What is bedwetting and how is it treated?
The majority of children are able to control day-time urination by the age of three, but often it takes a little longer to gain nighttime bladder control. If your child is more than five years old and wets the bed at night, doctors call it nocturnal enuresis. Nocturnal enuresis means ”involuntary nocturnal urination” also known as bedwetting. Bedwetting is a very common condition that affects children worldwide.
Bedwetting can be divided into two categories; primary and secondary. Children in the primary category have never been dry at night, while children in the secondary category experience involuntary urination during the night. Often, the child has been dry for more than six months and then suddenly starts wetting the bed again.
Causes of bedwetting
The ability to control the bladder varies from child to child, but if your child is more than 5 years old and still wets the bed at night, it probably means that he/she has not yet developed the necessary skills to stay dry at night. Normally, the hormone ADH tells the kidneys that the urine production must be slowed at night. Some children do not produce enough of this hormone, which means their kidneys continue to produce urine at the same rate as during the day. This may be one of the reasons for bedwetting. When your child gets older, they will gradually produce more of this hormone, causing bedwetting to become less frequent, and eventually to stop entirely. Bedwetting can also be caused by psychosocial stress, or have physical causes such as a metabolic disorder like diabetes, external pressure on the bladder caused by constipation, or a urinary tract infection.
No matter the cause, there is no need to worry. Every child develops in their own way and pace. Be patient, supportive, and help your child stay dry and comfortable during the night.
How is bedwetting treated?
The majority of children will outgrow bedwetting without ever needing any kind of treatment. As parents it can be hard to determine whether your child’s bedwetting is something that will pass on its own, or if treatment is needed. The treatment method always depends on the underlying cause of the bedwetting. Therefore it is crucial to get your child examined by a doctor, who, together with you, will decide if and which treatment will be the best option for your child. In many cases treatment might not be necessary at all.
The most common treatment methods of bedwetting are a bedwetting alarm, or medical treatment. The bedwetting alarm is a special kind of alarm that instantly wakes your child when he/she wets the bed. When your child’s sleep is interrupted their brain is forced to control the bladder and thereby prevent further accidents. This method is very effective, but only if your child is ready and motivated to try the alarm device.
The other treatment option is to have the doctor prescribe a drug called desmopressin acetate (DDAVP). DDAVP is made from the hormone "vasopressin” and works by decreasing the volume of urine at night. A pill with DDAVP is given an hour before bedtime for a shorter period of time.
When to take action?
Treatment is usually initiated before your child starts school. Around this age, your child is typically old and motivated enough for the treatment to be a success. You will quickly notice if the treatment is working, as the child’s self-esteem and wellbeing will increase significantly.
We always advise you to contact your family doctor if your child wets the bed at night. The doctor will diagnose your child and talk to you about the different causes and treatment possibilities.
Source: Camilla Vogt Pedersen, international nurse, ABENA.