Archive for the ‘Child anxiety and Bedwetting’ Category

Child Bedwetting

Saturday, March 29th, 2014

STOP BEDWETTING – Julie Revelant offers some good pointers in this article about child bedwetting she offers concise and sensible advice. The three key points are these: firstly, bedwetting rarely is incurable, the vast majority of children are cured, one way or another. Secondly, you should NEVER punish a child for bedwetting this is about the worst thing you could do as the child is already probably suffering from a low-self esteem which would hardly be helped by punishment. Finally, the child is likely for reasons which are easily found if they exist, looking at their poop or checking on their sleeping patterns.

Child Bedwetting

How To Stop Bedwetting For Good

Got a bed wetter? Sure, it can be frustrating for you and embarrassing for your kid, but it’s actually a common problem with approximately 5 to 7 million children in the U.S who wet the bed at night.

Find out what causes bed-wetting and what you can do to help your child finally stay dry.   

Bed-wetting is a big kid problem too

Although most 2- and 3-year-old kids are potty trained during the day, many still wet the bed at night. In fact, about 12 percent do even until age 6. After that point, however, experts agree intervention is needed.

One thing’s for sure: Bed-wetting isn’t caused by a psychological problem.  A significant life change such as a divorce, a death, or a move can trigger it, according to Dr. Howard Bennett, author of Max Archer, Kid Detective: The Case of the Wet Bed.

What causes bed-wetting?

There are several reasons why a child might be a bed-wetter. For starters, it could be genetic since “about three out of four children who are wet at night have a first degree relative that had the same problem,” said Bennett, who blogs at howardjbennett.com.

Bed-wetting might also be caused by a lack of communication between the bladder and the brain. When your kid is toilet trained, he or she learns to inhibit the contractions and hold the urine back. Yet even if your child is able to do it during the day, he or she may still wet at night because “whatever learning goes on between the part of your brain that is responsible for having your bladder empty or holding your urine in, is still immature,” Bennett said.

Another culprit might be that the bladder simply doesn’t have enough room. And those children often have problems holding their urine during the day as well, according to Dr. Hubert Swana, a pediatric urologist who practices at Nemours Children’s Hospital in Orlando, Fl.

If your child is a bed-wetter, here’s what you can do:

See the pediatrician

If your child suddenly starts to wet the bed and never did before, he or she might have a urinary tract infection or a more rare condition like diabetes or a neurological problem. Sleep apnea could be the culprit too. Be sure to talk to your child’s pediatrician who can identify a cause, rule out other health problems, and provide solutions.

Talk about it

Studies show that kids who wet the bed have low self-esteem, probably because they feel that it’s something they should be able to control. It can help to talk about how common it is and if a family member had the same problem, share that too.  “Children often feel bad about it, and it helps to know that somebody else in the same family had the same problem,” Bennett said.

Don’t punish

Kids don’t wet the bed on purpose, so discipline won’t stop it.

Pay attention to poop

Constipation can put pressure on the bladder, making it difficult to hold in urine and causing an urge to go. If your kid doesn’t have soft, easy and regular bowel movements, talk to the pediatrician.  

Get an alarm

The bed-wetting alarm is the best solution for bed-wetting. It’s about 75 percent effective, when used properly and when both parents and child are motivated. Swana says a process should be followed: Once your child wets the bed, you must wake him or her up and then instruct your child to change the sheets, take a shower and return to bed. When children realize they have to do this each time “eventually they learn to wake up by themselves,” he said.

Try medication

Desmopressin acetate is the most common medication to control bed-wetting and it’s effective in about 50 to 75 percent of children. Ask your pediatrician if it’s right for your child.

Mark the calendar

Keeping track of both wet and dry nights can help motivate your child to end his or her bed-wetting.

Drink and pee

Encourage your child to drink more fluids throughout the day and urinate as soon as there is an urge to go. “If you don’t pay attention to your bladder in the daytime, it’s hard to pay attention to it at night,” Bennett said.

Cut the caffeine

Drinking after dinner is okay, but avoid soda and sports energy drinks, because caffeine can trigger bed-wetting.

