Ask your parents about your nocturnal habits when you were at your bed wetting child age; you will probably hear the story of how you used to carry your PJ, wrappers, sheets and mats/bed out to spread every morning due to heavy bout of urine you ‘titrated’ them with, over the night. So, that your child you scolded, teased and sometimes abused for bedwetting might actually inherits the habit from you because bedwetting is hereditary. Stop making life difficult for the innocent child. It’s not his or her fault.
Bedwetting is often a normal part of growing up. Most children wet the bed at night until about the age of 3. Parents generally don’t get worried about bed wetting habits of kids until the kids are around age 6.
Though bedwetting is really not a sign of physical or emotional problem for a child, but it can become a big stressor for the child if parents, rather than being supportive to the bedwetting child, result to scolding and spanking as a means of correction on the child. The more you scold the child, the more the child becomes moody, withdrawn, low self-esteemed and stressed-up that triggers more wetting in the night. Scolding or losing your temper won’t make your child stop wetting the bed. It will only aggravate it.
When to get worried
Medical experts say Nocturnal Enuresis (Bedwetting) occur when children urinate without control while they sleep. According to the experts, most children can control their bladder during the day and night by the age of 4. About 10% of children age 6 or 7 still can’t stay dry, as they have day or night-time “accidents.” Nocturnal enuresis is slightly more common in boys than girls. If a child experiences bladder control problem during sleep after the age of 7, it’s worth looking into.
Types
According to the experts, there are two types of nocturnal enuresis.
–Primary nocturnal enuresis: children who never achieved dry nights since potty training (typically these children have no accidents during the day time)
–Secondary nocturnal enuresis: When a child achieved consistent dry nights for at least six months but has now started bedwetting again. Mostly, this type of bedwetting is related to a stressful event (e.g., birth of a sibling, parent divorce, etc.). Eating disorders and some medicines can cause secondary bedwetting.
Apart from the testing, care and treatment for both types, parents have a lot of supportive role to play to help the child out of bedwetting. Before we delve more on these let’s examine some predisposing factors to bedwetting.
Bedwetting Causes
Urology Care Foundation says being lazy or wilful is almost never a reason for a child’s loss of bladder control. In a small number of cases, behavior, it says, may play a role. No matter the causes, parents need to be patient and supportive. Bedwetting is caused by a combination of things:
Family history (genetics)
Bedwetting can be inherited. The “bedwetting gene” is strong among families. Half of all children who have this problem had a parent who also struggled with bedwetting. This percent increases to 75% if both parents had enuresis.
Slow development of brain-bladder control
Children who wet their beds are often described as “deep sleepers.” Deep sleep affects the way the bladder communicates with the brain. Instead of waking up to use the toilet, the child’s pelvic floor muscles relax and empty while the child sleeps. This brain-bladder control will develop naturally over time, or speed up with treatment.
Smaller than expected bladder capacity
Some children who have enuresis have bladders that can only hold a small amount of urine. This condition does not allow the child to sleep through the night without wetting the bed.
Making too much urine while asleep
Your child’s kidneys may make too much urine at night, and the bladder may not be able to hold it all. Normally, the brain produces a hormone called “antidiuretic hormone (ADH)” which slows the kidney’s urine production. It helps make less urine at night. When the brain does not make enough ADH or when the kidney stops responding to it, more urine is produced. The child will either have to wake up several times during the night to urinate or wet the bed. Caffeinated and carbonated drinks may also cause the kidneys to produce more urine.
Type 1 diabetes (insulin dependent diabetes mellitus or “sugar diabetes”) is caused by a lack of the hormone insulin. This hormone helps manage the sugar we get through food and drink. In untreated patients with type 1 diabetes, sugar is lost in the urine. This leads to a great loss of water. Some children with type 1 diabetes may have bedwetting as a symptom at the start of their illness.
Sleep disorders
Some children have sleep disorders such as sleepwalking or obstructive sleep apnea (OSA). With OSA, less oxygen from poor breathing will cause the heart to produce “atrial natriuretic peptide (ANP).” This substance will cause the kidneys to produce extra urine at night.
Constipation
The rectum lies behind the bladder. If constipation causes stool to store in the rectum, it will push on the bladder. This limits the way the bladder can hold urine, causing leaks.
Stress
Any form of stress can lead to bedwetting problems. If the stress from bedwetting itself affects your child or your family, it can make things worse. Children who wet the bed often fear being discovered and teased by their friends or siblings. Emotionally, a child can become withdrawn and nervous. Children with learning disorders or attention problems generally feel more stressed. These children commonly have bedwetting issues. Be aware of social stresses that can affect bedwetting, such as:
- A new brother or sister
- Sleeping alone
- Starting a new school
- A family crisis
- An accident or trauma
Enuresis, that is loss of bladder control leading to inability to control urination can be very embarrassing to the child and even the parents during sleepovers and vacations. While you as parent sort out diagnosis test and treatment with the pediatricians and other care givers, here are some parenting supports for bedwetters.
- Reducing the amount of fluids your child drinks, 1-2 hours before bed
- Creating a schedule for bathroom use (changing toilet habits)
- Wetting alarm devices
- Remember, bedwetting is not the child’s fault. Avoid punishing or teasing your child.
- Encourage regular bathroom visits during the day. Your child should try to go at least 5 times per day and just before bed.
- Your child should have at least one bowel movement each day. Stool should be well formed and soft. Ask your paediatrician how to improve bowel health, if necessary.
- Avoid foods high in sugar, carbonated and caffeinated beverages in children.
- Drinking should take place mostly during the day, just sips 1-2 hours before bed.
- Have your child wear Pull-Ups training pants when your child sleeps outside the home.
- To help manage bedwetting: use a mattress protector, washable/ disposable products and room deodorizers.
- After an accident, wash the child and use petroleum jelly to prevent skin chafing.
- Keep a calendar to write down how well a treatment is working.
Remember that enuresis ends on its own for most children
- Clean Up: Removing the Smell of Urine
- Praise and Reward for Staying Dry
- Involve Your Child in Cleaning Up
Avoid waking up the child from sleep. It does not stop bedwetting.