What is bed-wetting (enuresis)? – Enuresis refers to involuntary or unintentional release of urine on one’s body during the day or at night. In children, nocturnal enuresis (bed-wetting at night) is more common than bedwetting during the day.
Why do children urinate on themselves?
Children commonly urinate on themselves due to poor bladder control during childhood period. Bladder control is gradually and slowly achieved over time; and by age of 5 years, a child is expected to have achieved bladder control. So, when a child urinates on himself / herself repeatedly after the age of 5 years, it is considered abnormal.
What are the causes of bed-wetting?
The following are some of the factors that may lead to bed-wetting, especially at night:
- Developmental delay interfering with toilet training – The may be due to unduly delayed neurological development.
- Poor toilet training.
- Deep sleep.
- Small bladder volume.
- Urinary tract infection.
- Diabetes in children.
- Genetic (if parents, especially the father was affected while growing up, the children may be affected).
- May be voluntary, in which case it may be associated with behavioral or emotional disorder such as anxiety.
- Side effects of drugs, especially those that may cause confusion or behavioural changes.
What is the treatment for bedwetting?
Most cases of bedwetting in children do not require any specific treatment. Children usually outgrow it with time, especially as they grow into teenage years. Treatment may be needed when symptom is affecting the child’s proper functioning, especially his or her self-esteem. Treatment in cases where no particular cause is found consists of behavioural changes such as:
- Reduction in water intake before bedtime – Limit the quantity of water your child takes after dinner. This reduces the quantity of urine the child makes in the night.
- Alarm – Set alarm for the child to wake up and urinate at intervals. This ensures that he or she urinates before the bladder gets full.
- Bladder training – Set specific time intervals in which the child must go to pass urine. You may gradually increase this timing so as to train the bladder to hold urine for progressively longer periods. This progressively increases the capacity of the bladder.
- Rewards – Give the child little reward any night he / she achieves dryness until this becomes regular. This motivates the child to want to achieve more nights of dryness.
- Drugs – Use drugs only if bedwetting is affecting the child’s functioning. These drugs work by either reducing the rate of urine production by the kidneys or increasing the capacity of the bladder to hold urine. They only help the child achieve dryness temporarily (for as long as he / she is taking the drug. Bedwetting begins as soon as they are stopped. However, they may be useful while waiting for the child to achieve bladder control through behavioural changes. It is not encouraged to use drugs for children less than 6 years.
How can bedwetting be prevented?
It is difficult to prevent bedwetting in children, especially those related to child development as it takes time for neurological control of bladder to take place. However, those related to side effects of drugs or disease conditions like urinary tract infection or diabetes can be prevented by prompt identification and treatment of the conditions. Emotional support for children affected beyond the usual age is very important for them to achieve bladder control.