Try lifting

Here’s how it works: Before you go to bed, either pick your child up out of bed or wake him or her up to use the bathroom. This will serve as a reminder for what it feels like when your child’s bladder is full so he or she can pay attention to it at bedtime.  “It does help them stay dry until they either outgrow the problem, or if it doesn’t work, they’re more motivated to do something like the alarm,” Bennett said.

Julie Revelant is a freelance writer and copywriter specializing in parenting, health, healthcare, nutrition, food and women’s issues. She’s also a mom of two.

Child bedwetting is surprisingly common but parents and children involved in this condition rarely think it is that common and this can lead to feelings of guilt which in turn can reduce the chances of the parents talking to third parties to find a relevant cure. See this article at Fox News. Details on how to contact Julie are shown on the webpage.

Child Bedwetting

Monday, March 10th, 2014

TONSIL BEDWETTING LINK – Denise Mann’s article shows the interesting link between child bedwetting and the removal of tonsils and also, why is it that there is a preponderance for children who were born prematurely do not seem to benefit from this operation. Obviously there is a complex set of effects taking place in this scenario.

Child Bedwetting

Tonsil Removal Might Cure Bedwetting In Some Kids With Sleep Apnea

Study shows additional benefit of the surgery for certain children.

MONDAY, May 16 2011 (HealthDay News) — Half of children with sleep apnea who also wet the bed might stop their bedwetting if their tonsils or adenoids are removed, new research suggests.

Obstructive sleep apnea (OSA) is marked by interruptions in breathing while asleep; it is common among children with enlarged tonsils or adenoids. Exactly how sleep apnea results in bedwetting is not fully understood, but hormonal changes may play a role.

However, half of the 417 children in this latest study who had sleep apnea and were bedwetters stopped wetting the bed after they had their tonsils or adenoids removed. Children in the study were aged 5 to 18, and were followed for just under one year after their surgery, on average.

Those who did not stop wetting the bed after the surgery were more likely to be born prematurely, be male, be obese or have a family history of bedwetting, the investigators noted. Premature birth was the greatest predictor of continued bedwetting after surgery.

“If they haven’t seen an ear, nose and throat specialist, see one to see if the child who wets the bed has OSA that can be cured by tonsil or adenoid removal,” said study author Dr. Yegappan Lakshmanan, chief of pediatric urology at Children’s Hospital of Michigan, in Detroit.

The findings were to be presented Monday at the annual meeting of the American Urological Association (AUA), in Washington, D.C. Research presented at medical meetings should be viewed as preliminary until it has been published in a peer-reviewed medical journal.

There are many other causes of bedwetting, Lakshmanan said. “About 5 to 7 million children are bedwetters, and the causes fall into three main groups: bladder issues, sleep-related problems and the kidneys,” he explained. “The children in this study wet the bed due to sleep-related problems.”

So why weren’t they all cured? “Bedwetting is multifactorial even within these groups, and eventually we should be able to pinpoint the cause for every single child,” Lakshmanan said.

“There are several potential causes of bedwetting, and sleep apnea is clearly one of them,” said Dr. Lane S. Palmer, chief of pediatric urology at the Cohen Children’s Medical Center in New Hyde Park, N.Y.

“There are secondary positive effects of this tonsil- or adenoid-removing surgery, but I don’t know that I would jump to have my child’s tonsils or adenoids out as a primary treatment for bedwetting,” he said. “Children with sleep apnea and bedwetting should see an otolaryngologist first.”

“This study really underscores the fact that children who have other issues with sleep should be looked at for bedwetting because anything that depresses sleep at night can lead to bedwetting,” said AUA spokesman Dr. Anthony Atala, a urologist at Wake Forest University in Winston-Salem, N.C.

“If a child has bedwetting, pay close attention to their sleep patterns, and observe them while they are asleep and you can see whether they are breathing at a regular pace, and if not, seek additional help,” Atala said.

Children with sleep apnea can be difficult to rouse, which may cause the bedwetting, said Dr. Dennis Kitsko, an otolaryngologist at the Children’s Hospital of Pittsburgh. “But not every child with sleep apnea will wet the bed, and not every bedwetter will have sleep apnea.”

