BED-WETTING IN CHILDREN

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Bed-wetting or Enuresis can defined as a complete or near-complete micturition in the bed during sleep. The most common form of bed-wetting is monosymptomaticnocturnal enuresis (MNE) meaning that there are no daytime symptoms pointing to bladder dysfunction. Thus, the child has no pronounced urgency, no very frequent nor infrequent voiding and, most important, no daytime incontinence.

How common is it?

It is very common. Most children need to wear nappy or protective pants at night to avoid wetting their bed up until at least age five. At four years of age nearly one in three children wet, and this falls to about one in 10 by age six. Some teenagers wet the bed too. This is especially common if a parent or other close family member wet their bed at this age as well.

What causes it?

There are a number of causes of bedwetting (or enuresis). We don’t know all of them. Some children wet the bed due to being in deep sleep. They do not wake up to go to the toilet in time. Other children have smaller bladders that cannot hold onto a lot of urine overnight. Some children don’t make enough of a hormone called Anti-Diuretic Hormone, known as ADH. This hormone helps to concentrate urine overnight. Children who don’t make enough ADH have a lot of dilute urine and so wet the bed. Children with constipation may have problems with bed-wetting. They may have problems with daytime wetting too. Bed-wetting can run in families, but we have not yet found the gene that ‘causes’ bed-wetting. In rare cases, there is an underlying medical cause. So always have your child checked by a medical doctor before you start any treatment. Bed-wetting is NOT due to underlying behavioral problems. Never scold or punish a child for bed-wetting. They are asleep when it happens and cannot help it.

Will my child grow out of it?

Yes, most children grow out of bed-wetting. But, from the age of 6years there are treatments that you may want to consider. This is especially so if your child feels shame about their bed-wetting. It can also be a problem for children who want to sleep over at a friend’s house.

What treatments are there?

The treatment which seems to work best is the pad and alarm. There are many types on the market and some hospitals and pharmacies hire them out. They work through a pad that senses when your child starts to wet the bed. This then sounds an alarm to wake up your child (and the whole family!). Your child then needs to get up, turn the alarm off, go to the toilet, empty their bladder, go back to bed and re-set the alarm. It is VITAL that your child takes control and does these steps for himself/herself. If you do it instead, it will take longer for the child to learn to wake when he/she starts to pass urine. You may need to help your child through these steps for the first few nights. But then he/she should be able to manage the steps themselves. Most experts suggest using the alarm until your child has had 14 dry nights in a row. After 7 dry nights, some of them suggest ‘over learning’ i.e. increasing how much fluid your child drinks in the evening for 7 nights. This makes sure they are ready to stop using the pad and alarm. Reward your child (e.g. with stamps, stickers) when they get up and go to the toilet. The pad and alarm treatment may take up to 12 weeks to work, so this will help them stay motivated during that time. A synthetic form of ADH is also available. This is mostly used for short overnight stays (see below) or if the pad and alarm treatment fails.

 Some useful tips

  • Make sure your child drinks plenty of fluid spread evenly all through the day. There is NO evidence that you can help them get dryer sooner if you limit their fluid intake – it may even be a bad thing!
  • Don’t give drinks with caffeine (e.g. coffee, hot chocolate, Coca-Cola) late at night.

Try to have your child wear a pyjama top or nightie and no bottoms during the process. In this way the alarm will sound as soon as they start to pass urine

Author: Bibian Okoye

A Retired Chief Nursing Officer, PGDip IHM

13 thoughts on “BED-WETTING IN CHILDREN”

  1. Hi Bibian, thanks for this insightful article on bed-wetting in children. As a mom of three kids, I can relate well to this. My first son, reduced the frequency with which he bed-wets at the age of 3 years plus, immediately he clocked 4 years it becomes rare for him to bed-wet, now he is 6 years and there hasn’t been any occurrence of bed wetting from his end.

    However, it is not same with my second son. I found out that my second son usually urinate a lot he consume too much liquid in the night, like softdrink, juice or lots of water or in extremely cold weather.

