Nocturnal enuresis, or bedwetting as it is generally referred to, is a common problem among children.  An estimated five to seven million children in the United States suffer from this problem. Most children outgrow wetting their bed by 4 years of age. One out of five children in the United States wet their beds until the age of five, only one in 20 wet their bed by age 10 and only few have the problem in their teens. Following factors affect the age at which wetting the bed during sleep becomes a problem:

• Development and maturity of the child.

• The gender of the child: Bedwetting is more common in boys.

• Child’s physical and emotional health.

Children with bedwetting issues are at times considered willful, lazy or disobedient. A child with bedwetting can suffer from low self-esteem and a feeling of failure. It is up to the parent or caregiver to assure the child that it is involuntary and is simply due to the immaturity of the nervous system.  Children outgrow bedwetting after a certain age, however recent developments have made it possible to treat and cure bedwetting sooner.

Understanding Enuresis

Only about one percent of children with enuresis have an underlying disease, the others simply have a weak bladder control. There are two types of bedwetting: primary and secondary. Primary refers to a problem that has been ongoing without a break, whereas secondary refers to bedwetting that starts again after a child has been dry for some time (at least six months). Primary bedwetting can be caused if the child:

• Does not wake up when his/her bladder is full.

• Is not able to hold the urine for a long time.

• Has poor toilet habits during the daytime.

• Produces large amount of urine, especially during the evening and night.

Secondary bedwetting can be caused due to emotional or medical problems like urinary tract infection, diabetes, abnormalities or disease in the nervous system, structural or anatomical abnormality, obstructive sleep apnea and pinworm infection. Bedwetting also runs in families, most children who have a bedwetting problem have a parent who had the same too. Most children stop at the age the parent did.

When to Seek Medical Help?

80 percent of people who wet their beds only do so at night. However, if the child shows some or any of the following problems along with bedwetting then it is time to pay a visit to the pediatrician:

• Dribbling or straining with urination

• Wetting during the day.

• Pinkish or cloudy urine. Blood stains on pajamas or underpants.

• Constipation.

• Soiling, known as encopresis or fecal incontinence.

Self-Care at Home

Following are some tips to help your child stop wetting the bed at night:

• Make the child urinate before bedtime.

• Wake the child up various times during the night to use the toilet.

• Reduce fluids during the night.

• Limit intake of chocolates, carbonated drinks, caffeine or citrus, especially after 3 pm.

• Using a rewarding system might help. Make a chart with stickers and rewards where a certain number of dry nights, or stickers, earn him/her a reward.

• Make the toilet easily accessible to the child during the night.

It is very important for the parent to be supportive and patient. Make sure that other siblings do not tease the child about the problem and avoid punishing or blaming the child. There are moisture alarms and medications available in the market, but they are not a guaranteed cure for bedwetting.

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