What is it
As they grow and mature, young children gradually gain mastery over bodily processes, including bladder control. Many children stay dry at night by age three or four, about six months after they have mastered daytime bladder control. But in about 15 percent of children, bedwetting persists past the age of five (and acquires a medical name, enuresis). It may occur occasionally, or almost every night, and is more common in boys than girls. Many such children continue to have the problem for several years, though virtually all cases resolve by adolescence. It’s also not uncommon for children who previously had no trouble to have periodic lapses, particularly during times of stress.
Symptoms
- Involuntary loss of nighttime bladder control that persists beyond the age of five or six years.
What causes it
Less than IC percent of the time, underlying medical problems are the cause. These can be easily identified by a physician and include an unusually small bladder, diabetes mellitus, kidney problems, epilepsy, sickle cell anemia, urinary tract infections, or developmental disorders like autism or mental retardation. If a child who is toilet trained is also having trouble staying dry during the day, it’s a good indication that the bed-wetting has a physical cause.
A genetic component appears to be included as well: the disorder often runs in families. Some studies suggest that bed-wetting may be linked to a deficiency in a naturally occurring substance called antidiuretic hormone, or vasopressin, which regulates the flow of urine between the kidneys and the bladder.
Emotional factors (for example, acting out by the child) were once thought to be an important contributing factor. Although the stress of a move or a new sibling can cause periodic lapses in nighttime bladder control persistent bed-wetting is rarely psychological in origin.
What if you do nothing
Most children outgrow the problem without any adverse consequences. The best thing to do is to be patient and supportive. Anger or disgust from parents or taunting by siblings can lead to shame and anxiety in a child, leading to more serious psychological problems.
Home remedies
Maintain a supportive environment
A child will be frustrated and embarrassed by bed-wetting. Parents, too, will have their patience tried. Stay calm, and reassure your child (and yourself) that bed-wetting is a condition that can, and will, be overcome. Let the child know that others (particularly if they are family members) have had the problem but outgrew it.
Praise your child for dry nights; a calendar with gold stars or other rewards may help. Don’t become angry or blame your child for wetting the bed, and explain the importance of a sympathetic and encouraging home environment to other family members.
Watch your child’s fluid intake at night
Get him or her to drink plenty of fluids in the morning or afternoon to stretch the bladder and increase its capacity. Your child can drink fluids at night as well but not in excess, and should avoid beverages that contain caffeine.
Encourage bladder control practice
Have our child hold his or her urine for increasingly longer periods during the day up to 10 to 15 extra minutes. This may help improve bladder control.
Encourage urination before bedtime
Get your child in the habit of emptying the bladder as much as possible before going to bed. Once in bed try positive imaging: have the child imagine waking up in the morning with clean, dry sheets.
Consider wake-up breaks
Some experts suggest setting the alarm for several hours after bedtime and encouraging the child to get up and urinate at that time though others say this needlessly disrupts the child’s natural sleep cycles. Special bed-wetting alarms that attach to the underwear and that are set off by the first hint of moisture are also available. You can discuss these options with your doctor. With time, your child will learn to recognize a full bladder and get up on his or her own.
Protect your child’s bedding
To help minimize stress, make cleanup as easy as possible. Use two sets of sheets, with a rubber pad between them, and a plastic cover over the mattress. Children may wear an extra thick pair, or two pairs, of underwear, to help absorb urine. Don’t use diapers on children older than four; it will only humiliate them.
Work in partnership with your child
Have your child assist with tasks: laundering the sheets, making up the bed, putting out a fresh pair of pajamas and a towel before retiring. The job should be fun and not punitive. Involving your child may increase his or her sense of control and help to resolve the problem.
Prevention
No specific measures can prevent persistent bedwetting. Some experts believe that toilet training at too early an age and at too rapid a pace can be stressful for a child and may cause psychological conflicts that contribute to the problem. Recognize bed-wetting as a normal stage of child development one that, like walking and talking, comes at different times for different children.
