Bed wetting is common in young children who are learning to control the need to urinate during sleep.
Enuresis (en-yur-ee-sis) is the medical term for bed-wetting during sleep, is often just a stage in their development. It is more common among boys than girls. The American Academy of Family Physicians says bed-wetting isn't from naughty behaviour or laziness, and warns that although it may be a developmental stage, there may sometimes be a medical problem behind the bed-wetting child's behaviour, such as:
• Having a family history of bed wetting.
• Having difficulty waking from sleep.
• Being under physical or emotional stress.
• Having a urinary tract infection.
• Experiencing slow development of the central nervous system.
• Having a hormonal imbalance.
• Having an abnormality that affects the spinal cord, the urethral valve in boys or the ureter in girls or boys.
• Having a small bladder.
Children achieve bladder control at different ages. By the age of six years, most children no longer urinate in their sleep. Bed-wetting up to six years of age is not unusual, even though it may be frustrating to parents. If a child is younger than six years of age, treatment for bed-wetting usually is not necessary.
Although most children who wet the bed are healthy, your doctor can help you determine whether your child's bed-wetting is caused by a medical problem. First, your doctor will ask questions about your child's daytime and nighttime bathroom habits.
Then your doctor will do a physical exam and probably a urine test (called a urinalysis) to check for infection or diabetes. Your doctor may also ask about how things are going at home and at school for your child. Although you may be worried about your child's bed-wetting, studies have shown that children who wet the bed are not more likely to be emotionally upset than other children. Your doctor will also ask about your family life, because treatment may depend on changes at home.
Treatments for bed-wetting
Most children outgrow bed-wetting without treatment. However, you and your doctor may decide your child needs treatment. There are two kinds of treatment: behaviour therapy and medicine. Some behavioural treatments include the following:
• Limit fluids before bedtime.
• Have your child go to the bathroom at the beginning of the bedtime routine, and then again right before going to sleep.
• Use an alarm system that rings when the bed gets wet and teaches the child to respond to bladder sensations at night.
• Create a reward system for dry nights.
• Ask your child to change the bed sheets when he or she wets.
• Bladder training: have your child practice holding his or her urine for longer and longer times during the day, in effort to stretch the bladder so it can hold more urine.
Your doctor may give your child medicine if your child is seven years of age or older, and if behaviour therapy has not worked. But medicines aren't a cure for bed-wetting. One kind of medicine helps the bladder hold more urine, and the other kind helps the kidneys make less urine. These medicines may have side effects, such as dry mouth and flushing of the cheeks.
Helping your child cope with wetting the bed
Bed-wetting can lead to behaviour problems because a child may feel guilt and embarrassment. It's true that your child should take responsibility for bed-wetting (this could mean having your child help with the laundry). But your child shouldn't be made to feel guilty. It's important for your child to know that bed-wetting isn't his or her "fault." Punishing your child for wetting the bed will not solve the problem.
Explain that it tends to run in families (for example, if you wet the bed as a child, you should share that information with your child).
Remind your child that it's okay to use the bathroom during the night. Place nightlights leading to the bathroom so your child can easily find his or her way. You may also cover your child's mattress with a plastic cover to make cleanup easier. If accidents occur, praise your child for trying and for helping clean up. Reducing fluids before bed and having your child go to the bathroom when starting the bedtime routine, and again just before sleep, will often help reduce bed-wetting.