Bedwetting - Nocturnal Enuresis What is bedwetting? Bedwetting is when a child loses control of their bladder at night when they are asleep. It is not caused by Laziness Rebelliousness Sleeping deeply Do not punish your child for something that they cannot control What causes bedwetting? The most likely causes for bedwetting are: Failure to arouse from sleep in response to a full bladder. Child will sleep through wetting. Overactive bladder - this may cause wet pants and frequent trips to the toilet during the daytime. During the night child has multiple wets of variable size and they may wake when wet. The production of more urine at night than the bladder can store - child wets early in the night, large patches, only dry if they wake in the night, weak urine. We also know that fluid restricting in the evening and at night does not stop bedwetting. Constipation can lead to bedwetting. See soiling-encopresis. Bedwetting is rarely due to urine infection, disease or child abuse. Psychological problems are usually the result rather than the cause of bedwetting. About bedwetting Bedwetting is very common in young children. In a class of 30, the age of 5, there will be: 5 or more children in the class wetting their bed at least twice a week. At the age of 7, there will be about 2 in the class. At the age of 10, there will be 1 or maybe 2 in the first year of secondary school, there will be 1. At age 15, there will be 1 child in every two classes who wets their bed. Bedwetting occurs slightly more often in boys than girls. The chance of a child bedwetting is 77% if both parents were late getting dry, 43% if one parent was late and 15% if neither parent had a problem. Bedwetting is not considered a problem until children are about 7 years of age. Treatment programmes can be introduced at this age if your child wants to do something about it. Some children also wet their pants during the day. See Daytime Wetting. What can I do to help? Be patient and understanding and reassure your child, especially if they are upset. Evidence suggests that lifting the child fails to improve the chances of a child becoming dry at night and may encourage them to wet while asleep. Increasing day time fluid intake helps the bladder get used to holding bigger amounts of urine. See Newsletter 23, Guide to fluids. Children worry a lot about their parents getting angry with them and many parents are not aware of this. Parental 'worry' also impacts negatively on the child. Respond gently if your child wets the bed, even if you feel angry. Prepare the bed and your child. See Newsletter 10 on Mattress Protection. Praise and reward your child for staying dry or getting up to the toilet. Avoid any caffeinated drinks before bedtime eg. tea, chocolate, fizzy drink. Get your child to wee before bedtime. Get your child to shower or bath in the morning before they go to school, the smell of urine might embarrass them or lead to teasing. When should I get some professional help? If your child has been dry for over a year and suddenly starts to wet again. If your child is still wetting after the age of 6 or 7 and it is upsetting them. If the bedwetting is causing problems in the family. If your child is wetting during the day. If bedwetting is a concern, you can contact your doctor or the Public Health nurse through the school. What tests are needed? Special tests are not usually needed in bedwetting. The doctor may ask for a lab test on blood or urine to rule out any medical condition if wetting or bedwetting restarts after more than a year of dry beds. Scans or x-rays are not usually required unless there is daytime wetting. You may be asked to keep a diary of your child's wetting and fluid intake for a short while. How is bedwetting treated? There are several ways to treat bedwetting and your child can help decide what may work for them. Children under the age of 7 may not see the need to do anything yet. Bed alarms that wake your child as soon as they wet the bed are a good long-term treatment. They have a 70% success rate when used with support eg Public Health nurse and if your child is keen to become dry. See Bed Alarms for the database. The doctor may prescribe a medicine in the form of a nasal spray for use on school camps or overnight stays. See Newsletter 4 Desmopressin. Treatment of constipation may stop bedwetting in some children. A behaviour modification programme may be started. Your child may be referred to a paediatrician (child health specialist) or a urologist (specialist trained in conditions of the bladder and urinary system). Psychological problems are rarely the cause of bedwetting but teasing, bullying or punishment can be the result of it. Your child may be referred to a psychologist if a problem is suspected. Remember most children grow out of bedwetting. If you have tried one of the treatments when your child was younger and it didn't work, it is worthwhile trying it again don't punish the child for what he can't control. Where can I get more information? New Zealand Websites :- Kidshealth - Offers a range of information on child and youth health. Bedwetting can be viewed at: http://www.kidshealth.org.nz/index.php/ps_pagename/contentpage/pi_id/17 NZCA (The New Zealand Continence Association) - There is a children's continence section on the NZCA website: http://www.continence.org.nz/index.php?mode=display_content&page_id=54 Call free on 0800 650 659 Email: jan@continence.org.nz or Sonja@continence.org.nz Parent to Parent - offers a support service to parents of children with a range of conditions and can put you in touch with parents experiencing similar situations. Website: http://www.parent2parent.org.nz/ Paediatric Society NZ. 2005. - Best practice evidence-based guideline1: Nocturnal enuresis Bedwetting. This 37-page document is aimed at health professionals but may be of interest to those parents who want more detailed information on bedwetting. International Websites Continence Foundation of Australia - Has a children's section on bedwetting: http://www.continence.org.au/bedwetting.html ERIC (Education and Resources for Improving Childhood Continence) - ERIC has a number of leaflets that can be downloaded. It provides information for parents, children and adolescents and for health professionals. Website: http://www.eric.org.uk/ Wetbusters This site has a range of information and interactive pages for children, adolescents, and parents, to help stop bedwetting. It includes games to assist children. Website: http://www.wetbuster.com/ Acknowledgement is given to: The Paediatric Society of New Zealand http://www.paediatrics.org.nz Starship Foundation http://www.starship.org.nz back to top     website by: Coast Computers Ltd - Nelson login