Still, “snoring in children is abnormal,” said Dr. Linda Dahl, an ear, nose and throat doctor at Lenox Hill Hospital in New York City. “Children snore because their tonsils and adenoids are enlarged, and they end up getting other behaviors that go along with sleep apnea, including bedwetting,” she explained.

“There are many ancillary benefits that you may not attribute to removing large tonsil and adenoids, such as putting an end to bedwetting,” Dahl added.

As Denise suggests, rushing to your medical practitioner to alleviate child bedwetting through tonsil removal is probably not something to do without pause and further investigation. Obviously parents who are stressed by their bedwetting child notwithstanding the fact that it probably negatively affects their own sleep patterns – is understandable but each situation is different and so you need to review with relevant expertise the specific environment and see what is the best way forward. See this article at US News / Health.

Child Bedwetting

Thursday, February 20th, 2014

PDF – here is something we found on our search across the internet for our child bedwetting category article. It isn’t exactly an article but a PDF. See below for the headings.

Child Bedwetting

When Bed-Wetting Becomes A Problem

A Guide For Patients And Their Families

If you would like to download this PDF click National Kidney Foundation (US). This is a great 12 page document which should answer most of your questions about child bedwetting.

Child Bedwetting

Monday, January 27th, 2014

HOME PAGE – this is not technically an article but forms part of a website called Drynites which looks in detail at the causes for child bedwetting. The issues are nicely listed below the inclusion of this site in our post does not constitute any recommendations of their products, we are not an affiliate of their products. Our only reason for the inclusion of the text is to provide our readers with some basic information about the bedwetting condition.

Child Bedwetting

What Causes Bedwetting?

Bedwetting can happen for a number of reasons. Understanding what the possible causes might be will help to reassure both parents and children that it’s a common issue and, most importantly, that it’s out of a child’s control. Here’s why it happens:

Family history

It might come as a surprise but there is a strong hereditary factor to bedwetting. If one parent wet the bed as a child, there is around a 40% chance that their child will too. If both parents wet the bed, the odds can rise to around 70%.

Missed signals

During the night the bladder should send signals to the brain that it’s full which prompts us to “hold-on” and wakes us up to use the toilet.  For some children this connection has not yet been made and the brain doesn’t respond to the signal of a full bladder. This often sorts itself out naturally – but some children might need treatment, such as the enuresis alarm or buzzer, to help this process.

Small bladder capacity

For some children a smaller than average bladder capacity (the amount the bladder can hold before getting the sensation of fullness) can result in frequent trips to the loo during the day as well as problems at night. Help your child increase their bladder capacity by encouraging them to drink plenty of  fluid during the day (for children 4-8 years the 2010 Guidelines by NICE recommend 1,000 – 1,400mls of fluids a day, which is equivalent to about 8 glasses).

Lack of hormones

When we go to sleep our pituitary gland secretes a higher level of an antidiuretic hormone (ADH) that slows down the production of urine by the kidneys so we don’t have to wake up to urinate. Some children are simply at a stage where they produce too little of this hormone at night – and so wet the bed.

Constipation

Constipation is a recognised trigger for bedwetting episodes in some children. This is because the constipated bowel literally “leans” on the bladder and causes the bladder to empty before it is full. In this instance, it’s important to sort out the constipation first as this will most likely resolve the bedwetting.

Urine Infection

In some cases a urine infection can cause bedwetting, so if having a wee is causing your child pain or if they are passing urine much more frequently than usual, talk to your doctor.

No-one’s to blame

Any one of these reasons could explain why your child wets the bed, and it’s important to remember that it’s nobody’s fault. Bedwetting is something that is out of your child’s control but with support, encouragement, patience and, if necessary, some form of treatment, dry nights will not be far away.

We hope this information about child bedwetting article proves useful. Most bedwetting can resolve itself over time but the last paragraph in the above curated article makes a useful suggestion to ensure that no-one is to blame. Kindness is by far more useful with your child. You can see the original article at DryNites.

Child Bedwetting

Wednesday, January 8th, 2014

VIDEO – this is not an article, it describes a 2 minute video myth or fact about child bedwetting.

