While most children are potty trained by the
time they are three to four years old, wetting
the bed at night (nocturnal enuresis) is still
a common problem for many six to eight year old
children (affecting about 8% of eight year olds).
It is more common in boys and in families in
which one or both parents wet the bed as a child.
Bedwetting may be caused by your child having
a small bladder capacity (meaning it can not
hold as much urine as children who do not wet
the bed), not being able to tell when his bladder
is full, or during times of stress. Very rarely
is bed wetting caused by a disease or physical
problem.
Bedwetting is defined as being primary,
children who have never had dry nights, or
secondary, children who are now wetting the
bed, but who had previously been dry for
3-6 months.
Treating Bedwetting
About fifteen percent of children who wet the
bed will mature out of this problem every year,
but until he does, here are some steps you
can take to try and increase the number of
dry nights that he has:
- Reassure your child that this is normal
at this age and not his fault and understand
that he is not doing it on purpose. Also,
do not punish or blame your child for wetting
the bed and make sure that other family
members do not tease him about it.
- Avoid letting your child drink large amounts
of fluid two hours before bedtime.
- Have your child use the toilet just before
going to bed.
- Protect the bed with a plastic cover between
the sheets and mattress.
- Let your child help change the wet sheets.
- Consider practicing bladder-stretching
exercises, in which your child will try and
increase the time between urinating during
the daytime so that the bladder can learn
to stretch and hold more urine at night.
- Consider practicing an awakening routine,
in which you wake your child to urinate two
to three hours after he goes to bed, either
at the parent's bedtime or after setting
an alarm clock
Bedwetting Alarms
If the above methods do not work and your child
is still wetting the bed after he is 7-8 years
old we will consider using a bedwetting alarm
that senses when your child has begun to wet
the bed and sets off an alarm to wake them
up. This helps to teach your child to respond
to a full bladder and this method works in
over 70% of children after two to three months.
One such alarm is the Potty Pager, a self-contained
silent alarm that uses a mechanical vibration
to awaken your child when the alarm senses
wetness. It is available for $49.95 from Ideas
for Living, Inc. Call 800-497-6573 to order
or for more info.
Another type of alarm is the Sleep Dry alarm
that also has a wetness sensor to detect when
your child is wet and then wakes them with
an audio alarm. It is available for $50.95
from StarChild Labs at 800-346-7283.
Medicines for bedwetting
The medicines that are currently available
to treat bedwetting are Imipramine (an antidepressant)
and DDAVP. They both can be effective in reducing
the number of wet nights that your child has,
but they only work as long as your child continues
to use them. They also have possible side effects
and relapses are common when you stop using
them.
In general, we reserve using medicines in select
children when no other treatment works. They
may also be beneficial for your child to take
on special occasions, such as sleep overs,
camping trips, etc.
Important
Reminders
- Be patient. This is a persistent and
frustrating problem, but one that will
usually resolve as your child gets older.
- Call your pediatrician if your child is
also wetting himself during the day, complains
of burning during urination, is losing weight,
has blood in his urine, or if the problem
is affecting your child's self esteem.
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