Bedwetting, or nocturnal enuresis, is a common problem for children and adolescents. It is estimated that between five and seven million kids wet the bed. Unfortunately, this can be a source of stress in a family, causing shame and embarrassment in the child and frustration in both parents and child. It is important for everyone involved to understand the causes of bedwetting, and to realize that the child is not being willful or defiant, but simply cannot control it.
Researchers have found a number of causes for bedwetting:
1) Genetics – Enuresis often runs in families. If a parent wet the bed, he should share this with his bedwetting child. The child will often stop wetting the bed at the same age the parent stopped.
2) Small bladder – If a child has a small bladder, she may only be able to hold urine for a short time.
3) Deep sleep – A child who does not wake easily may wet the bed.
4) Poor bathroom habits – Children who put off urinating until they’re hopping up and down may have bedwetting problems. Also, children with infrequent bowel movements may experience added pressure on the bladder, which can cause bedwetting.
5) Hormone issues – If a child’s body does not make enough antidiuretic hormone, the kidneys will produce more urine.
6) Underdeveloped central nervous system – If the child’s nervous system is developing slowly, he may not realize that his bladder is full while sleeping and will not wake up to empty it.
7) Physical abnormalities – Abnormalities in the spinal cord, urethral valve (boys) or ureter (girls) can cause bedwetting.
8) Urinary tract infection – This infection can produce a strong desire to urinate and cause a child to urinate frequently.
9) Diabetes – Children with diabetes tend to urinate frequently.
10) Emotional causes – Enuresis can be caused by stressful situations such as abuse, losing a grandparent, frequent conflict in the home or moving to a new school.
Bedwetting until age five is common, and by the time they reach five years most children no longer wet the bed. For this reason treatment for bedwetting is not recommended before age five, if none of the symptoms of an illness are present. Once they have reached that age, however, there are a number of options available for treatment. A parent should first make an appointment with the family doctor or pediatrician to diagnose the underlying cause of the bedwetting. The doctor may recommend behavior therapy, such as using an alarm to wake the child when the bed becomes wet, or medicine if behavioral treatments are unsuccessful.
The parent should consult a doctor immediately, however, if a child under the age of five exhibits physical or behavioral symptoms in addition to wetting the bed, such as constipation, painful urination, blood in the urine or an urgent need to urinate frequently.
While bedwetting can be a trying problem, parents should be supportive and refrain from making the child feel guilty. Don’t allow siblings or others to tease the child about the bedwetting. Although the child should not be punished for wetting the bed, he should share the responsibility of cleaning up. Limit intake of fluids before bedtime, and make certain the child uses the bathroom before going to bed. Above all, remember that with time most children will simply grow out of bedwetting.
