By Dr. Angelo Gousse,
Bed-wetting also called nighttime incontinence or nocturnal enuresis characterized by involuntary urination while in deep asleep after the age at which staying dry at night can be reasonably expected. Beds soaked with urine, soggy sheets and pajamas and an embarrassed child are a familiar scene in many homes. Unfortunately, in the Haitian culture, some children are punished, humiliated, or even spanked.
Parents please do not despair. Do not punish the children, since the problem is a medical condition. The children are not doing it on purpose. Bed-wetting isn’t a sign of toilet training gone bad. It is also important to point out that it’s often just a normal part of a child’s development.
Generally, bed-wetting before age 7 should not be a concern. At this age, your child may still be developing nighttime bladder control as the brain develops.
If bed-wetting continues, treat the problem with patience and understanding. Lifestyle changes, bladder training, moisture alarms and sometimes medication may help reduce bed-wetting.
Symptoms
Most kids are fully toilet trained by age 5, but there’s really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed. Do not be concerned until after the age of18. Just be patient and supportive with the affected children.
When to see a doctor?
Most children outgrow bed-wetting on their own — but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.
Consult your child’s doctor if:
• Your child still wets the bed after age 7
• Your child starts to wet the bed after a few months of being dry at night
• Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
Causes
No one knows for sure what causes bed-wetting, but various factors may play a role:
• A small bladder. Your child’s bladder may not be developed enough to hold urine produced during the night.
• Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child. This is true especially if your child is a deep sleeper.
• A hormone imbalance. During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
•Urinary tract infection. This infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.
• Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring and daytime drowsiness.
• Diabetes. For a child who’s usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
• Chronic constipation. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bed-wetting at night.
Risk factors
Bed-wetting can affect anyone, but it’s twice as common in boys as in girls. Several factors have been associated with an increased risk of bed-wetting, including:
• Stress and anxiety. Stressful events such as becoming a big brother or sister, starting a new school, or sleeping away from home may trigger bed-wetting.
• Family history. If one or both of a child’s parents wet the bed as children, their child has a significant chance of wetting the bed, too.
•Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.
Complications
Although frustrating, bed-wetting without a physical cause doesn’t pose any health risks. However, bed-wetting can create some issues for your child, including:
• Guilt and embarrassment, which can lead to low self-esteem
• Loss of opportunities for social activities, such as sleepovers and camp
• Rashes on the child’s bottom and genital area — especially if your child sleeps in wet underwear
Sources:
Mayo Clinic – diseases –web site
AUA – website
Campbell Urology
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Angelo E. Gousse, MD
Clinical Professor of Urology –
Herbert Wertheim College
of Medicine – FIU
Voluntary Professor of Urology – University of Miami , Miller School of Medicine
Director of Fellowship:Female Urology,Voiding Dysfunction, Reconstruction
Memorial Hospital Miramar,
South Broward Hospital District
1951 SW 172 Avenue, Suite 305,
Miramar, FL, 33029
Tel: 954-362-2720
| Fax: 954-362-2761 www.bladder-health.net