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 Bedwetting
(Enuresis) |
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| What is Bedwetting (Enuresis)? |
| Enuresis is the medical name for bedwetting, which
is the involuntary passing of urine. The most common form of bedwetting
among children is nocturnal (night-time) enuresis. |
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| Is bedwetting common among children? |
Frequent bedwetting is common in children up to
the age of six. If the child is under six, he or she should not be put under
pressure because of this. It is important to remember that children do not
wet the bed on purpose.
Approximately 15-20 per cent of all five and six-year-old children wet the
bed. It has been found that most of them are boys. Even among teenagers
it has been found that up to one per cent of them experience this problem.
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| Why do children wet the bed? |
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In most cases no reason can be found for bedwetting. Often it is passed
on through the family. It has been found that many children who wet their
beds either have a brother, sister or a parent who has experienced the
same problem.
Sometimes there may be a medical cause such as cystitis or diabetes, or
psychological problems at school, at home, divorce of parents or some
domestic problem at home.
Another 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 anti-diuretic hormone
(ADH) which controls the production of urine. To rule out any medical
problem, a child needs to be examined by a doctor who will then decide
whether treatment is necessary.
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| What can a person do to help the child? |
In western countries and in some places in India,
bedwetting alarms are available which make a ringing or buzzing sound, or
vibrate if the child wets the bed. These have been found to be effective
in curing the condition in 70 per cent of cases. The alarm is very effective
because it makes the child wake up as soon as the first drop of urine hits
the underwear or the sheet. The child is thus made aware that he or she
is urinating and what it feels like when the bladder is full.
In any case a parent should not make bedwetting a big issue in the family.
Most children are embarrassed about wetting the bed. So it will help if
the family supports the child and shows a positive attitude rather than
ridicule the child.
Parents should not show their anger at the child or punish them if they
wet their bed. This could only make matters worse. It is important to help
the child cope with the problem. |
| Here are some simple steps to follow to help a
child overcome the problem: |
- Make sure the child does not drink a lot of fluids within two hours
prior to bedtime. There is still no guarantee that the child will not
wet the bed, but it may help.
- Ensure that 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 (in young children).
- Place clean nightclothes and sheets next to the bed so the child can
change if she or he wakes 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 comfortable with the idea, 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.
- Do not put a nappy on the child at night as this will make the child
less aware of the problem and not teach the child to notice when he
or she needs to urinate.
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| Many parents have been told to wake up their children
in the middle of the night to go to the bathroom. Studies show that the
positive effect of this is almost non-existent, since the children do not
wake up by themselves 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
the doctor if none of the above suggestions appear to be effective. |
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| When should a child be taken to the doctor? |
| When all the above mentioned steps do not control
this problem, A child should be taken to the doctor if the child: |
- Still wets the bed after the age of six
- Suddenly starts wetting the bed without having done so earlier
- Urine has a strong smell, or if the child says that it hurts during
or after urination
- Starts to wet himself or herself during the day
- Urinates more than usual, day or night
- Has constipation or defecates in his or her pants
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| What can a doctor do to correct this condition? |
| A doctor may ask questions to know certain details
about the child, such as the child's toilet habits, whether someone else
in the family had the same problem, etc. Then the doctor will examine the
child, feeling the stomach and abdomen. A urine sample may be requested
for in order to rule out a bacterial infection or cystitis. The doctor may
also request for a blood test. |
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| What are the medical treatments available? |
If bedwetting is caused by too little of the anti-diuretic
hormone (ADH) which controls the production of urine, a doctor may advise
suitable medication.
In some cases Imapramine, an anti-depressant medication, has been found
to be useful, for reasons which are not fully understood.
Whatever the medication, a doctor should be consulted before medical treatment
is contemplated. |
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| This page was last modified on June 27, 2001 |
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