Bed-Wetting

Most children are successfully toilet trained between the ages of two and four, and nighttime bladder control follows some six to 12 months later. When children older than five continue to wet the bed, the condition is given a medical name—nocturnal enuresis. The problem is common, affecting up to 15 percent of children between the ages of five and 15. In the vast majority of cases, enuresis does not signal any underlying medical or emotional disorder; it is simply the result of the child's small bladder capacity and ability to sleep deeply. In nearly all cases, the condition is benign and outgrown by puberty.

WHAT CAUSES BED-WETTING?
The reasons for bed-wetting are not completely understood, although the condition seems to run in families. In most cases, no cause is found. It can develop following successful toilet training and a long period of nighttime dryness. This acquired or secondary enuresis is sometimes the result of a stressful situation, such as an illness, the birth of a new sibling or a divorce. More rarely, bed-wetting is caused by an underlying medical condition such as a urinary tract infection or diabetes mellitus. In these cases, however, impaired bladder control will ususally be present during the day.

IS MEDICAL ATTENTION NECESSARY?
Most cases resolve themselves without medical treatment. If the lag between daytime and nighttime control becomes prolonged, however, your doctor can advise a course of action to help your child cope with and curtail nighttime incontinence. If your child has secondary enuresis, your doctor will want to examine him to identify and treat any underlying conditions that may be causing the symptoms.

COPING WITH BED-WETTING

• Use water-proof pads under the sheets to facilitate changing the bed after accidents.

• Lay out an extra pair of pajamas and set of sheets so the youngester can deal with the problem without waking the household.

• Limit before-bedtime drinks.

• Make sure the child uses the toilet before going to bed.

• Wake the child to use the toilet just before your own bedtime.

• Set an alarm to wake the child at some point in the night to use the toilet.

GETTING HELP
Call your doctor if your child:

• Is still wetting the bed after the age of five

• Begins to wet the bed again after a long period of dryness

• Has bladder control difficulty during the day as well as at night

WHAT TREATMENTS ARE AVAILABLE?
Once a medical problem has been ruled out, commonsense measures can cut down on the number of bed-wetting episodes until the child outgrows the problem. The best approach is a low-key one. Praise and reward dry nights, and maintain a calm, reassuring attitude about the wet ones. Resist the urge to scold or return a younger child to diapers, as this will only reinforce feelings of low self-esteem.

A number of prescription drugs are available to provide temporary relief from enuresis. These drugs are usually prescribed for older children who are under a lot of stress or who don't want to be left out of sleep-over parties or overnight trips. A moisture-sensitive alarm connected to the bed can sometimes be used to teach a child to waken before he has passed urine rather than after the bed is wet. However, check with your physician before using this method.

If you suspect that your child's bed-wetting could be a response to anxiety or another emotional disorder, your pediatrician may suggest consultation with a therapist.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.