Child Bedwetting

A Parent’s Guide to Bedwetting

Myths and Facts About Bedwetting. Help your child stop wetting the bed by separating bedwetting facts from fiction.

If you have suddenly noticed child bedwetting has become an issue then this video, at WebMD might be useful.

Child Bedwetting

Monday, December 16th, 2013

MEDLINE PLUS – in this article about child bedwetting the organization outlines some of the key information about this condition. We have chosen this site as it is not a commercial organization.

Child Bedwetting

Bedwetting Also Called Enuresis

Many children wet the bed until they are 5 or even older. A child’s bladder might be too small. Or the amount of urine produced overnight can be more than the bladder can hold. Some children sleep too deeply or take longer to learn bladder control. Children should not be punished for wetting the bed. They don’t do it on purpose, and most outgrow it. Until then, bed-wetting alarms, bladder training and medicines might help.

As always with conditions like child bedwetting parents suddenly find they have an issue and there is a sudden need for relevant and unbiased information – which is why we chose this site for this topic. NIH is a non-profit operation so you can review the information without having to worry about whether there is a hidden agenda in terms of solutions.

Child Bedwetting

Monday, November 25th, 2013

AT A GLANCE – in this ‘article’ the writer does an ‘at a glance’ child bedwetting list. Have a look at the list and see the key elements which might be useful for you and your child.

Child Bedwetting

Bedwetting At A Glance

Bedwetting is also called nocturnal enuresis.
There are two types of bedwetting: primary and secondary.
Primary bedwetting is bedwetting since infancy.
Primary bedwetting is due to a delay in the maturing of the nervous system.
Primary bedwetting is an inability to recognize messages sent by the bladder to the sleeping brain.
The “cure” for primary bedwetting is “tincture (or passage) of time.”
There are a number of interventions including medical and behavioral options.
Secondary bedwetting is wetting after being dry for at least six months.
Secondary bedwetting is due to urine infections, diabetes, and other medical conditions.
All bedwetting is manageable.
Always speak to your child’s physician for guidance.

Well, this is an at a glance child bedwetting article, see the original and much more at Medicine Net. Let us know what you think about this post…

Child Bedwetting

Sunday, November 3rd, 2013

NUMBERS – Here are a few figures about child bedwetting in the US. As you can see there is an element of stress and anxiety related to continued bedwetting which should provide parents with a warning sign should this occur – of course, bedwetting doesn’t automatically relate to anxiety/stress, you need to look for other signs and symptoms

Child Bedwetting

How Common Is Urinary Incontinence In Children

Studies indicate that 20% of all 5-year-old children and 10% of 7-year-olds wet the bed, and of these, up to 20% also have some degree of daytime incontinence. In addition, nocturnal enuresis is more common in boys, and diurnal incontinence is more common in girls. Secondary enuresis accounts for about one-quarter of all cases and is most often associated with some psychological stressor or anxiety.

As you can see, and have we have said before, child bedwetting is pretty common so as parents you should not be overly concerned about your child if you find he/she is wetting the bed. See this information at Medicine Net and also see other related articles.

Child Bedwetting

Friday, October 11th, 2013

BEDWETTING – Jan E Drutz MD And Naiwen D Tu MD – not quite ‘everything you need to know about child bedwetting – but it does cover a great deal of basic, and more than basic material that will assist parents in understanding the issues and then formulating a positive and constructive way forward. As I have mentioned before one of the problems for parents is that they become stressed by this condition which can exacerbate the situation – what your children want is someone calm and focused on a way forward.

Child Bedwetting

Patient information: Bedwetting in children (Beyond the Basics)

BEDWETTING OVERVIEW

Bedwetting (also called nighttime or nocturnal enuresis) is a common childhood problem. Children learn to control daytime urination as they become aware of their bladder filling. Once this occurs, the child then learns to consciously control and coordinate his or her bladder. This generally occurs by four years of age. Nighttime bladder control usually takes longer and is not expected until a child is between five and seven years old. (See “Patient information: Toilet training (Beyond the Basics)”.)

The number of children with bedwetting varies by age; at five years of age, 16 percent of children have some difficulty staying dry at night. By 15 years of age, only 1 to 2 percent continue to wet the bed. Boys are twice as likely as girls to wet the bed.

