Nocturnal Enuresis (Bedwetting)
Bedwetting, which is known medically as nocturnal enuresis, is involuntary urination during sleep. Although getting up in the middle of the night to change wet sheets can be annoying, nocturnal enuresis in children is almost always a temporary thing. Most kids wet the bed occasionally even after they are initially potty trained. Usually children will be able to sleep through the night without wetting the bed or waking up to use the toilet at around age five or six. In some instances, bedwetting may continue after the age of six for a variety of reasons. Understating the possible causes and options to prevent bedwetting can help parents deal with the situation appropriately.
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According to Medline Plus, nocturnal enuresis is a very common problem among children and affects about five million children each night. Bedwetting is broken down into two categories including primary and secondary enuresis. Primary nocturnal enuresis occurs when there have not been any periods of dryness. Normal bedwetting is considered secondary enuresis, which is when dryness overnight was achieved for about six months, but bedwetting starts again.
Before the age of about five, bedwetting is often due to a lack of bladder control, which children achieve anywhere from about age three to five. After age six, bedwetting may be caused by slower development, a small bladder, a urinary tract infection or a lack of an antidiuretic hormone, which slows urine production at night. In some instances, bedwetting may be due to chronic constipation. If the colon is full, it can put pressure on the bladder and leave little room for urine.
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Although emotional issues are not considered one of the main causes of bedwetting, it is possible increased stress can cause a child to start wetting the bed. Parents should consider stress, if a child starts wetting the bed after several months of staying dry throughout the night. Causes of stress may include, moving, the addition of a new sibling, parents divorce or death of a family member.
According to NYU Langone Medical Center, bedwetting is rarely the sign of a medical condition; however, occasionally it can be a symptom of diabetes, kidney disease or structural problems with the bladder.
Although bedwetting can happen to anyone, there are a few risk factors, which may increase a child’s chances of it happening. Both boys and girls deal with bedwetting; however, it occurs in boys about twice as often. According to the Mayo Clinic, family history also is considered a risk. If a parent wet the bed as a child, there is an 80 percent chance their child will also experience bedwetting. Children with attention deficit disorder also develop bedwetting more often than children without the condition.
In most cases, bedwetting does not require any treatment other than some bedtime routine modifications. Occasionally, if bedwetting continues, additional treatments may help. Treatments include the following:
- Lifestyle changes: Unless bedwetting is caused by an infection or structural abnormality, a few lifestyle or bedtime routine changes are usually recommended as the first ways to deal with bedwetting. For example, limiting fluids about an hour before bed may help. Parents should also encourage children to use the toilet right before going to sleep.
- Bedwetting alarms: Bedwetting alarms are available, which will make a noise as soon as moisture is detected. The alarm wakes a child as soon as urination starts, which allows the child to get up and use the toilet.
- Medications: Although medication is usually not needed to treat bedwetting, occasionally it can help. There are a few different types of medications that may be recommended. For example, some children may not produce enough of the antidiuretic hormone, which slows urine production while they sleep. Medication is usually available in pill form or a nasal spray.
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Although bedwetting does not pose any health risks to a child’s physical well-being, emotional complications can develop. Emotional issues are usually caused by feelings of embarrassment and self-esteem issues, which can develop. Depending on the age of the child, bedwetting may cause a child to be afraid to participate in normal childhood activities, such as attending sleep away camp or going to a sleepover at a friend’s house.
Negative emotions are more likely to develop the older the child is when wetting the bed. A parent’s reaction also plays an important role in a child’s perception of bedwetting and self esteem issues. According to Medline Plus, embarrassing a child about bedwetting may possibly lead to self worth issues. Negative reactions and punishments will make the situation worse and likely not solve the problem.
Usually bedwetting is nothing more than a passing stage of development that children will outgrow. It is important to remember staying dry overnight is often the last stage in toilet training, and children reach this milestone at different rates. Often a few changes are all it takes to keep kids dry overnight. Staying calm and keeping the situation in perspective can also help.