talking about health
Tuesday, January 3, 2023
“Mom, dad? I’m wet.”
Parents quickly spring into action when they hear these words. Changing wet sheets and comforting an upset or embarrassed child is no fun for anyone in the middle of the night.
Many families battle bedwetting. It is a normal part of child development. It’s no one’s fault, but that doesn’t mean it can’t be stressful, especially for older children. Here’s what you need to know about this common condition.
Types of nocturnal enuresis
Bed wetting, also known as bedwetting or bedwetting, is the involuntary release of urine while sleeping. It occurs after the age at which it is reasonably expected to remain dry at night. Bedwetting up to age 7 is common and not a concern. Most children stop wetting the bed on their own by the age of 12.
There are two general types of bedwetting:
primary nocturnal enuresis
This is when a child has not been able to stay dry at night. This usually occurs in younger children. For example, the child may stay dry during the day, but needs to wear a pull-up while sleeping.
secondary bedwetting
This is a recurrence of bed wetting. The child has been able to stay dry at night for an extended period, six months or more, but then begins to have problems again at an older age. For example, a child who has been dry at night since age 4, but then starts wetting the bed again at age 6.
Causes of bed wetting
When a child starts to wet the bed, especially if it is secondary, we work with the parents to find out why it happens. There is a strong family connection to bedwetting. About 40% to 50% of children with bedwetting had a parent who had problems with bedwetting as a child.
Other possible causes include:
Diabetes Urinary tract infection Vaginitis Deep sleep Small bladder or bladder nerves slow to mature Chronic constipation
Tips to help a child stay dry
Treatment is usually not necessary for primary nocturnal enuresis or children under 7 years of age. A watch and watch approach is usually the best option as we can expect an 8% to 10% improvement each year the child grows. Most children outgrow bedwetting on their own.
There are things parents can do to help a child with secondary nocturnal enuresis or who is older than 7, including:
Limit fluids at night.
Encourage your child to drink plenty of fluids during the day to stay hydrated and reduce thirst at night. Avoid drinks high in sugar or caffeine at night. Limit drinks within two hours of bedtime.
Incorporate urination into your bedtime routine.
Start the bedtime routine by urinating and then encourage the child to urinate again before falling asleep.
Set the alarm to urinate during the night.
Some children can keep themselves dry by urinating in the middle of the night. For example, a parent can set the alarm to wake the child at midnight, the child uses the bathroom, and then goes back to bed.
Use a moisture alarm.
These over-the-counter pads, also called bed-wetting alarms, are connected to a battery-operated alarm. This approach requires time, motivation, and patience. It can take one to three months to see results, but this option is low risk and may be a better long-term solution than medication.
Try prescription drugs.
Occasionally a child may be prescribed desmopressin as a short-term solution for bed wetting. This medicine holds water in the body so your child’s bladder does not get too full at night. There are some possible side effects with medications, which should be discussed with your child’s healthcare team. The drug is most effective in older children, and the overall success rate is around 30%. Other strategies, including timing, are usually tried before medications.
what not to do
Bedwetting can be frustrating and embarrassing for children. It can cause anxiety, especially for kids planning sleepovers with friends. Children look to their parents for their response to the situation and for acceptance despite their struggles.
If your child is experiencing secondary nocturnal enuresis, here are four things not to do:
Rebuke or scold.
Children do not wet the bed out of laziness or spite. Yelling or expressing your disappointment does not help children with bed wetting and can damage their confidence.
Retain liquids all day.
Depending on their age, children need between 4 and 8 glasses of water a day to stay hydrated. This improves mood, memory, energy, and attention while lowering the risk of constipation. Consider restricting fluids in the evenings, but encourage fluids during the day.
Deliberately embarrassing your child.
Discussing children’s bedwetting with peers or family members can increase anxiety and embarrassment. It does not motivate and can create lasting emotional scars.
Compare children.
All children are different and develop at their own pace. They cannot control how quickly the nerves in their bladders mature or the size of their bladders. Do not compare children to siblings or peers, as this will only increase stress and lower self-esteem.
Expect instant results.
Sometimes all a child needs is time and a supportive parent. There are no quick fixes to resolve bedwetting. Be patient, kind and compassionate.
Remember, bedwetting is nobody’s fault. His son is not lazy and he does not do it on purpose. Most likely it is a family gift passed down from one of the parents.
Talk to your child’s health care team about weight loss, burning or cloudy urine, daytime wetting, or increased thirst, as these could be signs of a different, treatable condition.
Manjunatha, MD, is a pediatrician in Pediatric and Adolescent Medicine in Eau Claire, Wisconsin.
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Source: news.google.com