General Information
DEFINITION--Involuntary urination during sleep that occurs more often than once
a month in girls over 5 and in boys over 6 years of age.
BODY PARTS INVOLVED--Urinary tract.
SEX OR AGE MOST AFFECTED--Both sexes, but more common in boys. The occurrence of
bed-wetting in children is: 15% at age 5; 10% at age 6; 7% at age 8; 3% at age 12; and 1%
at age 18.
SIGNS & SYMPTOMS--Bed-wetting at night. This is not significant until a
child is older than 6.
CAUSES--
In most cases, the cause of bed-wetting is unknown. Following are the most-common
causes or popular theories:
- Underlying illness, such as diabetes or a urinary-tract infection.
- A small or weak bladder that cannot hold one night's urine production.
- Psychological problems caused by stress or separation from the mother.
- Child who is a deep sleeper.
RISK INCREASES WITH
- Diabetes.
- Urinary-tract infection.
- Family history of bed-wetting (44% occurrence if one parent was bed-wetter, 77%
occurrence if both parents were bed-wetters).
- First born child.
HOW TO PREVENT--No effective preventive methods known. Show your child love,
support and understanding.
What To Expect
DIAGNOSTIC MEASURES--
- Your own observation of symptoms.
- Medical history and exam by a doctor.
- Laboratory studies of urine and blood to detect diabetes or urinary-tract infection
(sometimes).
APPROPRIATE HEALTH CARE
- Self-care, bladder exercise.
- Doctor's treatment.
- Psychotherapy or counseling.
- Alarms triggered by wetting.
POSSIBLE COMPLICATIONS
- Child becomes anxious and embarrassed. Psychological and emotional problems.
- Urinary tract infection.
PROBABLE OUTCOME--Bed-wetting may continue for several years. Your doctor will
want to rule out urinary-tract infections and diabetes as causes. If these are eliminated
and your child is normal in other respects, consider your child's bed-wetting represents a
delay in maturing that will resolve with time.
How To Treat
GENERAL MEASURES--
- Prepare the bed and the child: Protect the mattress with a heavy plastic cover. Provide
the child with extra-thick underwear and pajamas. Discontinue diapers or plastic pants by
age 4; they inhibit the child's motivation to improve. Put an extra pair of underwear and
pajama bottoms by the bed in case the child needs them during the night.
- Don't give any liquids to the child for 2-3 hours prior to bedtime.
- Have the child urinate at bedtime.
- Awaken the child to urinate after he has been asleep for several hours. If the child is
old enough, he may be able to set the alarm clock to awaken himself and empty his bladder.
- Reward the child for staying dry. Praise him, hug him and tell of his success to people
who are important to him, such as brothers and sisters. Use gold stars or happy faces to
mark dry nights on a calendar if the child likes it.
- Respond gently to accidents. Don't blame, criticize, restrict or punish the child who
has wet the bed. This can cause him to give up or lead to emotional problems.
- Follow instructions for any bladder-stretching or stream-interruption exercises or
behavior-modification devices.
- Try alarms that are triggered by wetting.
- See Resources for Additional Information.
MEDICATION--Medicine usually is not necessary for this disorder, but your doctor
may prescribe antidepressant drugs or a prescription nasal spray if other methods fail and
the family favors medical treatment.
ACTIVITY--No restrictions.
DIET--No special diet. Encourage your child to drink as much fluid as possible
during the day. Decrease fluid intake during the 2 to 3 hours before bedtime.
Call Your Doctor If
- You are concerned about your child's bed-wetting, and your child is older than 6.
- The child dribbles urine, has a weak urinary stream, has pain when urinating or must
strain to urinate.
- Medication is prescribed for the child, and new, unexplained symptoms develop.
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