Bedwetting (or sleepwetting) is involuntary urination while asleep after the age at which bladder control would normally be anticipated.
Most children (85-90%) will consistently stay dry by age 6. By age 10, 95% of children are dry at night. Studies place adult bedwetting rates at between 0.5% to 2.3%.
A small percentage (5 to 10%) of bedwetting cases are caused by specific medical situations. Most cases, however, do not have a specific identifiable cause. ( source : wikpedia )
Is bedwetting common?
Enuresis - the medical name for bedwetting - is the involuntary passing of urine and the most common form of bedwetting among children is nocturnal enuresis, ie that which occurs at night.
Frequent bedwetting is common in children up to the age of six. The child should not be put under pressure if younger than six - children do not wet the bed on purpose.
Approximately 15 to 20 per cent of all five- and six-year-olds wet the bed and most of them are boys. With teenagers, the figure is 2 to 3 per cent up to 14 and 1 per cent at 15 or over.
Why do children wet the bed?
Most children who wet the bed have done it all their life and in many cases no reason can be found.
Often it is passed on through the family. Bedwetting also happens, or has happened, to a close relative in up to 85 per cent of cases. About 57 per cent of children who wet their beds either have a brother, sister or a parent who has experienced the same problem.
It may have a medical or psychological cause such as cystitis, diabetes, problems at school, at home, or the divorce of parents.
One explanation could be that these children are heavy sleepers who do not wake up when their bladder is full. Also, some children develop bladder control later than others.
At night, some children produce too little of the antidiuretic hormone (ADH), which controls the production of urine. Tablets containing desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
What can I do to help the child?
Try using a bedwetting alarm which makes a ringing or buzzing sound or vibrates if the child wets the bed. These are successful in curing the condition in 70 per cent of cases.
The alarm is very effective because it makes your child wake up as soon as the first drop of urine hits the underwear or the sheet. Your child is thus made aware that they are urinating and what it feels like when their bladder is full.
There are different kinds of alarms. Some have a copper net which is placed under the sheet. The net is connected to a bell, which will go off as soon as the first drop of urine hits the sheet. Others have a small sensor, which is placed in the pants, and is also connected to a bell.
Do not make the bedwetting a big issue in the family. Most children are embarrassed about wetting the bed, so it will help if the family support the child and show a positive attitude. Don't get angry with the child or punish them if they wet their bed. This could only make matters worse.
Let the child know that many other children do it too. If someone in the family has had the same problem, tell the child about it. Knowing that others have been affected in the same way will help a child deal with the problem.
Make sure the child doesn't drink very much during the two hours prior to bedtime. There is still no guarantee that the child will not wet the bed, but it may help.
Ensure the child goes to the toilet before getting into bed. Protect the bed by using a waterproof mattress, or a fitted waterproof mattress cover under the bottom sheet. This must be fastened securely to prevent any danger of suffocation. Place clean nightclothes and sheets next to the bed so the child can change if they wake up.
Let the child change the sheets; not as a punishment, but in order to learn to deal with the problem. It will also make the child more aware of the situation. If the child is in agreement, keep a calendar or diary and mark dry nights with a star. Praise the child when he or she wakes up in the morning without having wet the bed. Encouragement is often the most helpful way of dealing with the problem.
Some children take longer than others to achieve night-time dryness - initially having maybe one or two dry nights a week and gradually building up the number of dry nights over the following months.
However, if your child is persistently wet every night for a week or two he or she may not be ready to become dry. In this case, as a temporary measure, you may wish to use absorbent night-time pants rather than going back to using nappies. You could then try again in about three to four months.
Many parents have been told to wake the child in the middle of the night and make them go to the bathroom. Studies show that the positive effect of this is almost non-existent, since the child does not wake up by him or herself because of the need to urinate.
It may take weeks or months before there is any change. Training a child will take time, so patience is required from all involved. Most children naturally stop wetting the bed eventually. Do not be embarrassed to discuss further options with your doctor or health visitor if none of the above suggestions appear to be effective.
When should a child be taken to the doctor?
* If the child still wets the bed after the age of six.
* If the child suddenly starts wetting the bed without having done so earlier.
* If the child's urine has a strong smell, or if the child says that it hurts during or after urination.
* If the child starts to wet themself during the day.
* If the child urinates more than usual, day or night.
* If the child has constipation or defecates in their pants.
What will the doctor do?
The doctor will start by asking questions about the child, such as when they learnt to go to the toilet in the daytime. They will probably also ask if someone else in the family has had the same problem. After this, the doctor will examine the child, feeling their stomach and abdomen. Often, the doctor will ask for a urine sample in order to rule out a bacterial infection or cystitis. The doctor may also take a blood sample.
What kinds of medical treatment are available?
If bedwetting is caused by too little of the antidiuretic hormone (ADH), which controls the production of urine, tablets containing Desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.
Imipramine, a tricyclic antidepressant medicine, has been found to be useful in some cases for reasons which are not fully understood.
Based on a text by Dr Bettina Norby
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