Bedwetting (also called nocturnal enuresis) is one of the most common childhood urology complaints and health issues. Children develop complete control over their bladders at different ages and night-time dryness is usually the last stage of toilet learning. While most children are toilet trained by the age of eight, either developmental delays or physical problems may cause some children to continue bedwetting.
Bedwetting is involuntary urination while sleeping, occurring after the age at which bladder control is expected to be established. This usually occurs when the body produces more urine overnight than the bladder can hold and the child does not wake up when the bladder is full.
When a child has not yet had a prolonged period of dryness, it is called primary nocturnal enuresis (PNE), while secondary nocturnal enuresis (SNE) occurs when a child, after having stayed dry for at least six months, reverts to bedwetting.
Causes of bedwetting
Most bedwetting is just a developmental delay and not considered a physical or emotional illness. Only about 5 to 10% of bedwetting cases are caused by specific medical conditions such as spinal cord lesions, congenital malformations of the genitourinary tract, infections of the urinary tract or diabetes. Bedwetting has a strong genetic component and a portion of bedwetting children (0.5 – 1%) will not outgrow the problem. Other causes include attention deficit hyperactivity disease (ADHD), consumption of caffeine, constipation, insufficient anti-diuretic hormone (ADH) production, sleep apnoea, sleepwalking or stress. Heavy sleeping, food allergies and being in contact with dandelions are not scientifically proven and are considered folklore and myths.
Treatment
Doing nothing or punishing the child is a common response to bedwetting and neither helps. Reassuring the child that bedwetting is common and can be helped is more appropriate. Making sure the child goes to the bathroom at normal times during the day and evening assists the child to not hold urine for long periods of time. Reduce the amount of fluid the child drinks a few hours before bedtime but do not restrict fluids excessively. Make sure the child goes to the bathroom before going to sleep.
Reward your child for dry nights – use a chart or diary that the child can mark each morning. While this is unlikely to solve the problem completely, it can help and should be tried before turning to medicines, especially in younger children (about five to eight years old).
Bedwetting alarms are another method that can be used along with reward systems and they are readily available without a prescription. The alarm wakes the child or parent when the child starts to urinate and have a high success rate if used consistently (alarm training can take several months to work properly and you may need to train your child more than once).
Medicinal treatments must only be used with guidance from your health care provider.
Our Employee Wellbeing Programme (EAP) is available 24 hours a day if you want to know more about bedwetting in young children.