Bedwetting in Children: Everything You Need to Know as a Parent

Bedwetting (or nocturnal enuresis) is an involuntary leakage of urine from the bladder during sleep, over which a child has no conscious control. Bedwetting is a common childhood problem that causes great distress to many families.

It affects millions of children worldwide, some adults, and elderly individuals.

Bedwetting is typically not considered abnormal or a problem in our modern-day society until after age 7. The rate at which both children and adults get bedwetted increases daily.

According to ancient history, children who were usually bed-wetted were forced by guardians to undergo several punishments.

However, the most interesting story about children’s bedwetting is not a taboo.

Although modern medicine and clinical sciences have proven that there is no exact cure for it, there are also some steps to take to control bedwetting.

Research on this topic has proved that a ratio of 2:1 between boys’ and girls’ bed wet. That means that twice the number of boys wet the bed than girls.

For parents, guardians, or caregivers, this process and time of their child’s life could be exhausting and frustrating.

Night after night, soggy sheets and pajamas are experiences one could wish had disappeared.

Some children who bed wet often experience low self-esteem and stigma, while for some, it is a standard developmental stage.

About two percent of adults experiencing bedwetting have an underlying disease or illness which may require immediate treatment.

How the Body Works?

As the body processes digestion, it removes toxic substances and waste products through the urinary system, which is in charge of making, storing, and removing urine. 

When the kidney cleanses the blood, urine travels from the kidney to the bladder, which is regarded as a holding container for urine. The bladder expands and fills until it becomes full.

Once the body is ready to release urine, the brain sends a signal to the bladder. Then, the bladder muscles contract and push urine out of the bladder through the urethra.

Young infants release urine uncontrolled by a simple reflex. In other words, children urinate when there is pressure on the bladder. But as they grow and mature, not only does their bladder grow with them, but they also gain control over the pelvic floor muscles.

Causes of Bedwetting

As bedwetting is a natural phenomenon that every child experiences, we have to understand what causes it.

1. Abnormality, injury, or disease of the nervous system causing neurological (brain) disorder.
2. Fatigue: The body needs adequate rest. If a child doesn’t get enough rest, he or she begins to behave abnormally.
3. Medical conditions such as urinary tract infection, type 1 diabetes, etc.
4. Genetic: Bedwetting (enuresis) can be inherited. One of your parents may have had the same issue while growing up.
5. Bladder capacity: Your child has too many muscles that prevent the bladder from producing urine, or he/she has a thin bladder that cannot hold a relatively high urine volume. This occurs mostly in teens and some adults.
6. When a child refuses to wake up when his/her bladder is full.
7. When there is an excessive production of urine at night.
8. Slow development of brain-bladder control.
9. Constipation: The urinal and excretory systems share the same muscles. Therefore, when stool is piled up, the rectum puts pressure on the bladder, causing a leak.
10. Caffeine: Regular intake of caffeine causes you to urinate frequently.

How can I deal with this?

If a particular sickness is making you wet in bed, your doctor should give you medication.

The medication works in two ways: it can either help the bladder hold more urine or help the kidneys make less urine.

Most children with bedwetting do not need to take medication, but there are some occasions when it can be useful.

Your doctor can advise you if the treatment is suitable for your child. Such medication includes Minirin, Imipramine, Desmopressin, and Anticholinergics.

It should be noted that not all children respond to medication, and these medicines may have side effects.

However, if your doctor finds no complications in the history and physical examination he has carried out and the urine appears negative, several behavioral approaches can be used for treatment.

• Food and fluid intake: Ensure that fluid intake is increased earlier in the day and reduced later before bedtime. However, try not to take drinks or eliminate the ones containing caffeine, dairy products, carbonated drinks, citrus juices, and artificial flavoring late at night. These include chocolate milk, tea, coffee, and cola. Parents should control how much food they give their children at night. Dinner should be served earlier, possibly from 6 pm to 7 pm.
• Schedule bathroom breaks: Bed wetting normally occurs during the first few hours of sleep. A good prevention method is ensuring your child uses the bedroom before bed. Also, have a regular toilet routine (every two to three hours) and right before bedtime. This also helps in bladder training.
• Easy access to the bathroom: Make sure your child can easily reach the bathroom at night. For example, use a night light in the hall or the bathroom.
• Be encouraging: Motivational therapy is important to the child’s mental well-being. Make your child feel good about making progress. Preserve the child’s self-esteem, as children who experience bed wetting often have low self-esteem and are embarrassed. Talking to your child with positive language, such as becoming “a big kid” when he/she doesn’t use a diaper anymore, is very helpful.
• Be patient: Getting angry, punishing, or making fun of your child for wetting the bed will only worsen the situation. Make sure the other siblings understand this and work hand in hand with you. Be positive about the child’s good and bad nights. Be patient enough to watch your child make progress, even if it’s slow.
• Practice wake-up calls at night: Trying out wake-up calls at night might be helpful. While this might be effective for some, it might not for others. Waking up a child at night for a wee would most likely interfere with his sleep and lead to sleeplessness.
• Deal with chronic constipation: Constipation contributes to bladder problems, especially at night. As constipation problems are resolved, less pressure is on the bladder since the rectum is behind it.
• Keep a record of each night: It can be helpful to keep a record chart of wet and dry nights. Your child should make the chart themselves, as it can be fun. Charts are used to record accidents. This will help your clinician diagnose and treat urinary incontinence.
• Moisture alarm: The alarm consists of a moisture-sensing device attached to the pajamas that wakes the child with a loud or vibrating alarm when your child pees on the bed. However, bedwetters do not always wake up because most are deep sleepers. You can write down your child’s response to the alarm and keep track of his or her progress.

Also, doctors prescribe bedwetting alarms for children with bedwetting issues. These alarms help them wake up on time to avoid bedwetting.

Children who are deep sleepers should be assisted by their parents and siblings in waking them up whenever the alarm comes up.

Conclusion

Conclusively, most children outgrow bedwetting. Parents should stick to being supportive of their children. Bedwetting patients should promptly seek medical advice in order to rule out any complications.