For most children, bedwetting resolves on its own without treatment. However, parents and children may worry about bedwetting since it is embarrassing and inconvenient. Some parents may also worry about underlying medical problems.

BEDWETTING CAUSES

Bedwetting may be related to one or more of the following:
The child’s bladder is maturing more slowly than usual
The child’s bladder holds a smaller-than-normal amount of urine
Genetics; parents who had enuresis as children are more likely to have children with enuresis
Diminished levels of vasopressin (a hormone that reduces urine production)
Deep sleep that prevents a child from sensing bladder fullness (this theory is controversial)

Physical or emotional problems rarely cause bedwetting. Most children with bedwetting do not have an underlying medical problem. Medical problems that may contribute to bedwetting include diabetes, urinary tract infection, fecal soiling (encopresis), pin worms, kidney failure, seizures, and sleep problems (such as sleep apnea). Most of these conditions can be diagnosed easily.

Constipation, a common problem in children, can also cause bedwetting. If your child’s bowel movements are infrequent, you should mention this to your child’s healthcare provider. (See “Patient information: Constipation in infants and children (Beyond the Basics)”.)

BEDWETTING DIAGNOSIS

The age at which enuresis is considered a “problem” depends on when the child develops bladder control and the perspective of the parents:

A parent who had enuresis as a child may not be concerned about his or her six-year-old with enuresis.
Parents of a four-year-old with enuresis may worry because their older child was dry at age three.

For most children, enuresis is a problem when it interferes with their ability to socialize with friends. However, it is understandable for parents to want reassurance that their child’s bedwetting is not caused by an underlying medical problem.

History — Important points for you to mention when discussing bedwetting with a healthcare provider include:

Problems with daytime accidents
Periods of dryness
Family history of bedwetting
Frequency of wetting episodes
Whether your child snores
The impact of the problem on the child and family
What treatments have been tried
Unstable-family issues

It is also useful to record a 24-hour diary of how much the child drinks and how much urine s/he passes. This includes recording the time and amount of fluids your child drinks, as well as the number of times the child urinates, including the amount urinated, if possible (figure 1).

Urinalysis — Urinalysis is a screening test for underlying medical problems. It requires testing a small sample of a child’s urine. Urinalysis can usually be done in the clinician’s office.

Further testing and referral — Most children who have bedwetting do not need further testing or referral. However, a child with who has daytime bladder problems or abnormal findings on urinalysis or physical examination may need further testing.

BEDWETTING TREATMENT

Initial treatment of bedwetting includes education and motivational therapy. Behavioral alarms or medication may be tried if enuresis does not improve with these interventions.

Before beginning treatment, it is important to consider how ready and able your child is to participate in the process. Both you and your child must be motivated. If your child is not mature enough to assume some responsibility for treatment, s/he should not be forced to do so.

Treatment is often prolonged and may involve cycles of success and failure. Treatment should include consistent follow-up with a clinician (approximately every four months).

Parents must understand that bedwetting is completely involuntary and that a child should never be punished for wetting episodes. Spanking and verbal scolding do not improve a child’s ability to stay dry.

When to seek help — You should speak with your child’s healthcare provider if your child has difficulty with needing to urinate frequently or urgently, extreme thirst during the day, burning with urination, swelling in the feet or ankles, or a new problem with bedwetting after weeks or months of being dry. These may be signs of a more serious condition that should be evaluated before any enuresis treatment is attempted.

If your child does NOT have the above problems, you may seek medical advice at any time, or you may try following the general advice or motivational therapy techniques described below. Motivational therapy techniques are best suited to younger children with enuresis. Most clinicians do not suggest alarm devices or medications until a child is at least seven years old.
Bedwetting education and advice
Bedwetting is common; it occurs at least once per week in 16 percent of five-year olds.

Bedwetting goes away on its own in most children.
Bedwetting is not the child’s fault; children should not be punished for bedwetting.

Encourage the child to urinate regularly during the day and just before going to bed (a total of four to seven times). If the child wakes at night, take him/her to the toilet.

Avoid sugary and caffeine-containing drinks, especially in the evening.

