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| Dear
Doc…
"Bedwetting—It’s
Not Worth Losing Sleep Over" Staying dry all night is a milestone that children reach at different ages. While most kids complete daytime toilet training between the ages of 2 and 4, it is not unusual for children to still have accidents at night for several more years. Most children end night-time accidents by age five. When kids continue to have accidents beyond age five, it is called “nocturnal enuresis,” or bedwetting. Bedwetting affects approximately 10 percent of children over the age of five. Although it is more typical in boys, girls can have this issue as well. Most of these kids don’t have anything physically wrong with them—they simply don’t have a big enough bladder to make it through the night, and their body has not yet developed the ability to wake up in response to a full bladder. This condition often runs in families, and kids usually grow out of it without any intervention. How parents respond to bedwetting is important. When handled well, this issue can have little impact on daily life. When handled inappropriately, it can become stressful for families and harmful to a child’s self-esteem. When bedwetting occurs, parents should not scold or punish their children. Instead, treat the event as natural, and downplay its importance. Quickly help change sheets and pajamas, and go back to the normal routine. Parents who insist that an older child wear a diaper at night may cause anxiety and embarrassment. If bedwetting occurs frequently, it is helpful for parents to sit down with their child and discuss a plan of action. Kids should limit the amount of fluid they drink once dinner is over and use the bathroom right before going to bed. If parents are going to bed later than the child, they should wake the child to use the bathroom again at that time. It is fine to use simple incentives, such as a sticker chart, to reward “dry nights”, but there should never be punishment for bedwetting. Parents should tell the child that they understand what is happening and that the child is not at fault. While this plan will help most children, a small percentage will continue bedwetting during their grade school years. Events like sleep-overs and camping trips can cause a great deal of anxiety for these kids. At this point, parents often request medication to help limit bedwetting. Most studies show that medicine is not a good long-term solution, but sometimes will be used for special events. Bed-wetting alarms, which awaken children when they begin to wet during the night, are more useful. These devices teach children to wake up quickly, and 50-75 percent of children who use them can learn to stop bedwetting. Very rarely, bedwetting is a symptom of a medical problem. Parents should contact their pediatrician if their child is also having frequent daytime accidents, as this can mean a problem with the bladder or kidneys. A child who was previously dry at night and suddenly starts bedwetting should also be seen. Other things to watch for include unusual straining when going to the bathroom, spraying of urine instead of a steady stream, discolored urine, or any pain when going to the bathroom. Overall, parents should be assured that bedwetting is common,
manageable, and almost always goes away on its own. A few simple
changes can make things much easier for both the child and the
parents. If you still have some questions, please ask your pediatrician! |
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