Bedwetting

This is a topic that is brought up a lot during routine visits. Bedwetting, or nocturnal enuresis, can be very frustrating for families and embarrassing for kids.

Bedwetting after the age of 5 is considered abnormal, however, if it is only occasional accidents, no further treatment is typically necessary. If it is occurring more than 2-3 times per month, or if the child is older than 6-7 years of age, it is time to make an appointment.

There is evidence that shows bedwetting can be hereditary. “If one parent wet the bed as a child, their child is 44% more likely to do so as well. If both parents had nocturnal enuresis, the likelihood increases to 77%” (National Association for Continence, 2018).

Let’s dig deeper…

There are two types of bedwetting:

A. Primary- this is when your child has NEVER had control over his or her bladder throughout the night.

B. Secondary- this is when your child starts bedwetting AFTER he or she has been potty trained throughout the night for >6 months. This form of bedwetting is sometimes caused by an underlying medical condition and should be evaluated by his or her PCP.

There are a few things that you can try at home to help treat bedwetting:

1. Try and maintain a solid bedtime routine. Kids THRIVE off of routines. Make sure that you are consistent with his or her bedtime, and that using the restroom prior to sleep is a part of that schedule.

2. Try to shield your child from stressors when possible. Big changes and stressors such as moving, divorce, family disruption, arguing, and starting a new school can cause bedwetting.

3. Push the water throughout the day and decrease it throughout the evening hours. I recommend proper hydration from the minute your kiddo wakes up. Try and not offer that large glass of milk RIGHT before bed.

4. Ensure that meals are not salt-heavy and avoid caffeinated beverages.

5. Bedwetting Alarm- this super cool gadget gets attached to underwear or PJs and wakes your child when moisture is sensed.

6. Some providers will advise parents to wake their child a few hours after they fall asleep to use the bathroom. Although this can be helpful, I am reluctant suggesting this bit of advice. Sleep is important and I do not like the idea of disrupting a good night’s rest.

It is essential to avoid punishment for wetting the bed, as this is not his or her fault. To avoid embarrassment, I suggest getting disposable underwear and/or waterproof mattress protectors.

Depending on the situation, there is a prescription medication that can be given prior to bed, called Desmopressin. This medication “turns the faucet off” or decreases the urine that is being produced throughout the night. This is a great option for kids that want to participate in a sleepover, and not have to worry about bedwetting.

If your child continues to have bedwetting issues after visiting his or her PCP, you might be referred to a specialist.

Bottom line…Be supportive. Don’t get discouraged. As always, let your medical team help!

Until next time,

Mandi

References

National Association for Continence. (2018). Pediatric bedwetting. Retrieved from

https://www.nafc.org/pediatric-bedwetting

National Sleep Foundation. (2010). Bedwetting and sleep. Retrieved from

https://www.sleepfoundation.org/articles/bedwetting-and-sleevp

Walle, J., Rittig, S., Bauer, S., Eggert, P., Marschall-Kehrel, D., & Tekgul, S. (2012).

Practical consensus guidelines for the management of enuresis. European

Journal of Pediatrics,171(6), pp. 971-983. Retrieved from https://link.springer.com/article/10.1007/s00431-012-1687-7

Walle, J., Rittig, S., Tekqul, S., Austin, P., Yang, S., Lopez, P.,…Herzeele, C. (2017). Enuresis: practical guidelines for primary care. British Journal of General Practice. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565868/