No de­fin­i­tive cause of bed­wet­ting

Bray People - - LIFESTYLE - YOUR HEALTH WITH DR. MICHELLE COOPER

BED­WET­TING IS a com­mon prob­lem in young chil­dren but, in time, most be­come dry at night with­out any treat­ment. How­ever, treat­ment is con­sid­ered for chil­dren aged five and over.

Al­though many chil­dren are dry at night by the age of three, it is com­mon for chil­dren to re­quire nap­pies at night un­til school age. How­ever, bed­wet­ting may oc­cur be­yond this age and about one in seven chil­dren aged five and one in 20 chil­dren aged 10 are bed-wet­ters.

There is usu­ally no spe­cific cause for bed­wet­ting; it oc­curs sim­ply be­cause the vol­ume of urine pro­duced at night is more than the child's blad­der can hold. The sen­sa­tion of a full blad­der does not seem strong enough to wake the child at night.

Fac­tors that can con­trib­ute to bed­wet­ting in­clude stress (aris­ing from school pres­sure, bul­ly­ing etc), drinks and foods con­tain­ing caf­feine which in­crease the amount of urine made by the kid­neys, and con­sti­pa­tion in which large stools in the rec­tum may press on and ir­ri­tate the blad­der.

Fur­ther causes in­clude a uri­nary in­fec­tion, sleep ap­noea (pauses in breath­ing whilst asleep), di­a­betes and rare dis­or­ders of the blad­der. A spe­cific med­i­cal cause is more likely if day­time wet­ting oc­curs in ad­di­tion to night time bed­wet­ting. TIPS * It is best to stop us­ing nap­pies when you de­cide that the time has come. Some older chil­dren are still put in nap­pies at night when try­ing to be dry but this gives them lit­tle mo­ti­va­tion. How­ever, in young chil­dren, if a trial with­out nap­pies does not work out you can go back to nap­pies and try again at a later date.

* There is a great vari­a­tion in the age at which chil­dren be­come nat­u­rally dry at night. Do not pun­ish chil­dren for bed­wet­ting - it is not their fault. If an im­prove­ment is no­ticed, praise and make a fuss of your child.

* Your child's co-oper­a­tion is im­por­tant. As soon as your child is old enough to un­der- stand, a sim­ple ex­pla­na­tion can be help­ful.

* En­cour­age your child to help change wet sheets when old enough. Chil­dren re­spond to be­ing given re­spon­si­bil­ity.

* Make sure there are no hid­den fears about get­ting up at night e.g. fear of the dark or of spi­ders.

* Restrict­ing drinks can help but does not cure bed­wet­ting. The blad­der has to get used to fill­ing up and hold­ing urine. Day­time re­stric­tion pre­vents this - chil­dren should drink at

“Fac­tors con­tribut­ing to bed­wet­ting in­clude stress and drinks and foods con­tain­ing caf­feine”

least 6-8 cups of fluid per day. A sen­si­ble plan is to only give drinks if your child is thirsty 2-3 hours be­fore bed­time.

* Par­ents may wake chil­dren to take them to the toi­let sev­eral hours af­ter bed­time. How­ever, this can pro­long the prob­lem; chil­dren have to get used to wak­ing up when their blad­der is full.

TREAT­MENT OP­TIONS

Bed­wet­ting alarms are a com­mon form of treat­ment. An alarm is usu­ally needed for 3-5 months to con­di­tion the child to wake and empty their blad­der when it is full. The alarm goes off as soon as wet­ting starts, wak­ing the child to prompt him or her to go to the toi­let.

Medicines con­tain­ing desmo­pressin work by re­duc­ing the amount of urine made by the kid­neys. How­ever, when dis­con­tin­ued, the bed­wet­ting of­ten re­turns.

Re­ward sys­tems such as star charts, can prove ef­fec­tive in mo­ti­vat­ing chil­dren to be­come dry.

There is a great vari­a­tion in the age at which chil­dren be­come nat­u­rally dry at night

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