Bed wetting

Nocturnal enuresis popularly known as bed-wetting, is involuntary passing of urine while asleep after the age at which staying dry at night can be reasonably expected. Day time control of passing urine is usually the first to be achieved followed by night time control.

Although the exact cause of bed-wetting is unknown, various factors may play a role such as:

  • A small bladder. The child’s bladder cannot yet hold urine for the entire night whole some children may have a smaller bladder than their peers.
  • Poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can.
  • The child produces a large amount of urine during the evening and night hours.
  • Excessive fluid intake.
  • Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child — especially if your child is a deep sleeper.
  • A hormone imbalance. During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
  • Family history. If one or both of a child’s parents wet the bed as children, their child has a significant chance of wetting the bed, too. Most of these children stop bedwetting on their own at about the same age the parent did.
  • Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.

Secondary bedwetting
While primary bedwetting occurs since infancy, secondary bed wetting occurs after being dry for at least six months and can be a sign of an underlying medical or emotional problem. Talk to the doctor for these common causes of secondary bed wetting which may be as a result of an underlying condition or problem that needs medical attention.

  • Stressful events such as sexual abuse, becoming a big brother or sister, starting a new school, or sleeping away from home may trigger bed-wetting.
  • Urinary tract infection. Physical symptoms such as painful urination, pink or red urine and hard stools can also cause lower abdominal pain. It can indicate an anatomical abnormality problem.
  • Structural or anatomical abnormality in the organs, muscles, or nerves involved in urination can cause urinary or incontinence problems that manifest themselves as bedwetting.
  • Diabetes is characterized by peeing frequently and unusual thirst. The body increases urine output as a consequence of excessive blood glucose levels.
  • Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep — often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring and daytime drowsiness.
  • Chronic constipation. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bed-wetting at night.
  • Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.
  • Pinworm infection is characterized by intense itching of the anal and/or genital area.

What you can do to help your child.
Despite an embarrassed kid, soggy sheets and pajamas, bed wetting is often a natural part of development, and the wetters usually grow out of it. However, the problem can last into the teen years. Parents, caregivers, siblings or people around the child need to be patient and understanding. The child needs to be reassured that bedwetting is a normal part of growing up that’s not going to last forever. It may comfort the child to hear about any other family members who struggled with it when they were young.

Besides letting them know that lots of kids have the same problem, ensure that the children’s siblings or friends do not tease them about wetting their beds. Children should be encouraged to drink more fluids during the daytime hours and less at night (and avoid caffeine-containing drinks). They should be guided to observe toilet times and even go to the bathroom one final time before bedtime. The kids can be woken up at night to use the toilet or potty. Those who have used bedwetting alarms say they can be helpful. The alarms work on the premise of waking a child if the wetness sensor detects urine.

Punishment or yelling shouldn’t be a solution when your child wakes up with wet sheets. Perform chores of cleaning up and making the bed with them. It may help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night. You can try a simpler measure by ensuring the bed has a waterproof mattress cover or pad. Lay fresh pajamas by your little one’s bed for a quick change in the middle of the night.

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