Bed-wetting
Bed-wetting, or enuresis, is a fairly common symptom occurring in approximately 15 percent of children. It is more common in boys than in girls. Most of the time, at least one parent also had bed-wetting problems. Bed-wetting is frustrating for both the child and parent because usually there is not a cause. Fortunately, most children outgrow it without treatment by their early teen years.
Bladder control occurs as babies mature. Babies initially empty the bladder by an automatic muscle reflex. As children age, they are able to consciously stop that muscle reflex so that they are able to stay dry during the day. Most children are able to stay dry at night around three years of age. At this age they are able to stop the muscle reflex unconsciously. Although urine accidents may occur for a variety of reasons, parents get concerned when a child has a persistent problem with bed-wetting after three years old.
Bed-wetting is usually due to the child being a deep sleep rather than having a bladder malfunction or abnormality. Another reason may be the child’s bladder control is developing slower than normal. At times, the child may be deficient in the hormone (antidiuretic hormone) responsible for making sure the bladder does not overfill at night. Sometimes bedwetting may occur with illness or extra emotional tension.
Children rarely wet the bed on purpose and usually feel bad about doing so. It is important not to make the child feel terrible about the incident. Punishment should be avoided, and the child should be a part of the clean up process. Ways to encourage a dry night are to limit liquids before bed, wake the child to urinate in the middle of the night and take them to the bathroom before going to bed. In addition, after having a dry night, be sure to celebrate and be encouraging with the child.
Bed-wetting is usually a benign symptom. However, if it is persistent or associated with stomach pain, fever or pain with urination, it is important to see a physician. Other concerning symptoms are day wetting, weak urine stream and constipation. The doctor may do blood tests and x-rays looking for a urine infection, physical problems and urinary tract abnormalities. Fortunately, most of the time there are no causes found for the bed-wetting.
Treatment options for children include the following:
- Behavioral conditioning devices (pad/buzzer)
- Medications
- Bladder training
- Psychological counseling
In summary, bladder function is dependent on child maturity and the capacity of the child to control the bladder muscles consciously and unconsciously. Bed-wetting is fairly common and most children outgrow it without the need for medical attention. However, with persistent bed-wetting, noninvasive treatments the child may try include changing fluid intake and bladder training. Both can decrease risk of wetting the bed.