Bedwetting in Children: Causes and Solutions PDF

**[BEDWETTING]** http://mayaclinic.in/patient-education/wp-content/uploads/2013/09/bw.jpg***Bedwetting means urination while asleep and it is very common.Most children stop daytime wetting by about 3 years of age and stop night time wetting by the time they are 5. Most preschoolers still wet their...

**[BEDWETTING]** http://mayaclinic.in/patient-education/wp-content/uploads/2013/09/bw.jpg***Bedwetting means urination while asleep and it is very common.Most children stop daytime wetting by about 3 years of age and stop night time wetting by the time they are 5. Most preschoolers still wet their bed from time to time though.A lot of children grow out of bedwetting by the time they start school, but some primary school-aged children still wet the bed.*** **[CAUSES OF BEDWETTING]: BEDWETTING IS NOBODY'S FAULT. DON'T BLAME YOUR CHILD!!!** - May be your child is a deep sleeper and it is hard for him to wake himself when he has a full bladder. It does not mean that he is lazy and done to get attention rather he has not yet learned how to hold and empty urine well. (Communication between the brain and bladder may take time to develop.) May be your child\'s body makes too much urine at night. Sometimes kidswet the bed will have a realistic dream that he or she is in the bathroom peeing - only to wake up later and discover he or she is all wet. - Constipation is one of the reasons for bedwetting as full bowels can put pressure on the bladder and lead to problems with holding and emptying urine well. - Bedwetting often runs in the family -- you might find that a close relative also did it when he or she was a kid. Just like your kid may have inherited eyes, lips probably he or she inherited bedwetting too. - There can be medical causes which need to be checked by your doctor. A lot of children who wet the bed produce more urine at night than others, because of a low level of a [hormone](javascript:showGlossary(1527);) that controls how much urine is made while they're sleeping. Others have bladders that just can't hold a lot. Your child\'s bladder is small or not developed enough to hold urine for a full night. - Sometimes children stay dry when sleeping in a strange place. This might be because they're worried about sleeping in the strange place, so they sleep more lightly. When they're at home and relaxed again, they often go back to wetting the bed. - Some children bed wets if something happens to make them very stressed; for example, a family issue or starting a new school, etc. In this case, the bedwetting will usually stop when the child feels more secure. ***\ *** **[HOW TO TAKE CARE OF BEDWETTING]** - ENCOURAGE YOUR CHILD to get up to urinate during the night. This advice is more important than any other. Tell your child at bedtime, \"Try to get up when you have to pee.\" - IMPROVE ACCESS TO THE TOILET. Put a bright light in the bathroom. If the bathroom is at a distant location, try to put a portable toilet in your child\'s bedroom. Boys will do fine with a bucket. - ENCOURAGE DAYTIME FLUIDS BUT DISCOURAGE EVENING FLUIDS. Encourage fluid during the day. The more fluids your child drinks, the more urine your child will produce, and more urine leads to larger bladders. Discourage your child from drinking excessively during the 2 hours before bedtime. Give gentle reminders about this. Avoid any drinks containing caffeine. - EMPTY THE BLADDER AT BEDTIME. Sometimes the parent needs to remind the child. Older children may respond better to a sign at their bedside or on their bathroom mirror. - GIVE YOUR CHILD SOME SIMPLE EXPLANATIONS FOR BEDWETTING. For example, 'When you're asleep your brain isn't getting the message that you need to go to the toilet, so you don't wake up'. Or you could say, 'Your bladder, where your wee is stored, hasn't grown enough to hold in all the wee at night, but this will change as your body grows'. - TAKE YOUR CHILD OUT OF DIAPERS. Although this protective layer makes morning cleanup easier, it can interfere with motivation for getting up at night. Special absorbent underpants can be used selectively for camping or overnight stay at other people\'s homes. They should be used only if your child wants to use them and rarely should be permitted beyond age 8. - PROTECT THE BED FROM URINE. Odor becomes a problem if urine soaks into the mattress or blankets. Protect the mattress with a plastic mattress cover. - INCLUDE YOUR CHILD IN MORNING CLEANUP. Including your child as a helper in stripping the bedclothes and putting