Many parents out there can probably attest to the fact that bedwetting is a common occurrence among kids. Let’s be honest, it can be stressful at times, not only for the parents due to the inconvenience of added laundry loads, but for the affected kids who probably have to deal with sibling-teasing and other social embarrassment. Sleeping over at friend’s place is most likely another issue.
Just how common is common then? It is estimated that 16% of children at the age of 5 may wet their beds at least once a week. Most will generally outgrow the condition when they reach teen hood. Nevertheless, the longer the condition persists, the slimmer the chance it will resolve spontaneous with approximately 1-2% of those age 15 and above still experiencing the condition.
What is bedwetting all about?
Contrary to common belief, bedwetting (also known as nocturnal enuresis) is not caused by laziness. Children usually learn to control their daytime urination around 2 to 4 years of age but night time bladder coordination usually takes longer. The common causes of bedwetting are:
- Slower than usual bladder muscles maturation in some children
- Overactive bladder/smaller bladder capacity
- Low level of anti-diuretic hormone which is responsible for conserving water in the body by causing less urine production.
- Deep sleep which prevents the brain from sensing bladder fullness.
It is interesting to note that there is a genetic predisposition to bedwetting i.e. parents who had this condition during childhood are more likely to have children with similar condition. Let’s look at the bright side, at least these parents can better understand the problem and take comfort that the condition will resolve itself eventually just like their own.
When do I seek medical advice?
You should probably be assured by now that bedwetting is quite common and there is generally no cause for alarm. Nevertheless, sometimes other underlying medical conditions such as diabetes, constipation, urinary tract infection, kidney failure, seizures and sleep apnea can also lead to bedwetting.
Do take note of the presence of other symptoms which may signify the presence of an underlying medical problem. Seek medical advice if your child has any of the following symptoms:
- Frequent and urgent need to urinate
- Difficulty urinating
- Burning pain during urination
- Extreme thirst
- Swelling around ankles or feet
- Experiencing new episode of bedwetting after weeks or months of being dry at night.
These may be signs of more serious underlying conditions that require further medical evaluation before appropriate treatment can be started.
Well, even if your child does not have the symptoms mentioned above, that should not stop you from seeking medical advice if you are in doubt. After all, it doesn’t harm just to be sure.
What should I do to improve my child’s condition?
First and foremost, do not be mad or blame your child for bedwetting. Bear in mind that they can’t help it either. Here’s a list of things you can do:
- Use a water-proof bedsheet.
- Spread out your child’s fluid intake over the whole day and limit fluid intake in the evening or before bedtime. Remember, insufficient daily water intake can cause harm to the kidney so do not deprive your kid of water.
- Avoid sugary and caffeine-containing drinks especially in the evening.
- Encourage your child to empty the bladder before bedtime.
- Train your child to wake up at night to empty the bladder. You can do it yourself or use an alarm clock.
- Stop using diapers or training pants at home especially if your child is older than 8. You can still use it for overnight visits.
- Put night lights in the hall and washroom so they can use the toilet easily.
- Motivate your child by agreeing on a reward if your child stays dry. Keep a record of their progress.
There are more treatment options that parents can initiate on their own that does not require medications. We have it summarized for you here.
Sometimes, doctors may also prescribe different medicines for the treatment of bedwetting based on the underlying condition although parents can consider trying out the behaviour therapies mentioned above for three to six months first. Complementary and alternative treatments such chiropractic manoeuvres, acupuncture and hypnosis are not recommended due to the lack of scientific evidence.
All in all, welcome to parenthood!
References:
- Schmitt BD.. Bed-Wetting (Enuresis). In: Instructions for Pediatric Patients, Saunders, 1999. p.209.
- Neveus T, Eggert P, Evans J, et al. (2010) Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children’s Continence Society. J Urol 183:441.
- Kiddoo, D. (2007). Nocturnal enuresis. BMJ Clinical Evidence, 2007, 0305.
- National Institute for Health and Care Excellence. Nocturnal enuresis – the management of bedwetting in children and young people.
- Glazener CM, Evans JH, Peto RE (2005) Alarm interventions for nocturnal enuresis in children. Cochrane Database Syst Rev; CD002911.
- Glazener CM, Evans JH (2009) Desmopressin for nocturnal enuresis in children. Cochrane Database Syst Rev; CD002112.
- Huang T, Shu X, Huang YS, Cheuk DK (2011). Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database Syst Rev; CD005230.
- Caldwell PH, Nankivell G, Sureshkumar P (2013) Simple behavioural interventions for nocturnal enuresis in children. Cochrane Database Syst Rev; CD003637.
