Bedwetting is part of growing up. Most children aren’t physically mature enough to prevent it until around age three, says Durban GP Dr Deseré Ferreira. The bladder still needs to grow, and they need to develop muscle control over it, and produce enough of the anti-diuretic hormone (ADH) that slows nighttime urine production.
The US National Institute of Health defines bed-wetting as a problem – “nocturnal enuresis” or “nighttime incontinence” – only after age 5 or 6. You should wait until then to get help, unless your child is embarrassed as it affects their social life by preventing sleepovers, or there are other problem signs. Pink or bloody urine, painful urination, extreme thirst, rash or hard stools may indicate a medical condition such as urinary tract infection, type 2 diabetes or severe constipation, says Ferreira.
Also take them to a doctor if they have been dry for six months or more, and suddenly start wetting again. It could indicate stress from a major life change (a new sibling, death of a grandparent, starting a new school), or a medical problem.
The Mayo Clinic reports that 15% of children still wet the bed by age 5, but just 5% do so by age 11. Wetting tends to run in families, and affects twice as many boys as girls. Most outgrow it, but there are steps you can take to help. “There are also medications that can be prescribed, ask your GP to assist,” says Ferreira.
1. Limit liquids
See that children drink plenty of water earlier in the day, but cut down from mid-afternoon.
2. Avoid potential bladder irritants
These include caffeine (which can lurk in chocolate and energy drinks), citrus juices and artificial colorants and flavourings, says Ferreira.
3. Try getting them into bed 30 minutes earlier
Some studies suggest children are then less tired, don’t sleep as heavily, and wake easier when their bladder becomes full.
4. Establish a bedtime ritual
Have them make a trip to the bathroom before changing into pyjamas or sharing a story, and again just before lights-out. If possible, carry them to the loo once more just before you go to bed.
5. Use night lights
Have one in their room, the passage and the bathroom, so they can see without becoming so fully awake that they struggle to get back to sleep.
6. Encourage, don’t blame
Children don’t wet the bed deliberately or from laziness, and anxiety and stress can make the problem worse, Ferreira cautions. Motivate them to take the steps above, and use star charts to reward effort, not just success (dry nights). If you were a bed-wetter, share your stories and reassure them that they will outgrow it; don’t allow siblings or others to tease.
7. Involve them in clean-ups
It can give them more motivation and a sense of control if you get them to put wet pyjamas and sheets in a wash basket, and help you remake the bed.
8. Protect the mattress
Use a waterproof cover, and give your child absorbent pants. Get rid of the smell in bed linen and pyjamas by adding half a cup of white vinegar to your wash.
9. Protect your child’s skin
At bedtime, help them apply a barrier cream to areas likely to get damp, to prevent a rash.
10. Consider a moisture alarm
Attached to mattress or pyjamas, it sounds as soon as it gets wet. It can take from two weeks to three months to make a difference, but persist. Alarms have a 75% cure rate, according to a study in the journal Paediatric Psychology.
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