Nocturnal enuresis, also known as bedwetting, is common among children and there are many causes.
1. What is enuresis?
Nocturnal enuresis is the inability to control urination at night while sleeping, after the age of 5-7, which is typically when a person should be able to control his/her bladder. There are 2 types of enuresis, primary and secondary. The most common form is primary enuresis and it refers to children who have never been successfully trained to control urination. Such a person has wet the bed since he or she was a baby and has never been dry for 6 consecutive months. Secondary enuresis refers to children who have been successfully trained to control their bladder and have had no incident during the past 6 months.
According to NAFC, 20% of children still wet their bed by age 5, but less than 5% of kids do so by ages 9 to 12. Bedwetting is more common among boys than girls in a ration 2:1.
2. What causes enuresis?
There are many factors that contribute to nocturnal enuresis and the most common are the following :
- Small bladder – this is a result of slower physical development
- Genetic factors – bedwetting usually runs in the family
- Increased nighttime urine production – related to the antidiuretic hormone, ADH
- Stress and anxiety
- Sleep problems – obstructive sleep apnea is a condition in which breathing is interrupted during sleep. There are also children who sleep so deep that they cannot wake up when they need to pee.
- Infections of the urinary tract
- Sexual abuse
- Abnormalities in the spinal cord
- Diabetes – the body increases urine output in order to get rid of the sugar
3. How can the parents help?
- Limit fluid intake before bedtime
- Have your child use the bathroom before and after sleep time
- Praise the child for dry nights by creating a reward system
- Ask your child to change the bed sheets when he or she wets
- Let your child know that lots of kids have the same problem
- Bladder training: have your child practice holding his or her urine for longer and longer times during the day, in an effort to stretch the bladder so it can hold more urine.
- Avoid criticism and talking about your child’s problem in front of others
- Consult an expert if the problem remains
- Medication in severe cases, after the age of 7
Bedwetting is not the fault of the child and the parents should not punish him/her for it. It is rarely a symptom of an underlying disease so the parents should not be alarmed but instead they should try to help their child outgrow this phase.