It’s not unusual for children to wet their beds during the period when they’re in the process of giving up nappies and going to the toilet. But what if it happens every night? And what age should the child be before you start worrying?
The scientific word for bedwetting is enuresis, and the condition is divided into two categories – primary and secondary enuresis.
Primary enuresis is when your child has wet his bed every night since coming out of nappies.
Secondary enuresis is when your child has slept dry for six months or more and even woken up at night to go to the toilet – but suddenly begun to wet their bed.
Dr Frans Jacob van Wijk, a urologist at The Urology Hospital in Pretoria, says as long as parents handle the problem correctly they need not worry that bedwetting will cause long-term psychological problems for the child.
The two types of enuresis have different causes. Primary enuresis could mean the child is sleeping so deeply that they battle to wake up to go to the bathroom. “The child might also have a small bladder or an irritable bladder,” says Dr Van Wijk. Another cause may be polyuria, which means they produce urine in excess during sleeping time.
Secondary enuresis could be the result of a bladder infection, constipation or a congenital defect. Some experts believe emotional trauma or stress can cause bedwetting. But Dr RA Campbell, a urologist at the same hospital, says bedwetting is seldom treated psychologically. “Psychological treatment is mostly used supportively.”
Dr Campbell says there are two major factors that are usually the main causes of enuresis. “There is the genetic factor. If one of the child’s parents suffered from it, there’s a 30 per cent chance the child will too. If both parents had it there’s a 70 percent chance.
“The other factor has to do with the child’s development. If a child battles to make it to other developmental milestones they will often struggle to sleep dry by the socially acceptable age.”
When is bedwetting normal?
It’s normal for children to have the occasional little slip until the age of four. According to bedwettingtherapy.com bedwetting tails off after that age. By the age of six only about 15 percent of children still wet their beds. Dr Campbell says if the parents had the problem, the age at which they began to sleep dry can be used as a marker.
What to do about it
Dr van Wijk has the following advice for parents:
- Discuss it with your child and assure them it’s normal.
- Don’t start any treatment until the child is motivated to cooperate.
- Start by giving the child responsibility for small tasks. Get your child to take their wet pyjamas or bedding to the laundry room, remind them not to drink too much fluid at night and to go to the toilet before bedtime. “It must be important to the child to sleep dry. They should be eager to sleep at friends’ houses and attend camps.”
- Reward your child if they go to some trouble to avoid the problem or if there are dry nights.
- Consult an expert if: your child is motivated but there’s no improvement within three months; your child suddenly begins to wet their bed after sleeping dry for six months or more; and if they begin to wet themselves during the day.
An expert could recommend any of the following:
- An enuresis alarm: an apparatus that goes off if a sensor in the underwear gets wet. This stimulates the unconscious to register that the bladder is full.
- Medication to reduce the volume of urine produced at night.
- Medication to relax an irritable bladder.
Don’t . . .
- Force your child to put their bedding or clothes in the wash as a form of punishment.
- Punish your child in any way for wetting their bed.
- Refuse to let your child drink anything after 4 pm for example. “If he’s thirsty let him drink. Limit the amount rather than preventing the child from drinking anything,” says Dr Campbell.
- Wake your child every two hours to go to the toilet. This just disturbs their sleep and yours.
- Make your child wear a nappy until they stop wetting their bed. -
EXTRA SOURCES: www.bedwettingtherapy.com ; www.webmd.com ; kidshealth.org