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Parenting

Bedwetting Causes and Coping Tips

2:00

Most children will go through a bedwetting stage and though some kids get through it rather quickly, others take longer before they have consistently dry nights.

Bedwetting can also be a symptom of an underlying disease, but not typically. In fact, an underlying condition is identified in only about 1% of children who routinely wet the bed.

Bedwetting is not only difficult for the child, but it can strain a parent’s patience as well. It’s important to remember that a child that wets the bed doesn’t do it intentionally. Children who wet are not lazy, willful, or disobedient. Bedwetting is most often a developmental issue.

Did you know that there are 2 types of bedwetting? They are called primary and secondary. A child with primary bedwetting has episodes of bedwetting on a consistent basis. Secondary bedwetting is bedwetting that starts up after the child has been dry at night for a significant period of time, at least 6 months.

So, what causes primary bedwetting? It’s usually a combination of factors:

  • The child cannot yet hold urine for the entire night.
  • The child does not waken when his or her bladder is full.
  • The child produces a large amount of urine during the evening and night hours.
  • The child habitually ignores the urge to urinate and put off urinating as long as they possibly can. Parents usually are familiar with the leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine.

Secondary bedwetting may occur because of an underlying or known medical condition or emotional problems. The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting.  Reasons for secondary bedwetting can include:

  • Urinary tract infection: The resulting bladder irritation can cause severe pain or irritation with urination, a stronger urge to urinate, and frequent urination. Urinary tract infections in children may indicate another problem, such as an anatomical abnormality.
  • Diabetes: People with diabetes have a high level of sugar in their blood. The body increases urine output to try to get rid of the sugar. Having to urinate frequently is a common symptom of diabetes.
  • Structural or anatomical abnormality: An abnormality in the organs, muscles, or nerves involved in urination can cause incontinence or other urinary problems that could show up as bedwetting.
  • Neurological problems: Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.
  • Emotional problems: A stressful home life, as in a home where the parents are in conflict, sometimes causes children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting. Children who are being physically or sexually abused sometimes begin bedwetting.

If your child suddenly begins to wet the bed after months or years of dry nights, talk to your child about it and your pediatrician. Your doctor may want to do an examination and bloodwork to rule out any health conditions. 

Most children do not stay dry at night until about the age of three.  And it's usually not a concern for parents until around age 6.

Bedwetting can be embarrassing for children. Be supportive and reassure your child that they won’t always wet the bed. Bedwetting often runs in families. If you want to share your own personal story, your child may see that people do outgrow it.

To help your child make it through the night dry, make sure he or she isn’t drinking a lot of liquids before bedtime. Make using the bathroom just before they get in bed part of a bedtime routine. Also remind them that it's OK to get up during the night to use the bathroom. Nightlights can help your child find his or her own way when they need to go.

Some parents wonder if they should wake their child up during the night to go. That’s a personal choice, however, keep in mind that if you deprive your child of rest and sleep, you may increase his or her level of stress. Stress can be a bedwetting trigger. Some children may also have a difficult time getting back to sleep once woken.

If your child wets the bed, you might consider getting a plastic bed cover to help protect the mattress.

If accidents do happen, try these tips to remove the smell and stains from linens, clothes and the mattress.

  • Try adding a half-cup to a cup of white vinegar to your wash to remove the smell from their sheets and clothes.
  • If you need to clean urine from a mattress, first use towels to blot up as much as you can.
  • Once you've blotted up as much of the urine as you can, saturate the entire area of urine stain with hydrogen peroxide. Let it stand for 5 minutes, and then use towels again to blot the area dry.
  • Once the mattress is dry, sprinkle baking soda over the entire area and let it stand for 24 hours. The next day, vacuum the baking soda away. It should be clean and odor free.

Bedwetting is one of those stages that kids go through that some day will just be a memory. Until then, reassure your little one that this too shall pass. Praise your child when they make it through the night without wetting the bed and let them know that if an accident happens, it’s OK – we’ll try again tonight.

Story sources: http://www.webmd.com/sleep-disorders/guide/bedwetting-causes#2

http://www.webmd.com/parenting/ss/slideshow-bedwetting

 