    Being in deep sleep also causes bed-wetting, especially when kids are not opportune to take their siesta. Thanks for the useful tips. You have got yourself great website.

  2. Bed wetting is a normal cycle of every child. I remember I bed-wetted as a child too. It was quite embarrassing to be ridiculed by my mom every morning. I can remember that I stopped bed-wetting after being woken up in the middle of the night to use the restroom. After a couple of months of this exercise, I stopped bed-wetting. 

    The pad and alarm system is quite similar to what my Mom did, however it’s automated and gives the parents freedom. I believe this could work for even younger children.

    Regards

  3. This is an interesting writeup and wonderful topic. I’ve seen cases of bedwetting and I once thought it’s only caused by deep sleeping. Little did I know it may be genetic or due to ADH or size of the bladder. This writeup really shed a spotlight on the named reasons and I’ve learnt a lot between. Great work, keep it up. 

  4. One of my family members had a problem growing up and wetting the bed, back then there wasn’t the information we have today and unfortunately she went un-diagnosed for longer than she should have.  Her parents thought is was a behavioral problem and I think this caused it to be worse, in the end she was diagnosed with MNE.

    I think we as parents need to be more patient with our children even if it is frustrating to us, think about how frustrating it is to them.  If we react with disgust or unpleasant feelings this can make the problem worse in the end for both Parents and Child.

  5. I absolutely love this insightful article because it is full of great information. This is fascinating and interesting to me.Have once been bed-wetting till age 10 until the habit stops itself. I will like to share this post for parents to read and make use of it. Using of pad and alarm and listed in this article will be preferable in controlling bed wetting.thanks for writing out this informative article. Best regards 

  6. I really appreciate this review. I could remember that I suffered bed wetting when I was a child and it was a very big shame and challenge to me. Unfortunately I hadn’t anything like setting alarm to curb this and it took me good number up to almost age 10 to stop bed wetting.  Currently, I have a friend’s son who’s issue is bed wetting. I am going to suggest this alarm setting to him. How can I help him purchase this alarm device that can wake him up at night please? Thanks.

  7. This is such an informative article on bed wetting in children. When our kids wakes up with wet sheets, it can leave them feeling embarrassed and uncomfortable, and leave the parents sleepless and stressed up. There is so much in this article you have said that will help your readers to know what to do to stop this bed wetting like, reduces drinks before bed and to eliminate caffeinated drinks etc. I am very impressed with your contents.
    Thank you for sharing this with us.

  8. My opinion about this topic

    I think the post will be very useful to young families with young children. The post defines Enuresis and how it can be managed. I agree; Bed-wetting should not be ignored because, “My child will grow out of it”, caring less of the social and psychological effect on the child. 

    Many parents experienced bed-wetting. I don’t know any family, including mine, that did not have the problem with all or some of their their children.

    I’m wondering whether the Pad and Alarm safe enough? Some children turn a lot in their sleep. Also, what is ‘dilute urine’?

    In all, the post is great and will be enjoyed by many young families.

    Good luck.

    1. |Thanks dear for the comment, I am glad you found it very helpful.

      The Pad and Alarm system is very safe, it has been tried in various homes and truly it really helped in reducing the rate at which these kids wet their beds. So if you still have a toddler that wets the bed at night, it right time you try it. thanks once again 

  9. I found it really interesting to learn that there can be a hereditary link to wetting the bed for longer than their peers. I have never heard of the alarm and pad idea, but that looks like a brilliant innovation that could give sound benefit with no embarrassment to the child. Great idea! Thank you for sharing this!

  10. Wonderful article – you explain well what bed wetting is, what it is not and simple, effective solutions. Thank you for instilling in those reading this article that scolding children who do this is not helpful and to not withhold fluids as well. It’s so important to stay hydrated! Thank fully I did not experience this issue but am sure many have or have children experiencing this problem and will find this article insightful. Thank you for sharing!

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