Bedwetting (nocturnal enuresis) is involuntary voiding of urine during sleep at least three times a week in a child aged 5 years or older. It is a common worldwide problem affecting both boys and girls below 16 years. It can be a distressing experience for the child and may lead to loss of self-esteem and isolation.
Children fear being discovered and are afraid to go to relatives' or friends' house. Although most parents are supportive, up to 30% parents become intolerant towards their child.How common is bedwetting? Can it correct
At 5 years of age, around 1 in 6 children still
wet the bed. This means that in a school class of thirty there will be
five who wet the bed regularly. Because the children and their parents
are too embarrassed to talk about the
problem it is unlikely that they will be
known to each other. Most of these children spontaneously grow out of
it. By the age of 10 only one in 15 still wet the bed. Even in adulthood
1 in 100 still suffers from the problem.Causes of Bedwetting
It is important to remember that it
is not the child’s fault. Parents must also not blame themselves.
Getting angry or punishing the child could make the problem worse.
Supporting and praising the efforts of the child to stay dry will help
the child to become dry sooner. Getting medical help relieves the
anguish for the family.
The cause of bedwetting is
usually a combination of three factors.
production of urine at night
2. Hyperactivity of the
3. Lack of arousal from sleep
Stressful early life events can trigger bedwetting
in those who have previously been dry for a long
isolated bedwetting usually do not have any underlying problem. However
if a child has been wet right from birth, always wet day and night, or
never achieved toilet training, then it is essential to see a Pediatric
Urologist to make sure that there is
no associated medical problem like ectopic ureter, where one kidney
drains not into the bladder but, outside the body directly.
Treatment for Bedwetting
simple methods like waking up the child (alarms) and giving awards for a
dry night (star chart) are undertaken. If bladder over activity is
suspected, a bladder relaxing medication is prescribed. If night time
alone is a problem, a medicine to reduce the volume of urine in the
night is prescribed. When urine infection is suspected, an antibiotic is
It is essential to avoid bladder
irritants as black current, coffee or coke. Constipation can make
bladder problems worse. Taking plenty of fruits and vegetables can help
to prevent this. Often parents restrict children’s water intake. This is
not necessary; in fact these children need plenty of water and regular
toilet visits during the day.