Nighttime bedwetting, medically described as nocturnal enuresis, is a common problem affecting an estimated 5 to 7 million children in the United States.
Chances are high that your child has a classmate, friend or teammate who also wets the bed. As common as bedwetting is, however, it is a topic that is seldom discussed outside the family.
Bedwetting Facts
Bedwetting is defined as the nightly release of urine in children over the age of 5 or 6. Until this age, bedwetting as a part of toilet training can be perfectly normal. Supportive treatment includes toileting before bed, limiting late evening fluids, waterproof protection for the bed and/or disposable pants. 85% of children will be dry at night by the time they reach the age of 5 years. Others may continue to have bedwetting for a longer time. Each year, 15% of children with bedwetting spontaneously get to dryness. As a parent, the problem lies in not knowing if your child will be in this category, or in the 85% who persistently wet the next year.
We know that bedwetting is inherited. It affects about half of the offspring if one parent had bedwetting, up to three-fourths if both parents had a history. Genetics cannot be changed, but it does help children to know this history about their parents. Remind them that nightly wetting is not their “fault." Historically, bedwetting was felt to be associated with deep-seated emotional problems, but we now know that most of the kids are well adjusted, happy, and just happen to have this embarrassing problem.
Causes of Bedwetting
Mention your child’s bedwetting to his or her health care provider at their 5 or 6 year old check-up. An easy urine test can be done in the office to rule out any serious causes for bedwetting, such as diabetes or urinary tract infection. You may also be asked about associated daytime wetting, new onset of bedwetting, or past history of urinary tract infections. In the absence of any of these things, the majority of children with bedwetting are urologically normal and do not need further testing.
The cause of bedwetting seems to be multi-factorial. Children with bedwetting often have a smaller bladder capacity than that of their same-age peers. Parents also report that their bedwetting children are very sound sleepers. It is often the combination of these two characteristics that contribute to bedwetting. Some research suggests that bedwetting children produce more urine in the nighttime than their peers. Constipation, medications, and food sensitivities can contribute. The incidence of bedwetting decreases as children get older, so there appears to be a developmental or maturational factor, as well.
Whatever the cause, know that children do not wet on purpose and giving parental support is better than punishment or ridicule. Assisting with bedding changes and laundry, reminding your child to go to the bathroom two times before bed, have water be the beverage of choice after dinner, and developing discreet plans for overnight stays are ways that parents can help.
Solutions
When your child voices a readiness for bedwetting treatment or seems embarrassed by bedwetting, there are some effective strategies that can help. The book “Seven Steps to Nighttime Dryness” outlines treatment in detail and is a great parent resource. Research shows that bedwetting alarms offer a simple, permanent cure for bedwetting and are an effective first-line treatment in children over 6 who have nightly wetting.
Bedwetting alarms are moisture sensing devices that are attached to the child’s underwear. When urine is sensed, the alarm sounds to alert the child and parents that wetting is occurring. Initially, children may sleep through the sound so the parent’s role is an important one. Parents go to the child’s room, remind him or her that their alarm is sounding and it’s time to go to the bathroom now. Over a period of a few weeks, the child begins to stop the flow of urine in response to the alarm and has urine left to empty in the toilet. Ultimately, the brain and bladder begin to work together to alert the child to wake up before wetting occurs. Bedwetting alarms do not need a prescription and the best selection can be found online at www.BedwettingStore.com
Other temporary solutions include medication such as desmopressin, which decreases the amount of urine produced that night. Having less urine production will allow some children to sleep dry on the nights that they take the medicine. This can be effective for special occasions, such as camp or sleepovers. Using disposable pants and waterproof bedding continues to be important for these situations.
Effective solutions are available and you no longer have to “wait for your child to outgrow it." Bedwetting treatment can speed up the process of getting to nighttime dryness, allowing your child the freedom to participate in sleepovers when they are ready.
Renee Mercer is a Pediatric Nurse Practitioner, specializing in the treatment of children with enuresis, or bedwetting. She sees children and teens with bedwetting in her private practice, Enuresis Associates, in Elkridge, Maryland. Renee has more than 20 years of experience in pediatrics and developed her interest in enuresis after appreciating the unmet needs of children with this condition.
After years of frustration finding products to treat bedwetting, Renee co-founded The Bedwetting Store a comprehensive online and catalog source for bedwetting alarms and other products to assist children in achieving dryness. Her best-selling book, “Seven Steps to Nighttime Dryness”, was published in 2004 as an adjunct for families who were dealing with bedwetting, but did not know what to do next.
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Nighttime bedwetting, medically described as nocturnal enuresis, is a common problem affecting an estimated 5 to 7 million children in the United States.
