents divorce, losing a loved
one, or the arrival of a new baby in the home. Sometimes bed-wetting occurs after a period of dryness because the child's
original toilet training was too demanding.
Low Functional Bladder Capacity
Another common cause in children with bed-wetting is due to a small functional bladder capacity. These children have a reduced
amount of sensation of the need to urinate and feel more urgency. Some of these children may also display daytime symptoms.
When a child's functional bladder capacity is low they are less able to hold a normal amount of urine at night. Some evidence
suggests that some bed-wetting children also produce less anti-diuretic (a hormone that reduces making urine) during sleep. This
causes the child to create more urine at night.
Bed-wetting and Deep Sleep
Many people believe that children wet the bed because they are deep sleepers. This theory is not supported by research. Most
children are deep sleepers, and children with bed-wetting do not differ from other children in how deeply they sleep. Wetting
episodes can occur during any stage of sleep.
Food allergies are rarely related to bed-wetting. Children taking medications for allergies may wet more frequently when taking
medications. As a general rule, caffeine, which is in many foods, such as soda and chocolate, should be avoided whenever
possible. A small percentage of children are sensitive to foods that contribute to nighttime bed-wetting. A number of children
benefit from eliminating foods such as citrus.
Emotional Distress Due to Bed-wetting
Bed-wetting is disturbing to children and parents. Emotional grief is most often the result of bed-wetting, not the cause. Children
who have been dry at night for a year or more and then start bed-wetting again may be different. Among these children (about
20% of bed-wetters), emotional distress may be a cause of bed-wetting.
Physical Learning and Bed-wetting
Some children who wet the bed have not learned how to control the muscles they to use for bladder control during sleep. They
cannot make the physical response during sleep, and they cannot wake up in the night to go to the bathroom. These reactions
can be learned with appropriate training.
Medication and Treatments for bed-wetting
Speak with your child’s pediatrician who will ask you to complete a history of your child's daytime and nighttime bathroom and
dietary habits. Then a physical exam will be preformed and perhaps a urine test (called a urinalysis) to rule out problems in the
urinary tract and bladder. A treatment approach is then developed based upon the child's particular situation. The best treatment
program combines education, behavioral modification with a bed-wetting alarm, cautious use of medications, dietary changes
and positive reinforcement that is individualized for each child and their family.
In general, medication treatments produce a temporary decrease in wetting frequency so long as the child takes the medication.
When the child stops taking medications, the bed-wetting returns. Medications rarely “cure” bed-wetting. Medications may
provide a temporary solution to the problem and allow children to control bed-wetting for short periods of time.
Urine Alarm Treatment
This treatment can be administered by parents under professional supervision. A battery powered alarm device used by the child
is activated when the child wets. If the sound fails to wake the child, the parents have to wake the child. Repeatedly waking a
child immediately after the beginning of urination teaches the child to control muscles even during sleep. The treatment takes 12
to 16 weeks.
Parents and children need to cooperate to complete the training. The most common causes of failure with this treatment are not
waking the child every time the alarm sounds and not continuing the treatment for the full period. The opportunity for success is
very high with this equipment (called bell and pad) if it is used under a therapist’s supervision.
Behavior therapy with a urine alarm is the best treatment for plain bed-wetting. Many years of research supports this claim. A
permanent solution to bed-wetting can be expected for about 5 of every 10 children treated with a urine alarm. Available evidence
shows that children treated with a urine alarm improve in their self-esteem and peer relations. There are no known negative side
effects of urine alarm treatment.
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