Wetting the bed can be an embarrassing issue for many children- wet soggy bedsheets and pyjamas and a frustrated child are a common scene many mornings, in countless homes. Bedwetting or what doctors refer to as nocturnal enuresis is the unintentional passage of urine at night.
For infants toddlers and preschoolers, bedwetting should not be a concern since urination for them is involuntary. Children start gaining bladder control at the age of four. At first, they learn bladder control during daytime then nighttime control comes later. A good number of children are fully toilet trained by the age of five, but for some, the age between 5 and 7 bedwetting remains a problem.
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What Causes Bedwetting?
Bedwetting is caused by the inability of the child to waken to a full bladder, or the bladder becomes excessively active at night and cannot store urine or kidneys make a large amount of urine that the bladder cannot hold. Bedwetting is therefore not about the child’s laziness, intentional bad behaviour or being rebellious.
When Should You Seek Help?
Most children outgrow bedwetting on their own, but some need a little help with lifestyle changes, bladder training, and in some extremes, medication. Bedwetting is a normal part of a child’s development, but at times it can be a sign of an underlying condition that requires medical attention. You should seek professional help if your child:
- Stills wets the bed after the 7thbirthday
- Starts to wet the bed after a few months of staying dry at night and daytime
- Passing of urine is accompanied by pain, excessive thirst, hard stool, snoring or pink/red urine.
What Can You Do to Achieve Night-time Dryness?
Helping a child with bedwetting takes patience and resilience as you train the child’s brain and bladder to work together. Here are some practical steps that you can take.
1. Keep a keen eye on fluid intake
Fluid intake for kid’s growth and development is essential, but if you are dealing with bedwetting, control of what and when your child drinks are critical. Moderate fluid intake especially late hours is widely suggested. Increase fluid intake earlier in the day and limit it from late afternoon.
For some kids it may look like a punishment, so you will need to explain why you are doing it and how it will be of benefit. Avoid keeping the child thirsty as it can worsen the situation by causing constipation. Keep the child hydrated throughout the day. If the school allows, you can give your child a water bottle, to encourage steady fluid intake throughout the day rather than having thirst overload. If your child is active in sports, do not limit fluids.
Avoid caffeinated drinks, citrus foods and drinks like orange juice as they can irritate the bladder. Caffeine beverages are actually discouraged for children at any time because they stimulate the bladder.
2. Voiding just before bed
Many children due to fatigue rush to bed with an almost full bladder. Just before the child goes to bed, make sure that they make a trip to the bathroom. Encourage the child to squeeze all the urine out by applying some pressure. Some specialists also encourage waking the child few hours (2 to 3 hours) after falling asleep, since that is when most bedwetting occurs. If you choose to wake the child up, ensure that you awaken them completely. Carrying a sleeping child to the bathroom is counterproductive as they cannot sense what is going on in the bladder and cannot adequately empty the bladder when half asleep. If the child is not able to fall asleep after waking up, do not insist on it.
3. Bladder training
Some children have smaller bladders with a low holding capacity. There are some simple exercises that you can use to improve bladder control and stop bedwetting. For bladder training, encourage the child to hold urine for some time, despite the urge to urinate. During urination, ask the child to hold and release the urine stream, to strengthen the bladder control muscles. As the child’s bladder capacity and muscles strength increases, the child should be able to hold more without urinating often.
For children who are prone to urinary tract infections, bladder training exercises are not recommended as they worsen the infections.
4. A bedwetting alarm
A bedwetting alarm has a special moisture sensor that is placed in the child’s pyjamas in the area where the initial drops of urine would be felt. When the child begins wetting, the sensor triggers a buzzer to go off and alert the child or those in range, that wetting is occurring. The alarm is intended to awaken the child so he or she can wake up, go to the toilet and finish urinating. However, sometimes the child may not hear the alarm, and someone else may need to awaken the child.
The alarm conditions the child to get accustomed to responding to a full bladder. The training requires a sustained effort of several weeks or even months. Its success is heavily reliant on consistent use every night. Once you achieve nighttime dryness, continue using the alarm for a minimum of two weeks then you can comfortably withdraw it.
And here is the video about how to help a child for bedwetting.
Drugs are used as a last resort when everything else has failed. We highly recommend that you should not buy drugs without informing your child’s paediatrician. Preferably, let the prescription and recommendation come from the doctor. The reason as to why we insist on this is because the child may require other investigations, to diagnose an underlying condition. The doctor will also prescribe the required dose and if need be, give a combination of drugs for treatment of other conditions.
The most commonly used drugs either cause slow nighttime urine production or calm down the bladder. Bedwetting typically resumes after completion of medication, so basically it does not cure the problem. Generally, if medication must be used, it should be used together with other strategies mentioned above.
While implementing the interventions suggested above, always be sensitive to your child’s feelings. Offer support, encouragement and inspire the child to express their feelings. Celebrate every effort no matter how small, to motivate the child. Avoid punishing the child and discourage other children from teasing the child who wets the bed. With constant reassurance, understanding and support, the child will achieve dry nights.