Bedwetting

Night time wetting is one of those problems talked about frequently when it relates to toddlers but rarely when it comes to school age children and even less when it’s a teenage issue.

But the problem is out there and it’s more common than you may think.

While most children are dry at night by around 3 years, 10% of 5-year-olds are regular bedwetters. If a 5-year-old is distressed about wetting it may help him to know that there are probably two more children in his class who also wet at night even though they are unlikely to let their friends know.

Night wetting – or enuresis – is more common in boys than girls. It is quite rare in teenagers, but it does occur. The first step is to make sure that there isn’t a medical reason for the problem, or some other source of anxiety that may be causing the child to wet. If those things have been discounted, time will be the answer.

Most parents who have been through this problem and have tried all the “cures” say that, in the end, maturation takes care of it – it just takes some children longer.

What causes bedwetting?

• It tends to run in families (it may help your child to know if this was a problem for his/her parent)
• Deep sleep – difficulty waking up
• A slower than normal development of the central nervous system that reduces the child’s ability to stop their bladder emptying at night
• A reduced level of antidiuretic hormone which reduces the amount of urine made by the kidneys
• Urinary tract infection
• Abnormalities in the urethral valves or ureter, or the spinal cord
• Small bladder.

This last factor is thought to affect up to 85% of children with night time enuresis.

What treatments are available?

Most children grow out of it without treatment but there are some practical solutions that can help:

• If your child has a small bladder it can help to encourage them to drink more during the day (preferably water because sugared drinks can irritate the bladder) and to practise holding their urine for longer and longer periods.
• Some parents have found hypnosis to be very effective.
• Some children are helped by an alarm system. The alarm sounds when the child starts to wet and teaches them to respond to bladder sensations.
• A reward system for dry nights may encourage younger children.
• Your doctor may suggest some medicines for older children if other methods haven’t worked.

Strategies on how you can help

It’s important your child doesn’t feel guilty about something he/she can’t control. A school aged child may feel embarrassed about wetting and be reluctant to spend the night away from home especially on sleepovers, school camps etc.

Have a private face-to-face discussion with your child in order to elicit his/her feelings, acknowledge those feelings, and reassure that you’re there to help and support your child.

For camps, one option is to put a pull-up or dry nites pants in the child’s sleeping bag for them to wriggle into after lights out. Put a plastic bag in their toilet bag for them to dispose of the pants in the morning. Let a teacher or parent on camp know about the possibility of wetting and let your child know who to go to if they have concerns while away.

When staying overnight with a friend, put a pull-up in the child’s toilet bag and tell them to take it with them to the toilet at bedtime to put the pants on in private. The plastic bag system in the morning will work here too.

Where can you find more information?

A national organisation to support families in NZ who have children with wetting and soiling problems has been set up by parents and health professionals working in this field.

The KEEA (Kiwi Enuresis Encopresis Association) Trust was set up in 2001. Enuresis is the medical term for bedwetting and encopresis the medical term for soiling. They have regular newsletters with helpful tips and information for families.

You can find out more on this link.

Or check out www.continence.org.nz or the bladder helpline 0800 650 659.