Bed-Wetting

(Enuresis)

Definition

Involuntary urination during sleep that occurs more often than once a month in girls over 5 and in boys over 6 years of age. It is more common in boys than in girls.

Signs & Symptoms

Bed-wetting at night (occasionally during the day). This is not significant until a child is older than 6.

Causes

In most cases, the cause of bed-wetting is unknown. The following are the most common causes or popular theories:

  • Underlying illness, such as diabetes or a urinary-tract infection.
  • A small or weak bladder that cannot hold one night’s urine production.
  • Psychological problems caused by stress or separation from the mother.
  • Child who is a deep sleeper.

Treatment

  •  Don’t give any liquids to the child for 2-3 hours prior to bedtime.
  • Have the child urinate at bedtime.
  • Awaken the child to urinate after he has been asleep for several hours. If the child is old enough, he may be able to set the alarm clock to awaken himself and empty his bladder during the night.
  • Reward the child for staying dry. Praise him, hug him, and tell of his success to people who are important to him, such as brothers and sisters. Use gold stars or happy faces to mark dry nights on a calendar if the child likes it.
  • Respond gently to accidents. Don’t blame, criticize, restrict or punish the child who has wet the bed. This can cause him to give up or lead to emotional problems.
  • Follow instructions for any bladder-stretching or stream-interruption exercises or behavior-modification devices.
  • Try alarms that are triggered by wetting. Reports indicate a 70% cure rate when using them.

Medications

An antidepressant (imipramine) or a prescription nasal spray (vasopressin) may be recommended if other methods fail and the family favors medical treatment.

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