When should bed wetting become a concern? Dr. Erin Hannagan, pediatrician at Keystone Pediatrics in Chambersburg, shares what you need to know about the common causes and solutions for childhood bed wetting issues. (This article first appeared in the Public Opinion newspaper.)
Bed Wetting
Bed wetting (nocturnal enuresis) is a common problem in children, occurring in approximately 15% of 5 year-olds. Although we don’t know why, it’s more common in boys than girls. Most of these children have isolated incidents of bed wetting. Children who have been dry for at least 6 months and then begin to have bed wetting issues have secondary enuresis. This may be due to a stressful event (for example divorce or birth of sibling), but it is important to rule out other causes.
Common Causes
Several potential causes include delayed bladder maturity, genetics, increased fluid intake before bed, disturbed sleep (often bed wetters are deep sleepers) or urinary tract infections. Small bladder capacity, due to actual size or from constipation leading to reduced function or size of the bladder, can also be a culprit. While bedwetting can be frustrating to parents, it’s important to handle these incidents calmly. It’s not the child’s fault and they should never be punished. Parents should approach these incidents as something that the parent and child can work through together as a team.
Start Here
Initially, parents should attempt to have children void regularly during the day and just before going to bed. If the child wakes at night they should be taken to the bathroom. Parents can also wake children during the night to take them to the bathroom. High sugar and caffeine based drinks should be avoided in children with bedwetting, especially in the evening as well as salt and sugar. Daily fluid intake should be concentrated in the morning and early afternoon. Depending on the cause, motivational therapy can help as well—reward charts for dry nights might help. Penalties are counterproductive.
Other Options
If motivational therapy fails after 3 to 6 months, bedwetting alarms may be used. These are alarms that are placed on a bed pad that detects moisture and either has an auditory alarm or vibrating belt. These work best for motivated families and children. Occasionally medications are given, but may have side effects and should be used only when other interventions have not worked or when children will be away from home. If you continue to feel frustrated, consult with your child’s pediatrician for practical advice on your child’s specific case.
Talk to Your Doctor
Chronic bed wetting can be a medical or psychological problem. It’s important to rule out some unrecognized medical disorders including seizures, urinary tract infection, constipation, sleep apnea or pinworms. Often it is more likely due to one of these reasons or children will outgrow it. If bed wetting is worsening or if other symptoms are present they may need to be seen to rule out other medical problems. It may be helpful to keep a diary of when your child goes to the bathroom. The good news is that although the exact cause may remain unknown after testing, bed wetting typically resolves on its own.
For more information about Keystone Pediatrics, click here.
