Bed-wetting also called nighttime incontinence or nocturnal enuresis — is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected.
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Nobody knows but some reasons that are thought to be responsible:
- Immature bladder-brain coordination: The nerves which signal your brain to tell that bladder is full are not fully developed in children. That is why in deep sleep your child may not feel the urge to get up and urinate
- Small bladder:A child born with a small bladder may not hold urine produced during night
- Stress:Parental conflict, sibling rivalry, sexual abuse, new schooling, etc… may contribute to bed wetting
- Bad toilet habits: Ignoring the urge to pass stool may lead to hard stools and constipation. A loaded bowel can give rise to pressure on bladder and bed wetting
- Hereditary predisposition: Bed-wetting can run in families and child usually overcomes it at an age when parents have overcome it.
Which children need to be shown to the child specialist?
- Secondary bed-wetters: Children who initially achieved bladder control and later started bed wetting after staying dry for more than 6 months
- Bed-wetting persisting even after 7 years of age
- Signs and symptoms of urinary infection e.g. burning pain while urinating, cloudy urine, red colored urine, frequent urination, genital rashes, etc.
- Signs and symptoms of Diabetes: Weight loss, drinking or eating more than usual, lethargic, etc
- Bed-wetting even during daytime
What are the usual things done by the child specialist?
- Clinical evaluation
- Psychiatric evaluation
- Urine routine and microscopy
- Fasting blood sugars
- Ultrasonography of kidneys and bladder
- Ultrasonography of spine
Simple things which can help your child overcome this problem
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- Positive reinforcement: Praise and offer small rewards when your child remains dry by night. You can maintain a calendar along with your child and mark with stars or special colors the days your child does not wet his/her bed
- Banish the blame: Do not scold or embarrass your child as he/she is not doing purposefully. It will increase the anxiety and problem will persist for a longer time
- Make sure your child goes to the washroom before putting him or her to bed
- Try limiting liquid intake to 2 -3 hours prior to bed time
- Do not give caffeinated drinks like colas or tea in evening or night
- Try to time when they pass in urine at night and wake them up before that
- Do not fight or quarrel in front of children
- Toilet training and avoid constipation
- Talk to them patiently about the problem and reassure them
- Encourage the child to help with morning bed clean up
Tools available to help overcome bed wetting:
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- Moisture alarms: Alarms which go off when your child start urinating. This will wake up your child and he/she can go to the toilet for urinating completely. These alarms are very effective but it may take a few weeks before you can see the results. They are available online in India
- Waterproof Mattress/ Vinyl covers: You can invest in waterproof mattresses or vinyl covers which will avoid soiling
Role of medicines in bed-wetting:
Certain medicines and nasal sprays are available for bed-wetting but the results are 30-40%, do not cure the problem completely and have their share of side effects. Once the medicine is stopped the problem may recur. So these should be used only after consultation with your pediatrician.
Remember this is just a phase, it won’t last forever.
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