CHEERS TO LIFE

Tackling your child’s bed-wetting

Pediatric urology problems are some of the most commonly occurring of childhood conditions. Simple problems like undecided testis and hernias are extremely prevalent occurring in 1 out of every 100 boys. Complex urologic problems in children like, posterior urethral valves, vesicoureteric reflux, bladder exstrophy, hypospadias, ureteropelvic junction obstructions and renal transplantation, need specialized surgical training in the care of children and are best done by a paediatric urologists.

Bed-wetting

Toilet training a child takes a lot or patience, time and understanding. Most children do not become fully toilet trained until they are between 2 and 4 years of age. Some will be able to stay dry during the day. Others may not be able to stay dry during night until they are older.

Causes of Bed-wetting

Night-time bed-wetting, called enuresis, is normal and very common among preschoolers. It affects about 40% of three year olds. All of the causes of bed-wetting are not fully understood, but the following are the main reasons a child wets the bed: bladder is not yet developed enough to hold urine for a full night, or child is not yet able to recognize when his bladder is full, wake up, and use the toilet.

Most school-age children who wet their beds have primary enuresis. This means they have never developed nighttime bladder control. Children who are older when they develop nighttime bladder control often have at least one parent who had the same problem. In most cases, these children become dry at about the same age that their parent(s) did.

Dry to wet

Often, a child who has been dry will suddenly start bedwetting again. When it happens it is usually due to stress in the child’s life. Such stress could be due to change, such as a new baby at home, moving or a divorce. If your child wets the bed after having been dry in the past, your pediatrician should do an evaluation. Bed-wetting may be a sign of stress.

Symptoms

Some parents fear their child’s bedwetting is due to a disease or other physical problem. Actually, only about 1% of bed-wetting cases are related to diseases or defects such as Bladder or kidney infections, Diabetes or defects in the child’s urinary system. With any of these cases, there will often be changes in how much and how often your child urinates during the day. Your child may also have discomfort while urinating. Tell your doctor if you see any of the following signs at any age:

·         Unusual straining during urination, a very small narrow stream of urine, or dribbling that is constant or happens just after urination.

·         Cloudy or pink urine, or bloodstains on underpants or nightclothes.

·         Daytime as well as nighttime wetting.

·         Burning during urination.

Tests

If your pediatrician suspects a problem, he/she may take a urine sample from your child to check for signs of infection or other problem. Your pediatrician may also order tests, such as ultrasound of the kidneys or bladder, if there are signs that wetting is due to more than just delayed development of bladder control. On occasion when a child wets day and night then a voiding cystouretrogram is performed if it is necessary.

Managing bed-wetting

Reassure your child that the symptoms will pass. Until that happens naturally, the following steps might help. *Take steps before bedtime. Have your child use the toilet and avoid drinking large amounts of fluid just before bedtime. *Use a bed-wetting alarm device. If your child reaches the age of 7 or 8 and is still not able to stay dry during the night, an alarm device might help. *Until your child can stay dry, put a rubber or plastic cover between the sheet and mattress. *Let your child help. Encourage your child to change the wet sheets and covers. This teaches responsibility. At the same time it can relieve your child of any embarrassment.

Do Medications help?

When no other form of treatment works, your doctor may prescribe medication. The use of medications to treat bed-wetting is used once all other treatment modalities are exhausted. The type of medication that will be used varies on the child and the history of bedwetting.

Parental support

It is important that parents give support and encouragement to children. They should be sensitive to the child’s feelings about bedwetting. Make sure your child understands that bedwetting is not his fault and that it will get better in time. Reward him for “dry” nights, but do not punish him for “wet” ones. Remember, your child does not have control over the problem and would like it to stop, too!

Do not pressure your child to develop nighttime bladder control before the childs body is ready to do so. As hard as your child might try , the bed-wetting is beyond a childs control, and may only get frustrated or depressed because they cannot stop it.

Set a no-teasing rule in your family. Do not let family members, especially siblings, tease a child who wets the bed. If your child has enuresis, discussing it with your pediatric urologist can help you understand it better. Your pediatrician can also reassure you that your child is normal and that he/she will eventually outgrow bed-wetting.