When is it a problem?
by Healthy MOM™ Dr. Ilana Dickson, Samaritan Pediatrics
Physician
For many children, bedwetting is not uncommon. Although most
children are potty trained overnight by 5 years of age, 15% of them
will still have trouble keeping their bed dry and rates among
children 15 years and older can be as high as 1 to 2%. And this
problem is exhibited more in boys than in girls.
Most reasons for bedwetting are benign and will resolve with
time. However, waiting for this to happen can be challenging. Both
parents and children can be filled with anxiety as they wonder if
something is seriously wrong. It can be socially embarrassing as it
may keep children from going on sleepovers and families from going
on vacations. And let's face it, who wants to be washing sheets on
a regular basis? On the more practical side, it is a major
inconvenience and nuisance.
The majority of bedwetting can be attributed to one or more of
the following:
- Your child's bladder is maturing more slowly than usual
- The amount your child's bladder can hold is smaller than
others
- Your child has difficulty waking from a deep sleep
- There is a strong family history of bedwetting
- Vasopression (a hormone that helps hold urine) is
decreased
Less commonly, bedwetting can be associated with medical or
emotional problems. Medical problems can include, but are not
limited to: diabetes, constipation, urinary tract infection, pin
worms or kidney disease. Emotional problems are usually due to
psycho-social stress factors in the home or at school. Medical and
emotional problems can be diagnosed by a physician, however these
serious conditions are by far the minority of the root cause of
bedwetting.
The following points are things you may try at home:
- Talk with your child about this and encourage him/her to get up
out the bed if he/she feels the urge to go to the bathroom
overnight
- Make sure your child wears clothes that are easy to maneuver
overnight if he/she gets up to go to the bathroom i.e.
undergarments that pull off easily
- Make the path to the bathroom easy and accessible with proper
lighting as needed
- Make sure your child uses the bathroom before bed
- Restrict your child's fluid after dinner
- Protect the bed with a waterproof sheet to avoid a mattress
that smells of urine
- When your child does wet the bed, simply place a towel or two
on the wet spot thus avoiding the changing of sheets in the middle
of the night
- Include your child in the morning clean up of the soiled sheets
as part of a daily routine and maintenance
- Never tease or allow siblings to tease your child about this
problem
- In an effort to "goal-motivate" your child, create a calendar
of stickers to represent dry nights and offer a reward after a
certain number of dry nights
Other modes of treatment may be tried in conjunction with your
physician and include bedwetting alarms, medications, talk therapy
as well as number of alternative therapies.
If you are the parent of a bed-wetter, remember that this
problem is one that in most cases will resolve over time and
require minimal to no intervention. It is also important that you
remember how common this problem is -- this may be especially
difficult when you observe that your 3- or 4-year-old is dry at
night but your 5- or 6-year-old is not.
For more information please go to the American Academy of
Pediatrics at www.aap.org/healthtopics/toilettraining.cfm.
*Information in this article obtained from an "UpToDate" review
article called: Bedwetting in Children, May 2009.
Healthy MOM™ is brought to you courtesty of
Samaritan Health Services.
