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Most children
begin to stay dry at night around three years of age. When
a child has a problem with bedwetting (enuresis) after that
age, parents may become concerned.
Physicians
stress that enuresis is not a disease, but a symptom, and
a fairly common one. Occasional accidents may occur, particularly
when the child is ill. Here are some facts parents should
know about bedwetting:
- Approximately
15 percent of children wet the bed after the age of three
- Many
more boys than girls wet their beds
- Bedwetting
runs in families
- Usually
bedwetting stops by puberty
- Most
bedwetters do not have emotional problems
Persistent
bedwetting beyond the age of three or four rarely signals
a kidney or bladder problem. Bedwetting may sometimes be related
to a sleep disorder. In most cases, it is due to the development
of the child's bladder control being slower than normal. Bedwetting
may also be the result of the child's tensions and emotions
that require attention.
There
are a variety of emotional reasons for bedwetting. For example,
when a young child begins bedwetting after several months
or years of dryness during the night, this may reflect new
fears of insecurities. This may follow changes or events which
make the child feel insecure: moving to a new environment,
losing a family member or loved one, or especially the arrival
of a new baby or child in the home. Sometimes bedwetting occurs
after a period of dryness because the child's original toilet
training was too stressful.
Parents
should remember that children rarely wet on purpose, and usually
feel ashamed about the incident. Rather than make the child
feel naughty or ashamed, parents need to encourage the child
and show faith that he or she will soon be able to enjoy staying
dry at night. A pediatrician's advice is often very helpful.
Parents
may help children who wet the bed by:
- Limiting
liquids before bedtime
- Encouraging
the child to go to the bathroom before bedtime
- Praising
the child on dry mornings
- Avoiding
punishments
- Waking
the child during the night to empty their bladder
In rare
instances, the problem of bedwetting cannot be resolved by
the parents, the family physician or the pediatrician. Sometimes
the child may also show symptoms of emotional problems--such
as persistent sadness or irritability, or a change in eating
or sleeping habits. In these cases, parents may want to talk
with a child and adolescent psychiatrist, who will evaluate
physical and emotional problems that may be causing the bedwetting,
and will work with the child and parents to resolve these
problems. Treatment for bedwetting in children includes behavioral
conditioning devices (pad/buzzer) and/or medications. Examples
of medications used include anti-diuretic hormone nasal spray
and the anti-depressant medication imipramine.
For additional/related
information see other Facts for Families: Problems with Soiling
and Bowel Control (#48), Children’s Sleep Problems (#34).
Article
#18 Updated 5/99
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