CHILDREN WETTING THE BED

 

Enuresis means bed-wetting during sleep and it is quite a common problem in children that occurs more in boys than girls. Myths such as drinking too much water before bedtime cause bed-wetting, it is a mental or behavior problem or occurs because the child is lazy to go to the bathroom or is trying to irritate the parents are baseless. Some of the common causes of bed-wetting are:

  • Abnormal urethra valves in boys or urea in girls,
  • Abnormalities in the spinal cord,
  • Child may not be able to wake up on time,
  • Delayed development of the central nervous system reduces the child's control over his bladder so that he is not able to stop the bladder from emptying at night,
  • Genetic factors in families,
  • Lack of anti-diuretic hormone that reduces the amount of urine made by the kidneys,
  • Small bladder that cannot hold urine for a long time, and
  • Urinary tract infections.
  • Children gain bladder control up to the age of five. Bed-wetting by younger children is not uncommon and need not be treated. If your child is older than five years and still wets the bed, then you should consult the doctor. Be sure to tell the doctor about the child's daytime and nighttime bathroom habits, which may be followed by a physical exam and a urine test called ‘urinalysis’. The doctor may also check for problems in the urinary tract and the bladder. Though it is unlikely that bed-wetting in children is related to emotional upheavals, changes in family life may result in increase in bet-wetting accidents.
  • Most children outgrow bed-wetting and do not need treatment but if your doctor decides that your child does need a treatment, he/she may use medicines or the behavior therapy to teach the child not to wet the bed. Some of the behavioral treatments for enuresis are:

    • Giving rewards to the child on nights when he or she does not wet the bed.
    • An alarm system that rings whenever the bed gets wet, so the child learns to be more alert and respond to bladder sensations at night.
    • Ask your child to change sheets and clean himself when he or she wets, without shaming him.
    • Teach bladder training exercises to the child to make him learn how to hold his or her urine for longer and longer times.

    Children older than seven years who do not respond positively to behavior therapy may need medicines. However, medicines cannot cure bed-wetting and have their side effects too. They can just help the bladder hold more urine or the kidneys to make less urine. Bed-wetting leads to behavior problems such as feeling of guilt and embarrassment, so you should be careful not to scold the child and make him feel responsible for it. Child needs training more than punishment and it may help your child to know that the exact cause of bed-wetting is unknown and if it tends to run in your family.

     

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