Bed-wetting in children: When to worry, Parents?

 What is bed-wetting?

Bedwetting is also called nocturnal enuresis; it happens due to the inability of child's bladder to hold urine which results into an involuntary passing of urine after the child is asleep at night. It is a problem or issue when the child can be expected to remain dry for his age.  

• Bedwetting is not a serious problem. It can be seen among children under 7 years of age. Most children get their toilet training accomplished by the age of 5. Although, it is not necessary to develop the urinary bladder control at this particular age. Bladder control is related to the developmental milestones and it differs in each child. Many kids do not wet their beds at a very young age of 3 years whereas there are instances where kids in the age group of 5-7 who wet their beds at night. 
• Bed-wetting is not a major problem, it is a result of development process in children and it usually tends to stop on its own without any special attention. 
• It can be embarassing for the older or teenage child to wake up in wet, soggy pajamas and smell dirty due to the pee. Yellow-stained bedsheets and blankets all make them feel nervous about their incontinence. Many children fear of getting scolded by the parents and they have emotional breakdown every morning. 

When can we consider bed-wetting a matter of concern?

If your child is over 7 years of age, passes urine in bed at least 2-3 times a week and consistently for 3 months consecutively at night during sleep, he is having problem of bed-wetting or nocturnal enuresis. Though not serious, it can actually affect the child's mind and behaviour. 

You need to worry when your kid is older than 7 years and try to help him get rid of this issue as early as possible. If the situation remains unchanged with your home management and continues till your child turns 10 or 12, you need to consult a doctor and seek help. 

Bedwetting can be managed by intricate family support, guidance and behaviour management in children. Scolding and punishing stares do not help your child. Your child needs your support to overcome this condition. 

Is bed-wetting a natural or common thing in children? 

Bed-wetting can be common in children as they have less control over the bladder at night. But if it persists beyond 7 or more years of age, you need to see a doctor to rule out any possible underlying causes of bed-wetting.

What are the symptoms of bed-wetting?

Bed-wetting symptoms are:

• Involuntary passing of urine during sleep.
• Regular pattern of bed-wetting at night
• Twice or thrice a week bed-wetting
• Bed-wetting continues for three months in a row.

See your doctor if your child:

• has pain during urination
• has constant itching on the urethra
• has difficulty passing urine
• Feels unusually thirsty
• has change in the color of urine
• has constipation (passing hard stools)
• feels extremely tensed about this habit and behaves unusual
• Starts to wet the bed after remaining dry for months

What are the causes of bed-wetting?

Bedwetting does not happen due to any exact cause. In many kids it is a normal and common thing and as their bladder mature, they acquire the urinary control.  

Some of the causes may be responsible for bed-wetting:

• Underdeveloped or small bladder
• Immature nervous system that cannot identify the bladder is full.
• Structural abnormalities in the nerves or urinary system.
• deficient production of antiduretic hormone.
• Stress and anxiety or fear of something
• Diabetes in children
• sleep apnea 
• Family history of bedwetting may be a factor. If both or one parent used to wet bed in their young age, it is natural for their kid to do so. 
• History of constipation in child
• Urinary tract infections
• Result of sexual abuse in the child

What is the treatment of bed-wetting?

Bed -wetting usually needs no treatment unless there is any associated medical condition causing it. It is often seen as a part of development in children. It starts and stops naturally on its own in most kids. 

Your child doctor may provide  you helpful tips to manage and stop bed-wetting at home. If these tips fail to improve the situation, your child doctor may prescribe some medications to control the night time urination and slow down the urinary bladder contractions at night.

How to help your child cope up with bed-wetting? What tips can help?

It is possible to cope up with bed-wetting. Your child needs to understand that some changes in the lifestyle can help prevent bed-wetting episodes. 

Common useful tips to control or stop bed-wetting are:

1. Restrict fluid intake in the evening. Explain your child with love and make him habituated to this routine. Children need time to form it a habit. Let it be a gentle approach. 
2. Avoid taking juices or milk at night.  It can produce more urine at night. Tell your child that if they have fluids like juice or milk more at night, they will end up bed-wetting. 
3. Avoid giving any caffeinated beverages to the child in the evening. 
4. Ensure your child has normal bowel movements through the day. Provide high-fibre diet to improve bowel emptying. 
5. Use double-voiding technique before going to bed. Make sure your child empties the bladder twice within some intervals before going to bed.  This ensures the bladder is pretty less contained with urine. 
6. Use of moisture-sensing alarms fitted to the pads in the pyjamas can be worn to help the child get awaken at night as soon as he starts to pee in the pad. The sensor puts on the alarm when it senses the moistness on the pad. The noise can help your child or you to awake and make them go to the bathroom for peeing.  This can form a daily habit of waking up at regular intervals to pee, eventually with no longer need of the alarms.  It may take few months to be successful and you as a parent need to remain patient.
7. Avoid scolding your child when he bed wets. Showing calmness reduces their stress and anxiety and they learn to cope up naturally and faster.
8. Take your child's help and have a separate laundry box for the soiled clothes of your child. Gently teach them to help you in washing the dirty clothes. This technique can prove useful as the child's brain may process the things in a natural manner and he strongly wishes to overgrow bed-wetting anyhow. 
9. Keep extra pair of pyjamas and bedding handy. This can reduce the chaos at night and you may not end up having words with your sleepy child. Use a plastic shield covering over the bed-sheet to prevent soiling. 
10. Talk to your child and put into practice tips to overcome bed-wetting. Family support makes it quite easier to handle bed-wetting in children. 
11. If your child has diabetes, talk to the doctor regarding bed-wetting and continue the diabetes medications as ordered. 
12. Counselling by child psychologist can help if your child has stress, anxiety or fear related issues. Child who has been a victim of sexual abuse should get counselling sessions done to speed up recovery from the mental stress. This can help him cope with bed-wetting in turn. 

Bed-wetting needs attention if there is any underlying medical cause. Talk to your doctor, if the bed-wetting is actually disturbing the life of your children and there are associated unusual physical symptoms. Seek your doctor's help and get useful tips to manage bed-wetting. Bed-wetting usually is not a worry for parents. Take it easy and let your child cope up naturally. Forming habit of lifestyle changes proves to be extremely helpful.