Its a nightmare for parents when it comes to managing a child with bedwetting. Also, it gives tremendous psychological stress to a child while coping with the same problem. 

Most doctors consider a bedwetting child to be any girl older than age four and any boy over age five who wet the bed. Bedwetting generally declines with age. About 10% of all six-year-olds and about 3% of all 14-year-olds wet the bed. In a very small number of cases, bedwetting can continue into adulthood. 

There are 2 types of Enuresis:

  • Primary Enuresis: In this case, the child has never been dry at night or only is occasionally dry at night.
  • Secondary Enuresis: Children who have been dry at night for a considerable period of time may have occasional episodes of bedwetting. These are usually related to stresses in a child’s life and clear up on their own.

Three of the more common events likely to cause bedwetting in young children are:

  • Hospitalization
  • Entering school
  • The birth of a sibling

Children can also experience stress from such family problems as divorce, parental alcoholism, financial pressure as well as abuse and neglect. If the symptoms persist, you should consult your child’s doctor because the cause may be a physical problem which may require diagnosis and treatment.

We will discuss here more about Primary Enuresis, as this is the main complaint of parents.

Chronic bedwetting is thought to be related to:

  1. A physically and/or neurologically immature bladder and/or 
  2. A deep sleeping pattern.

 Apparently, these children often sleep so deeply that they are not aware of the message the bladder sends to the brain saying it is full. It is presumed that bed-wetting is an inherited condition. Usually, a parent, aunt, uncle, grandparent or other family members will have had the condition. Also, children with attention deficit disorder, learning disabilities or allergies seem to be more likely to be bed-wetters than children in the general population.

Effect of Bedwetting on the Child and Family: 

Nocturnal enuresis.

By the first grade, most children are embarrassed by their bed-wetting condition. They tend to withdraw from social activities that require sleeping outside their home. They also often suffer from low self-image. These children’s feelings can be greatly affected by the attitudes of their parents, who may feel that their efforts to end the bed-wetting have failed. Parents may also feel frustrated, angry and embarrassed about their children’s bed-wetting condition. Parents can help their children reduce negative feelings about their bed-wetting condition and speed up the process of overcoming it, by offering positive support, understanding and encouragement.

TREATMENT

VERY VERY IMPORTANT to remember,  almost all children outgrow their bedwetting habit. As children mature, their muscles become stronger and their bladder capacity increases. They tend to sleep less deeply and to become more sensitive to messages the bladder sends to the brain. 

There are two approaches to treatment: Medical or Behavioral. The medical treatment usually consists of the use of one of two drugs, which are hardly required if parents have great patience.

Behavioral treatment is often more effective and certainly is safer than medical treatment. While behavioural treatment may take somewhat longer to show results, the improvement usually continues indefinitely. There are several methods that may be helpful:

  1. Control water intake before sleeping: Let the child have 1 glass of water while having dinner, following that, do not offer any liquids and take the child to the bathroom at least 2 times before she /he goes to bed. 
  2. Night Lifting: After baby sleeps, about 2-4 hours later wake up the baby or just lift the baby and make child pass urine in the toilet. And early morning when baby wakes up to make her pass urine in the toilet.
  3. Moisture alarm: Moisture alarms are considered a useful and successful way to treat bed-wetting. Medical research has shown that moisture alarms have helped many children stay dry. This treatment requires a supportive and helpful family and may take many weeks or even several months to work. Moisture alarms have good long-term success and fewer relapses than medications.An alarm consists of a clip-on sensor probe that attaches to the outside of bed-clothing. An alarm is set off when the child begins to wet the bed. The alarm wakes the child, who will then go to the bathroom to finish and then go back to sleep. This slowly conditions the brain to respond appropriately during sleep to messages from the bladder.
WHEN SHOULD PARENTS VISIT THE DOCTOR?
  1. Your child is at least 6 or 7 years old and has never been able to stay dry overnight.
  2. Your child is troubled by wetting the bed–even if the child is younger than 6 years.
  3. Your child was once able to stay dry but has begun bed-wetting again.
  4. You are troubled and frustrated by the bed-wetting.

The learning material is a compilation from internet source ( https://childdevelopmentinfo.com/child-psychology/bedwetting/#.WXCsGISGPIV) and from my clinical experience, for easy understanding by parents.