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Bedwetting

Updated: Jan 19, 2020



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


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


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



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