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Bed Wetting

Definition
Recurrent, uncontrolled urination that occurs during sleep

Sex or Age Most Affected
Affects both sexes, but more common in boys. The occurrence of bed-wetting in children is: 26% at 4 years, 7% at age 5; 3% at age 10 ; 1.5% at age 14 and 1% at age 18 (Yes! even at 18)

Signs & Symptoms
Bed-wetting at night. This is not significant until a child is older than 4 yr.

Causes
In most cases, the cause of bed-wetting is unknown. Following are most popular theories:

  • Child who is a deep sleeper
  • Underlying illness, such as a urinary-tract infection.
  • A small or weak bladder that cannot hold one night's urine production.
  • Lack of adequate toilet training
  • Psychological problems caused by
    • Emotional insecurity due to separation from the mother.
    • Feeling of rejection
    • Birth of new baby
    • Immediate fear situation
  • Organic Factors: some abnormalities in spinal column &/or genito-urinary system.

Risk Increases With

  • Repeated urinary-tract infection and juvenile diabetes.
  • Family history of bed-wetting, in either parent.

Prevention
Show your child understanding for this problem. Give him love, support instead of condemning him/ her in front of sibling/ outsiders, which mothers commonly do, thinking they can embarrass him enough to give up this habit.
Remember your child wants to get rid of the habit much more than you do.

Diagnostic Measures

  • Observation of symptoms.
  • Laboratory studies of urine and blood to detect juvenile diabetes or urinary-tract infection.

Possible Complications
Psychological and emotional scars that may affect the child's personality for years. These are much more problematic than physical damage in the long run.

Probable Outcome
Bed-wetting may continue for several years. You must rule out urinary-tract infections and juvenile diabetes as causes. If these are eliminated and your child is normal in other respects, consider your child's bed-wetting a minor variation of the age at which bladder control is socially expected.

General Measures

Prepare the bed and the child

  • Protect the mattress with a heavy plastic cover.
  • Provide the child with extra-thick underwear and pajamas.
  • Discontinue diapers by age 4; they inhibit the child's motivation to improve.
  • Put an extra pair of underwear and pajama bottoms by the bed in case the child needs them during the night.
  • Have the child urinate at bedtime.
  • Awaken the child to urinate after he has been asleep for several hours. If the child is old enough, he may be able to set the alarm clock to awaken him and empty his bladder during the night.
  • Reward the child for staying dry. Praise him, hug him, and tell of his success to people who are important to him, such as brothers and sisters.
  • Don't blame, criticize, restrict or punish the child who has wet the bed. This can cause him to give up, or lead to emotional problems. Respond gently to accidental bed-wetting.
  • Follow instructions if your counselor suggests behavior-modification devices.

Medication
Medicine usually is not necessary for this disorder, but your child may be prescribed antidepressant drugs as a last resort. Remember these have to be continued for a minimum of 3-6 months. Patience, more for mothers than children, is need of the day.

Diet
No special diet. Encourage your child to drink as much fluid as possible during the day. Decrease fluid intake during the 2 hours before bedtime.

Contact Your Doctor

  • Your child's bed-wetting continues beyond 4 years of age.
  • Child dribbles urine, has a weak urinary stream, has pain when urinating or must strain to urinate.
  • Child already on prescribed Medication, and new, unexplained symptoms develop.