Bedwetting in children – what you need to know
As seen recently in the West Essex Life Magazine, Dr Monika Bajaj, Consultant General and Neurodevelopmental Paediatrician (MBBS, MD,DNB, MRCPCH) explains the main things parents need to know about bed wetting in children. You can read the full article here.
What is normal voiding and toilet training?
Normally a child is developmentally ready for toilet training between the age of 2-4 years. Girls are typically ahead of the game in this arena… and bowel control occurs before bladder control. By 5 years of age 90-95% children are fine during the day and 80-85% children continent at night.
What is bedwetting?
A child is said to have bedwetting when they are 5 years or older and wet the bed at night, regularly or intermittently. Some children can have accidents during the day as well as night. This can be due to an overactive bladder but other medical problems such as abnormalities of the urinary tract, spine or constipation need to be explored in this situation. Children with neurodevelopmental problems such as ADHD, autism and learning difficulties are more likely to have delayed maturation and ongoing bedwetting.
How common is bedwetting?
Bedwetting is a common problem and can run in families. Up to 10% of 7 year olds, 3% of 9 year olds and 1-2% teenagers wet the bed. Both boys and girls are affected but approximately 60% of children who wet the bed are boys.
What are the causes?
Current research suggests that bedwetting has three major causes:
1) children who wet the bed find it difficult to arouse themselves from sleep i.e. they are deep sleepers and their brain does not awaken to the sensation of a full bladder
2) many produce too much urine due to less ‘Vasopressin’ a chemical (hormone) that makes us produce less urine in the night and lastly
3) the urinary bladder maybe too “irritable” and contracts too often which results in multiple wet patches through the night.
Some genes can run in families which cause bedwetting and family history is up to positive in 50% cases. So if there is a family history of bedwetting in 1 or both parents the likelihood of bedwetting increases in the child.
Is bedwetting harmful?
The body is not harmed by bedwetting but it must be noted that many children with bedwetting children may suffer from low self-esteem, feel less confident and feel anxious. It is of utmost importance that parents do not blame the child and think they are being lazy or difficult. They must tell the child that it is not the child’ fault.
What can we try at home to stop my child wetting the bed?
Many families try stopping drinks in the evening or lifting the child during the night. These strategies usually do not help. A better idea is to do bladder training. This means that the child should go to the toilet six times per day, drink at least 6 water-based drinks through the day (ideally more than 1 litre of fluids per day). The child should be encouraged to take regular toilet breaks. Preventing constipation is also helpful.
When should parents seek help?
The problem will usually go away by itself, but it may take many years. Its frequency is <1% in adults.
Active treatment is considered usually after the age of 6 years. If a child is not improving with the above simple measures parents can self refer or ask their GP to refer. There are several treatment options available: tablets to reduce bladder irritability, the bedwetting alarm and the drug Desmopressin. The vast majority of the children will become dry by these methods.
Dr Monika Bajaj has clinics at The Holly Private Hospital on Monday and Wednesday afternoons.