Bed-wetting is also called nighttime incontinence or nocturnal enuresis and it refers to the involuntary urination while asleep after the age at which staying dry at night can be reasonably expected. Bed-wetting can affect anyone, but it’s twice as common in boys as it is in girls.
No one knows for sure what causes bed-wetting, but various factors may play a role including :
- A small bladder – Your child’s bladder may not be developed enough to hold urine produced during the night.
- Inability to recognize a full bladder – If the nerves that control the bladder are slow to mature, a full bladder may not wake your child especially if your child is a deep sleeper.
- A hormone imbalance – During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
- Urinary tract infection – This infection can make it difficult for your child to control urination. Signs and symptoms of urinary tract infection may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.
- Sleep apnea – Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring and daytime drowsiness.
- Childhood diabetes – For a child who’s usually dry at night, bed-wetting may be the first sign of diabetes in children. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
- Chronic constipation – The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bed-wetting at night.
- A structural problem in the urinary tract or nervous system – Rarely, bed-wetting is related to a defect in the child’s neurological system or urinary system.
- Stress and anxiety – Stressful events such as becoming a big brother or sister, starting a new school, or sleeping away from home may trigger bed-wetting.
- Family history – If one or both of a child’s parents wet the bed as children, their child has a significant chance of wetting the bed, too.
- Attention-deficit/hyperactivity disorder (ADHD) – Bed-wetting is more common in children who have ADHD.
Effects of Bed-wetting on Your Child
Bedwetting children should grow up having as normal a childhood as possible and not have to suffer from the shame, guilt, and embarrassment that can lead to low self-esteem.
As a parent, your first step in helping your child is to realize what he or she is going through. Remember that bedwetting is not your child’s fault.
Make informed decisions regarding your child’s health by learning about what you can do for your bedwetting child to help them manage bedwetting and avoid the negative impact it may have on their life.
In a study comparing the stress of significant life events in a child’s life, the distress a bedwetting child feels is comparable to that of trying to get good grades and being teased by others. Only divorce and parental fights ranked higher in terms of stress levels in a child’s life.
Bedwetting can lead to behaviour problems because your child feels guilty and embarrassed. Children who wet the bed may be withdrawn the next morning or feel they have no control over the problem.
In school, they may have lower social skills and performance than other children. A child suffering from bedwetting may exhibit more aggressive behaviour, trouble paying attention in class, and poor self-image.
Bedwetting children are in constant fear of being found out and teased. They dread situations when they must sleep away from home, such as family vacations or sleepovers.
Out of fear of being discovered, many bedwetters are anxious about staying away from home or having friends stay over.
In one study, children who wet the bed were asked what the best thing would be about staying dry all night.
Many answered that the best thing would be being able to have friends stay over at their house or being able to stay over at their friends’ house.
What You Can Do To Support A Bed-wetting Child
Maintain a supportive environment:
A child will be frustrated and embarrassed by bed-wetting. Parents, too, will have their patience tried. Stay calm, and reassure your child (and yourself ) that bed-wetting is a condition that can, and will, be overcome. Let the child know that others (particularly if they are family members) have had the problem but outgrew it.
Praise your child for dry nights:
A calendar with gold stars or other rewards may help. Don’t become angry or blame your child for wetting the bed, and explain the importance of a sympathetic and encouraging home environment to other family members.
Watch your child’s fluid intake at night:
Get him or her to drink plenty of fluids in the morning or the afternoon to stretch the bladder and increase its capacity. Your child can drink fluids at night as well, but not in excess, and should avoid beverages that contain caffeine.
Encourage bladder control practice:
Have your child hold his or her urine for increasingly longer periods during the day—up to 10 to 15 extra minutes. This may help improve bladder control.
Encourage urination before bedtime:
Get your child in the habit of emptying the bladder as much as possible before going to bed. Once in bed, try positive imaging: have the child imagine waking up in the morning with clean, dry sheets.
Consider wake-up breaks:
Some experts suggest setting the alarm for several hours after bedtime and encouraging the child to get up and urinate at that time, though others say this needlessly disrupts the child’s natural sleep cycles. Special bed-wetting alarms that attach to the underwear and that are set off by the first hint of moisture are also available.
Protect your child’s bedding:
To help minimize stress, make cleanup as easy as possible. Use two sets of sheets, with a rubber pad between them, and a plastic cover over the mattress.
Work in partnership with your child:
Have your child assist with tasks like laundering the sheets, making up the bed, putting out a fresh pair of pajamas and a towel before retiring. The job should be fun and not punitive. Involving your child may increase his or her sense of control and help to resolve the problem.
Give your child herbal tea, at least one hour before going to bed. Herbal teas such as lycopodium, ursi, causticum, oak bark, bearberry, pulstilla and wormwood are effective remedies for bed-wetting.