Daily Dose

Treatment Strategies for Bedwetting

1.15 to read

I receive quite a few emails daily and many have to do with bedwetting. The best way to attack the problem of bedwetting begins when you and your child have had a discussion about their feelings related to bedwetting. This often happens as they get older and continue to have problems with bedwetting and they are anxious or embarrassed. If you bring up the subject and they would rather just wear a pull up at night, and go back to playing outside rather than discuss strategies for staying dry, it is not time to tackle the issue. Timing is everything! As you start to discuss strategies to stop bedwetting, begin with having your child keep a calendar of their dry nights. This gets them involved and gives you an idea of their level of commitment. Then start setting their alarm clock to awake them in the morning and see if they can get up on their own. If the alarm doesn’t wake them up for school it is probably not going to awaken them in the middle of the night. Remind them to recognize their need to go to the bathroom during the day too, and have them go every several hours to feel the sensation of their bladder filling throughout the day. Many of these kids are infrequent voiders during the day and have actually stretched their bladder wall and hypertrophied the bladder muscle. Lastly, make sure that they are not constipated and put them on something like Miralax to ensure that they do not have stool that also compresses the bladder (the colon sits right above the bladder and can push on the bladder). Talk about a reward system that they would like to use while working on the problem. It doesn’t have to be a major reward, small things work equally well. I think the rewards should be given by the week, rather than the day. I also give rewards for effort, not just for dry nights. Trying is the whole idea. Sometimes the brain and bladder are just not ready and you do not want your child to feel defeated even though they have tried their hardest. If all of this is successful it is then time to set up a “bedwetting alarm system” (numerous ones available over the internet). The alarms consist of a bell and pad. The alarm sounds when the pad senses moisture. The alarms that actually buzz are more effective than those that only vibrate. Remember, your child is already hard to arouse and vibration alone will probably not work. Once you begin using the alarm and you hear the alarm go off, you will need to go into their rooms and call their name or shake them too, to actually get them awake and to the bathroom. In the beginning it may almost be like sleep walking them to the bathroom. Then rinse off the pad and reset the alarm and put them back to bed. Over time they should arouse more easily and the time spent awake and going to the bathroom should shorten. As you can see this is disruptive to everyone’s sleep so best done over the summer or a long winter break. It often takes at least a month for bedwetting to stop and the alarm system should really be used for several more months to reinforce the process. There is also a drug call DDAVP that works on the kidneys to reduce the flow of urine. This medication works when given but does not “cure” the problem. I often use this for children who are worried about a camp or overnight experience, before they have started the alarm system regimen. It has not been shown to be as effective as the alarm system, but in difficult cases I have used it in conjunction with the alarm system. You might want to discuss the pros and cons of this drug with your pediatrician. Remember this takes time, motivation and determination on both the parent and child’s part. Remain positive and optimistic throughout the training process. It is not a sprint but a longer race, and don’t expect overnight success. Remind them of their other childhood accomplishments and that with time and determination they will be successful with bedwetting too. That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Parenting

Bedwetting Accidents

1:45

I’ll admit it; I was a bed-wetter on and off until I was about 6 years of age. The biggest hurdle I faced in getting past leaving a little puddle of urine in the bed during the night, was visually realistic dreams. I would actually see myself get out of bed, walk to the bathroom and sit on the toilet. Unfortunately, I was only dreaming and would awaken after feeling a wet spot in the bed. It was quite embarrassing.

An accident in a friend’s bed during a sleepover was the last straw.

It took several pre-bedtime experiments to finally help me make it through the night dry; but eventually I was able to tell reality from dreams.

How common is bedwetting? Nocturnal enuresis (the medical name for bedwetting) is involuntary urination that happens at night during sleep after the age when a child should be able to control his or her bladder.

About 13 percent of 6 year olds wet the bed, while about 5 percent of 10 year olds.

Bedwetting sometimes runs in families – if one or both parents wet the bed when they were children, odds are that their children will too.

Most of the time, bedwetting goes away on its’ own. Until that time, it can test a parent’s patience and cause a child plenty of anxiety.

To help a child cope with this uncomfortable time, reassure your child that bedwetting is a normal part of growing up for many kids, and that it will not last forever. If you have stories of your own experiences, this would be the time to share them with your little one.

My child also wet the bed and one sure way to stop her tears of embarrassment was to tell her one of my own personal experiences.  It didn’t take long to switch from sobbing to laughing over our shared nighttime horror.

Kidhealth.org offers these tips for breaking the bedwetting spell:

- Try to have your child drink more fluids during the daytime hours and less at night (and avoid caffeine-containing drinks). Then remind your child to go to the bathroom one final time before bedtime. Many parents find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

- When your child wakes with wet sheets, don't yell or punish. Have your child help you change the sheets. Explain that this isn't punishment, but it is part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.

Sometimes, bedwetting can be a signal that there is a medical condition that should be checked out. If it begins suddenly or is accompanied by other symptoms, talk to your pediatrician.

The doctor may check for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes, or severe stress.

Call the doctor if your child:

•       Suddenly starts wetting the bed after being consistently dry for at least 6 months

•       Begins to wet his or her pants during the day

•       Snores at night

•       Complains of a burning sensation or pain when urinating

•       Has to pee frequently

•       Is drinking or eating much more than usual

•       Has swelling of the feet or ankles

•       Is 7 years of age or older and still wetting the bed

Bedwetting can be a sign that a child is under a lot of stress. Often, when a child loses a family member or pet, is doing poorly in school or is frightened about something, they will suddenly start wetting the bed – even if they’ve never done it before or have mastered the art of getting through the night dry.

Your support and patience can go a long way in helping your child feel better about and overcome the bedwetting.

Remember, the long-term outlook is excellent and in almost all cases, dry days are just ahead.

As for me, I had to find a touchstone to let me know the difference between dreaming and actually getting up to go the bathroom. It was the bathroom light switch. If I actually touched the light switch and turned it on, then counted to five before moving, I was really awake. If the light was already on and I walked to the toilet and sat down- I was dreaming.

Story source: http://kidshealth.org/en/parents/enuresis.html#

 

 

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