Dr. Halima Janjua and Dr. Audrey Rhee discuss the causes and treatment of bedwetting and how parents can help their child.
Wetting the Bed Is Common for Some Children
You’re frustrated. You’re exhausted. Your child is already in school – and he is still wetting the bed at night. You’ve tried limiting liquids after dinner. You’ve woken your child up in the middle of the night and asked him to empty his bladder. Still, no luck.
You are not alone. Parents often worry about bedwetting in their children, a problem defined as involuntary urination in children 5 years of age or older. But in reality, approximately 15 percent of children in the United States are still wetting the bed at age 5.
When to Talk to the Pediatrican
Bedwetting is not a concern until your child is 5 years old. When your child is older than age 5 and still wetting the bed, you might want to talk with your child’s primary care physician or a pediatric nephrologist or urologist.
Typically, boys wet the bed more than girls, and typically, they present no other medical problems. The underlying issue is usually a bladder not yet matured. There are chances that there is a family history of bedwetting as well.
Also, keep in mind that about 15 percent of children age 5 or older actually stop wetting the bed each year.
8 Tips for Achieving Accident-Free Nights
- Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day.
- Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
- Be encouraging. Make your child feel good about progress by consistently rewarding successes.
- Eliminate bladder irritants. At night, start by eliminating caffeine (such as chocolate milk and cocoa) and if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate a child’s bladder.
- Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
- Consider if constipation is a factor. Because the rectum is right behind the bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one third of children who wet the bed, though children are unlikely to identify or share information about constipation.
- Don’t wake children up to urinate. Randomly waking up a child at night and asking him or her to urinate on demand isn’t the answer, either – and will only lead to more sleeplessness and frustration.
- Don’t resort to punishment. Getting angry at your child doesn’t help him learn. The process doesn’t need to involve conflict.
Urinary Bed Alarms
If the above strategies don’t help, a bedwetting alarm is often the solution.
You can clip the alarm to the child’s underwear or place it on the pad on the bed. Once the device detects any moisture, the alarm goes off.
But, parents should not expect the alarm to wake up the child. Instead, this is a signal that they need to take the following steps:
- Get up to wake their child.
- Get him or her into the bathroom.
- Clean off the bed.
- Repeat the process.
Medications: Not Usually Recommended
Although there are medications, including a synthetic form of a hormone, that can address bedwetting, they are not typically prescribed unless a child is already on the medication.
There are side effects to the medications and it’s a temporary fix, a Band-Aid remedy, when what the child needs is an overall solution.
Parents often wonder if a child is bedwetting on purpose. It’s typically not the child’s fault. It’s important for families and parents to not get too stressed about the situation because bedwetting often resolves on its own.
Parents should talk to their child to see if there is motivation to change. If a child still sneaks drinks late at night and eats what he shouldn’t, then it doesn’t make sense to invest in an expensive bedwetting alarm.
Talk opening with your child about he feels, and remind him that bedwetting is common, not his fault, and nothing to be ashamed of. If bedwetting runs in your family, share your experience with your child.
As the child gets older and has opportunities to go to slumber parties and weekend trips, bedwetting can affect his or her confidence and social life. This will most likely motivate the child to solve the problem and avoid feeling embarrassed.
When bedwetting signals more serious issues
Occasionally, bedwetting is a sign of something more significant, including:
- Sleep apnea - If a child snores a lot or shows signs of sleep apnea, discuss this with your pediatrician. Otherwise, this is not a first course of evaluation of a child with bedwetting issues.
- Urinary tract infections (UTIs) - A urine sample can detect these infections, which is a typical test doctors will order when bedwetting is an issue.
- Diabetes - A urine sample can also detect diabetes in children.
If a child also has daytime incontinence, age is something to consider. Generally children will outgrow the issue. In preschool, approximately 20 percent of children have daytime incontinence. But, only 5 percent of teenagers have these symptoms.
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