them into the washing machine provides a natural disincentive for being wet. Older children can perform this task independently. Also, make sure that your child takes a shower each morning so that he does not smell of urine in school. The mattress can be protected with a plastic cover. - RESPOND POSITIVELY TO DRY NIGHTS. Praise your child on mornings when he wakes up dry. A calendar with gold stars or \"happy faces\" for dry nights may also help. - RESPOND GENTLY TO WET NIGHTS. Your child does not like being wet. Most bed-wetters feel quite guilty and embarrassed about this problem. They need support and encouragement, not blame or punishment. Siblings should not be allowed to tease bed-wetters. Your home needs to be a safe haven for your child. **[YOU SHOULD NOT DO ]** - Don't blame, punish, criticise or tease your child, and don't let others do this to her. This can make her tense and anxious and make the problem worse.  - It's not a good idea to make young children clean up after themselves, as they might see it as a punishment for something they have no control over. Children often feel sad when they wake up in a wet bed, and the last thing they want to do is upset you. - Keep in mind that behaviour change programs, such as [star charts](javascript:showGlossary(3907);), won't work because your child can't control the bedwetting. **[ADDITIONAL HOME CARE for 6 YEARS of child]** Follow the previous recommendations in additionto the guidelines given below: - ***Help your child understand his goal.*** - ***Bedtime pep talk about self-awakening. To help your child learn to awaken himself at night, encourage him to practice the following pep talk at bedtime.*** - ***Daytime practice of self-awakening.*** - ***Parent-awakening.*** - ***Encourage changing wet clothes during the night.*** **[ADDITIONAL INTERVENTION FOR CHILD ABOVE 8 YEARS]** Follow the previous recommendations. Talk with us about possibly using enuresis alarms or drugs as well, as described below: - ***Bed-Wetting Alarms*** Alarms are used to teach a child to awaken when he needs to urinate during the night. They go off when they become wet. One type awakens you with a loud noise (buzzer), the other type with an annoying vibration. They have the highest cure rate (about 70%) of any available approach. They are the treatment of choice for any bed-wetter with a small bladder who can\'t otherwise train himself to awaken at night. The new transistorized alarms are small, lightweight, sensitive to a few drops of urine and easy for a child to set up by himself. Some children as young as 5 years want to use them. Children using alarms still need to work on the self-awakening program. Request the special instruction sheet on bed-wetting alarms. - ***Alarm Clock*** alarm clock is angryIf your child is unable to awaken himself at night and you can\'t afford a bed-wetting alarm, teach him to use an alarm clock or clock radio. Set it for 3 or 4 hours after your child goes to bed. Put it beyond arm\'s reach. Encourage your child to practice responding to the alarm during the day while lying on the bed with eyes closed. Have your child set the alarm each night. - ***Drugs*** Most bed-wetters need extra help with staying dry during slumber parties, camping trips, vacations, or other overnight stays. Some take an alarm clock with them and stay dry by awakening once at night. Some are helped by temporarily taking a drug at bedtime. One drug (given by nasal spray) decreases urine production at night and is quite safe. Another drug (taken as a pill) temporarily increases bladder capacity. It is safe at the correct dosage but dangerous if too much is taken or a younger sibling gets into it. If you do use a drug, be careful about the amount you use and where you store the drug, and be sure to keep the safety cap on the bottle. The drawback of these medicines is that when they are stopped, the bed-wetting usually returns. They do not cure bed-wetting. Therefore children on drugs for enuresis should also be using an alarm and learning to get up at night **[STAY POSITIVE]** *Do not be discouraged if one treatment does not work. Some children will respond well to a combination of treatments involving medicines and bedwetting alarms. Also, in most cases, bedwetting decreases as the child\'s body matures. By the teen years, almost all children outgrow bedwetting. Only about 2% to 3% of children continue to have problems with bedwetting as adults. Until your child outgrows bedwetting, your child will need a lot of emotional support from your family.*