Eight-year-old Tommy is tired of waking up every morning in a wet
bed. "He is frustrated and his mother is worried, but bedwetting is
not something to panic about," says Dr. Vera Loening-Baucke,
professor of pediatrics at The University of Iowa College of Medicine
and staff physician at UI Hospitals and Clinics.
"Bedwetting is very common, but it is considered a problem when it
occurs in boys over the age of 6 and in girls older than five,"
Loening-Baucke says. Bedwetting, called enuresis, is the involuntary
discharge of urine during sleep. Bedweting affects 15-20% of 5-year
olds, 7% of 7-year olds and 1-2% of adolescents and adults. Boys are
twice as often affected than girls. Primary enuresis is bedwetting in
a child who has always wet the bed. It is considered to be due to
developmental delay. Rarely is a urologic, medical or neurological
abnormality the cause in a child who has primary bedwetting and no
daytime wetting. Secondary enuresis occurs in a child who has been
dry for a period of time prior to the occurrence of bed wetting.
"Bedwetting can be frustrating to the child and parents, causing
feelings of low self-esteem in the child. Just as in potty-training,
never be angry with or punish a child for wetting the bed, he or she
is not doing it deliberately," Loening-Baucke says.
Bedwetting may run in families. Research has shown that if the
father wet the bed as a child, there is a 39 percent greater chance
the child will wet the bed, and if the mother has a history of
enuresis, there is a 23 percent greater chance. If both parents have
a history of bedwetting, there is a 77 percent chance the child will
also wet the bed.
"It has been suggested that some children may have a sleeping
disorder that makes it difficult to awaken them. However, no
scientific studies have explored this theory, " she adds, "and most
children are deep sleepers, irrespective if they wet the bed or not."
In some children, nighttime urine formation is the cause of
bedwetting. Normally, a hormone released at night reduces urine flow,
but this hormone may be lacking in some children, Loening-Baucke
explains.
Whatever the cause, parents have several options to help children
with this problem, Loening-Baucke says. "Try restricting the amount
of fluids the child drinks at night and make sure the child urinates
before he or she goes to bed," Loening-Baucke says. "Self-monitoring,
motivation and responsibility training with charting of successful
nights should be the initial approach. Parents should try to
determine the time of night bedwetting occurs. If parents know when
it is likely to happen, they can awaken the child to urinate."
The next step is to use a conditioning device called a bed-wet
alarm, Loening-Baucke says. "An alarm sounds when the child's pajamas
are wet. The goal for the initial week is for the child to wake up
when the alarm goes off, then the child will wake up earlier and
earlier when the alarm goes off, making the puddle smaller and
smaller, till the child will wake up prior to the alarm going off and
prior to wetting the bed. Three out of four children will be dry
after six months using the bed-wet alarm," Loening-Baucke says.
"If these options fail, your physician may suggest medication,"
she adds, "such as low does antidepressant with effect on bedwetting
or a hormone medication to reduce the urine volume at night. The
hormone treatment can be great for a sleep-over, for camping or
travel."
The outcome is good, 15 percent of children spontaneously outgrow
the bedwetting every year.
For more information about bedwetting, talk to your physician.
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