Expert tips on dealing with bed-wetting in children

If your child wets the bed, here are some expert tips on how you can manage the condition.

Bed-wetting is a common feature amongst children. While, up to a certain age it is okay for your child to bed the bed, after a certain point it becomes an area of worry. We spoke to Dr. D.K. Guha, Head of Department, Pediatrics, Sri Balaji Action Medical Institute, Delhi, about the problem and how you as parents can help your child overcome it. Here are excerpts from the interview.

Why do children wet the bed?

Bedwetting or nocturnal enuresis, as we scientifically call it, is often accompanied by emotional problems such as acting out. Most of us often mistakenly believe that these psychological problems are the cause of bedwetting. Instead, it happens to children who are a bit emotionally stressed or disturbed because of tensions in the environment around them. Fortunately, it is a common problem, which is treatable.

What can a doctor do to help the child?

We should not take bed-wetting as a mental or behaviorial problem. If a child is younger than 6 years, treatment for bed-wetting usually is not necessary. Although a majority of children who wet the bed are healthy, the family doctor can help you determine whether your child's bed-wetting is caused by a medical problem. First, the doctor will ask questions about your child's daytime and night time bathroom habits, followed by a physical examination to check for the existence of any infection or diabetes. At times, bedwetting happens when a child is emotionally upset. A doctor may need to know about the environment in which the child lives and accordingly decide on a treatment.

How can parents help?

As a parent, it is important to be aware of the fact that bed-wetting isn't your child's fault and punishing them will not solve the problem. Also, you cannot expect an immediate change in them of not wetting their beds, as this being a routine, they would need to practice and develop over time. Parents require a lot of understanding towards their child's needs and limitations. Have your child sleep at the same time every night as this will help in training their bladder to respond at certain times during the night. Parents must keep an eye on what their children are drinking before and after the dinner. In the meantime, they should keep explaining to them that bedwetting is not their fault as a lot of times, kids take it to heart that there's something wrong with them and hence, they end up wetting their beds. There are some parents who tend to hide their child's bedwetting disorder. I would advise that they should rather visit the pediatrician and explain them about their child's symptoms, daily habits, current health, routine and sleep schedule and accordingly, the doctor would prescribe the medications. At night, when kids go into deep slumber and don't feel the sensation to use the bathroom, you can set alarm at regular intervals for night time breaks. This habit of waking up in the middle of the night will become sort of a regular habit gradually.

Is there a cure in psychology that can help? What does it entail?

Definitely, there is a cure for bed-wetting but one should not attempt the management unless the child is willing and above 8 years of age, besides ensuring that the psychological issues and pressures within the family have been ruled out or resolved. Also management of bed wetting issues must be avoided if any stress is anticipated, such as a family move or birth of a sibling. Parents must be reassured that it is a developmental issue and their child is not lazy or refractory. Therefore, they must avoid punishing, embarrassing and shaming the child or become too much aggressive in their approach. Instead, involve the child in a treatment plan. Contact their school principal or class teacher for assistance. One may try behavioral treatment like;

Pad and Bell Technique: This is an reminder and behavioural treatment for children who wet the bed often. In this technique a sensor is place either in the child's clothes or bed which beeps an alarm when it gets wet. This in turn wakes the child, who can then go to the bathroom to relieve himself. In the long run, this helps train the child to go to the washroom when he wants to urinate.

Sleep Dry Alarm: This is another alarm system that works the same way as the Pad and Bell technique and alerts the child when he passes urine. Being more sensitive to moisture, this alarm sounds off and trains the child's body to sense a full bladder. According to the manufacturers this technique takes about three weeks to work.

Bladder Stretching Technique: This is where you help your child improve the amount of time he can control the urge to urinate. Done over a period of time, this technique involves asking your child to control the urge to urinate for a particular period of time, increasing the number of minutes he can control himself. This eventually leads to him not wetting the bed.

When does bed wetting become an issue of concern? When do parents need to seek a doctor's assistance?

When bed-wetting occurs with daytime wetting followed by bowel problems, it becomes a sign of a serious problem. In certain cases, bed wetting can end up in urinary infection. It is necessary to consult the doctor in such situations immediately and get the urine tests done. Meanwhile parent should seek consultation from a medical specialist if their the child experiences any of these conditions like diurnal enuresis, dribbling (leakage of urine without the child's knowledge), identification of significant psychological problem or child abuse, urinary tract infection, genitourinary abnormality, failure to improve with adequate trial of bladder retention or behavioral conditioning, Diabetes insipidus / mellitus etc.

Does this condition often resolve on its own?

Bedwetting in children is a common problem especially for children below the age of 4. The causes may vary depending on the factors such as genetics, bladder control, deep slumber, constipation and hormones. No matter whatever is the cause, a majority of times, bedwetting eventually resolves on its own.

What physical conditions can lead to bed wetting?

Medical conditions which can manifest as enuresis are myelomeningocele, mental retardation, Urological lesions or anomalies, Diabetes mellitus etc.

Image source: Getty Images

---

For more articles on children's health, visit our children's health section. For daily free health tips, sign up for our newsletter.