Bedwetting is a common occurrence among children between the ages of five and ten. The National Institute of Health estimates that over five million children suffer from this condition. Essentially, bedwetting is defined as an inability to control the release of urine. This most commonly takes place at night, but can happen at any time of day. The problem is diagnosed as bedwetting only if the incidents occur at least twice monthly. Most children who suffer from bedwetting have never achieved consistent overnight dryness, and in some cases bedwetting can recur after the causes have been resolved due to stress or other environmental factors in the child’s life.
Types of Bedwetting
Primary enuresis is the failure to remain dry overnight, and is usually caused when the body produces more urine than the bladder can hold. The child’s brain has not yet learned to respond to the stimulus of a full bladder and, as a result, the child wets the bed. Secondary enuresis, by contrast, occurs after the child has already successfully managed to stay dry consistently for a six month period. It is usually brought on by changes in the child’s living situation or sleeping habits, or sometimes by an illness or emotional upset.
Causes of Bedwetting
In some cases, medical problems can cause bedwetting incidents. Diabetes, urinary tract infections and birth defects are among the most common medical causes. In general, though, the problem is caused by an interruption of the connection between brain processes and bladder functions that prevents the child from realizing that he or she needs to awaken and go to the bathroom. The bedwetting action is not deliberate on the child’s part, and is not a voluntary choice.
In most cases, a thorough physical examination is required in cases of bedwetting in order to rule out medical causes for the condition. Blood and urine tests may be performed in order to determine if diabetes or urinary tract infection is to blame. Most physicians will also collect information from the child’s parents regarding the history of the bedwetting incidents and the events surrounding these episodes, especially in cases of secondary enuresis.
Strategies for Dealing with Bedwetting
Parents can help children manage bedwetting incidents by scheduling regular bathroom breaks during the day, and especially right before bed. Restricting fluid intake before bedtime is a useful strategy that can sometimes provide some relief, but generally is not enough on its own to control the problem. Parents should avoid disciplining or blaming children for bedwetting incidents, as this can actually make the problem worse by causing stress that further complicates the situation. Younger children may respond to positive reinforcement and rewards for remaining dry throughout the night. However, rewards are less likely to produce good results in older children.
Some parents have achieved considerable success by using bedwetting alarms to help train children to remain dry at night. These innovative devices detect the first signs of wetness and awaken the child with a loud noise, prompting the child to go to the bathroom rather than wet the bed. Consistent use of a bedwetting alarm can often produce good results within a few months by helping train the child to be aware of the body’s signals, leading eventually to consistently accident-free nights without the alarm.
A number of prescription drugs are available that can help reduce or eliminate bedwetting incidents. These should typically be used only after other methods have been tried and have failed. One of the most effective prescription treatments for bedwetting is desmopressin, which actually decreases the amount of urine the body produces for a few hours. It can be used on an as-needed basis or as a long-term treatment for bedwetting. Other medications are also available, but they typically have side effects that make them less desirable for younger children.
The good news is that most children outgrow bedwetting by age ten regardless of treatment. In many cases, parents and children can devise strategies that work to reduce the number of embarrassing incidents, eventually resulting in an end to bedwetting for good.