Bedwetting – Causes and Treatment

Bedwetting – Causes and Treatment

Is your child aged 5 or over still wetting the bed? According to ERIC, The Children’s Bowel and Bladder Charity, bedwetting affects half a million children and teenagers in the UK.  However, a lot of parents are unaware that there is treatment available to help cure this issue.

A child sleeping in his bed with the slogan - Bedwetting – Causes And Treatment

Bedwetting or otherwise known as nocturnal enuresis

The involuntary discharge of urine during the night. The child unconsciously wets the bed during their sleep. Nocturnal enuresis is something that should not be ignored. As the child is getting older, the more distressing and disabling it becomes.

The impact of bedwetting can cause a lot of distress and can continue to affect them as adults. The affected kid/s can have a lower quality of life and more likely to be bullied. There’ll be higher incidences of behavioral and emotional problems and more likely to miss out on education and social activities.

Time may come when bed wetting becomes a problem. A parent’s first port of call should be to see their GP, local health visitor or public health nurse. This is to rule out any medical causes such as a urinary tract infection, diabetes or psychological issues such as stressful life events. The right people can give you a plan for treatment, advice, and support.

Below are some tips to help your child achieve dry nights on a permanent basis. An alarm or medication is not being used for children under 7.

Tips that parents can do to help achieve dryness at night

Encourage your child to drink at least 6 – 8 cups throughout the day with the last drink at least an hour before bedtime.  Avoid fizzy drinks, blackcurrant squash and drinks containing caffeine, i.e. tea, coffee, coke, and hot chocolate as these stimulate the kidneys to produce more than average amounts of urine.

Praise and encouragement

There is research to show some children experiencing bedwetting have lower self-esteem, feel helpless and have feelings of lack of hope and optimism.  It is therefore essential to encourage and praise your child for all efforts they are making regardless of whether they have had a dry night or not.

Night time routine

Ensure your child goes to the toilet the last thing before going to bed.  If the child needs to go again leave a night light on in their room to ensure they have easy access to the toilet.  Leave an extra pair of pajamas and bed sheets nearby to enable a quick change during the night if necessary. Allow your child to help you with changing sheets and nightclothes as becoming actively involved. gives them ownership of their situation.

Reward charts

These can improve motivation and are suitable from the age of 5 years until approximately the age of 10.  There should be an achievable goal and the reward must be of value to the child. Achievements should be given immediately and consistently. Rewards can be achieved by for example drinking enough fluids during the day, going to the toilet just before getting into bed and helping to change the bed sheets or helping with laundry if the child is old enough.

Alarm treatment has a high rate of success and usually cures motivated children aged 7 years and older.  Here I discuss treatment for children aged 7. Body-worn alarms, vibrating alarms, and alarms where the sensor pad is positioned under the child in the bed can be used.  However, they all work under the same principal. Alarms achieve dryness over time by training the child to recognize the need to pass urine and to wake to go to the toilet or to hold on. Assist the child when wet bed sheets or clothes should be changed.

The child will eventually learn to wake up and hold on to the sensation of a full bladder. Without the alarm, a child will be able to sleep right through the night without the need to go to the toilet.  Alarms are more likely to be successful with professional help. Treatment can take 3-6 months for success. Medication will only treat the symptoms but not cure enuresis. Desmopressin is a widely used drug. This works by reabsorbing water into the collecting ducts of the kidneys resulting in a lower volume of urine in the bladder. Enuresis will usually return unless the child has naturally outgrown it.

The role of medication in nocturnal enuresis is mostly as a short-term treatment. It only allows the child to recover their confidence or as a temporary measure for nights away from homes such as school trips or sleep-overs.  It can also be useful as an adjunct to the alarm as a way of easing in the initial week of alarm treatment.

Things that parents should avoid doing to prevent bedwetting or making the situation worse.

a little girl sleeping and dreaming on bed
  • Getting cross or punishing your child.  Firstly it is not their fault, and something which is initially out of their control before treatment has commenced.  This will most likely be counterproductive and make the child feel worse.
  • Positive reinforcement rather than negativity will lead to better results sooner.
  • Waking your child at night to go to the toilet before they have wet the bed. It stops the child from developing an association between a full bladder and the need to wake.
  • It is also important that the child takes responsibility to have dry nights and take ownership of the problem.
  • Using pull-ups or nappies.  The use of pull-ups or nappies in older children will not give any incentive to the child and will suppress any motivation to become dry at night.  It provides a subconscious message that they will at some point have another bedwetting incident.

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