Childhood Bedwetting : More Common Than You Think And Often Easily Treatable
Many toilet trained children who are normally dry during the day often do not stay dry during the night. Up to 30% of children up to the age of 6 wet the bed at least once a month. Sometimes the causes behind the bed wetting need to be addressed medically, but most are common developmental issue that resolve over time. If you have a child who is experiencing bedwetting (known as enuresis) it is important not to be distressed over it or shame the child. The best way to address bedwetting is to understand why it can happen and then develop a plan to manage it. Your pediatrician at The Pediatric Center can help you with this and there are plenty of other resources available.
Types Of Bedwetting
In childhood bedwetting there are two main observed types:
- Primary – where the bed wetting is has been continual from early childhood, meaning there haven’t been any significant lengths of time where the child had remained dry at night.
- Secondary – where the bed wetting begins to recur after a long period of dry nights, such as six months at least.
Both types of childhood bed wetting have possible issues that may contribute to the episodes. In primary bedwetting situations, the causes are most often one or more of the following reasons:
- The child is not yet able to hold in urine all night
- The child sleeps so soundly or deeply that they do not wake up when they have a full bladder
- The child may produce copious amounts of urine during the night
- The child has difficulty with toilet habits during waking hours, such as waiting too long before using the bathroom, ignoring the need to urinate, trying to hold back urination, etc.
In the instance of secondary childhood bed wetting, the causes can be of a medical situation or often due to emotional issues. Some of the underlying causes of the secondary type are:
- Urinary Tract Infections which can cause frequent urination
- Neurological issues
- Emotional events – bouts of stress or chronic stress can contribute to bedwetting. This can range from changes like a new baby or a move from one home to another, or more serious causes such as family conflicts and abuse.
Also of note, in addition to the primary and secondary causes of childhood bedwetting, some cases may be due to heredity. Many children who wet the bed have a parent who also wet the bed. Interestingly, these children will often “grow out” of wetting the bed at around the same time their parent did. For these children, medical intervention is certainly not needed. It would be a good idea to bring this up with your pediatrician, but this type of bed wetting will just have to be managed with patience, support, and sensitivity. Plastic or absorbent pads can be used underneath sheet to protect mattresses, children can wear night-time “pull ups”, using the toilet before bed and avoiding liquids before bed can all help.
Managing Primary Bedwetting
Management of the primary type of bed wetting is utilizing many of the same techniques and habits as for the childhood bedwetting that may be hereditary. After consulting with the professionals at The Pediatric Center or with your own pediatrician to determine the cause of the bed wetting is not medical, there are several different things you can do to minimize the occurrences of the episodes, break bad habits that contribute to the bed wetting, and keep bedding cleanup to a minimum. Training pants and plastic sheets or absorbent pads can control odors and moisture and make bedwetting easier to clean up after. Have your child help you with stripping the bed and doing the laundry to encourage awareness and responsibility. Try to keep the consumption of liquids (especially soda or juice) to a minimum before bed. Encourage going to the toilet before bedtime. If your sleep habits allow it, try waking up the child 1-2 hours after the have initially fallen asleep, escort them to the bathroom and have them empty their bladder before going back to sleep. You can make a weekly or monthly chart of wet nights and dry nights to see what tactics worked, and possibly reward the child for dry nights (but never punish a child for a wet night-remember, children don’t wet the bed on purpose and it is not their fault). After these options have been tried for a number of months and no progress has been made, a pediatrician may introduce a bedwetting alarm. These have a moisture monitor that detects urine and alarms the child to wake up and use the toilet. They seem to work in 50-75% of children who use them. Stay away from and medicines or devices that claim to cure childhood bed wetting. If you have questions, call The Pediatric Center before spending money or time on any of these “cures”. Lastly, just accept that some kids will continue to wet the bed until they simply grow out of it. Nearly all children who wet the bed will have ceased by the time they are teens.
Managing Secondary Bedwetting
If you have been seen at The Pediatric Center and have spoken with your pediatrician of your concerns about bedwetting, you may be asked a lot of questions about your child’s toilet habits. You may be asked how much your child uses the toilet per day, if your child is constipated, if the urine is cloudy or blood-tinged, if there have been changes in the child’s demeanor, if there is any pain or burning during urination, and others. These will help to determine if the cause of the childhood bed wetting is medical in nature and of the secondary type of bed wetting. It is possible that the pediatrician will then need to have a closer look at the child’s urinary tract, kidneys, and bladder. Blood tests may be taken to check for diabetes or other issues. If warranted, you child may be referred to a pediatric urologist for treatment and counseling. Until a diagnosis is made and treatment commences, use the same management techniques as for primary childhood bed wetting.
Considerations For The Child
Probably the most important thing you can do during the episodes of childhood bedwetting is to address the emotional concerns of the child. They should know that it is not their fault, it is not “wrong” and that it will stop eventually, they will not always wet the bed. Be patient with accidents, do not ever tease or shame the child for childhood bed wetting. If you need to, inform other family members of the situation so that there are no surprises and so that there is no teasing. Try not to make a big deal about the management or cleanup of the bed wetting. Do not punish a child for wetting the bed. The Pediatric Center can offer more resources to you and information about your child’s bedwetting. If you have a child who wets the bed or have any questions regarding childhood bed wetting, call or visit us at The Pediatric Center. We can manage and treat childhood bedwetting in a helpful way.