It may be helpful to have the child drink most of his or her fluids in the morning and early afternoon to prevent overfilling of the bladder during the night. Before trying this, keep a diary of the amount of fluids your child drinks in a 24-hour period (figure 1). Based on the total, you can create a schedule to spread fluids through the morning, afternoon, and evening. One recommendation is to offer 40 percent of fluids in the morning, 40 percent in the afternoon, and only 20 percent in the evening. For example, if a child generally consumes 32 ounces (approximately 1 liter) in 24 hours, the parent should offer 13 ounces (approximately 400 milliliters)—about 40 percent—in the morning, 13 ounces (approximately 400 milliliters) in the afternoon, and 6 ounces (approximately 200 milliliters)—about 20 percent—in the evening.

Remind the child every night to get out of bed and use the toilet when s/he needs to urinate. Also remind the child to empty his or her bladder immediately before bedtime.

Help the child locate the toilet easily by using night lights in the bathroom and hallway. Consider placing a portable potty seat in the child’s room if the toilet is far from the child’s bedroom.

Stop using diapers, training pants, or pull-up pants at home since these may prevent a child from wanting to get out of bed, especially if the child is older than eight years. They may be used for special occasions, such as overnight visits with family or friends.
Protect the child’s mattress with a waterproof sheet to avoid urine odor.

After wetting accidents during the night, encourage the child to go to the bathroom before changing into dry pajamas. You can place a dry towel over the wet part of the bed, or you can make the bed in several layers, alternating a fitted sheet with a waterproof pad; this allows you and/or the child to quickly and easily remove the wet items and avoids the need to re-make the bed. Leave dry pajamas and towels out so that a child can find them easily.

Ask the child to help with morning bed clean-up, including removing and washing bed sheets. Also ensure that the child showers or bathes daily to avoid urine odor on the skin.

Do not tease or allow siblings to tease a child who has wet the bed.

Behavior therapy for bedwetting

Motivational therapy — Motivational therapy involves keeping a record of progress, with bigger rewards for longer periods of dryness. You and the child should agree about the reward in advance and might progress from a sticker on a calendar for each dry night to a favorite book for seven consecutive dry nights.
Motivational therapy is a good method to try first for younger children.

Self-awakening — Self-awakening therapies aim to teach a child how to recognize when the bladder is full during the daytime, in the hopes that s/he can recognize this feeling during the night. It is most likely to be successful in children over the age of six years [1].
The child should practice a self-awakening routine before bedtime every night. Have the child lie on the bed, pretend it is the middle of the night, and feel that the bladder is full. Ask the child to imagine that his or her bladder is saying, “Wake up before it’s too late.” The child then goes to the bathroom.

The child should also try to practice self-awakening techniques during the daytime. When s/he feels the urge to go to the bathroom during the daytime, s/he should be told to go to the bedroom and lie on the bed, and pretend he or she is sleeping. Tell the child to lie still while thinking about the bladder being full and needing to get up. After a brief period of time, s/he should get up and go to the bathroom to empty.

If self-awakening does not work, you may awaken the child at least once during the night. Use the smallest amount of prompting possible; progress from turning on a light, saying the child’s name, touching the shoulder or face, gently shaking, or using an alarm. Once awake, the child should get to the bathroom without assistance.

Bedwetting alarms — Enuresis alarms are the most effective method for controlling bedwetting. They are typically reserved for children older than seven years of age. Alarms are not generally used first since they are moderately priced and require the child and parent to be highly motivated. You may consider trying alarm therapy after three to six months of other behavioral training techniques, before treatment with medication.
Alarms work by using a sensor that detects the first drops of urine in the underwear. When the sensor is activated, it sends a signal to an alarm device, which is intended to wake the child with a sound, light, or vibration. A table of available alarms is provided here (table 1). The alarm helps to train the child to wake up or stop urinating before the alarm goes off.

Children should be in charge of their alarm and should test it every night before sleeping. With the sound or vibration in mind, the child should imagine the sequence of events that will occur if the alarm goes off [1]:
The child turns off the alarm, gets up, and finishes urinating in the toilet

The child returns to the bedroom, changes his or her bedding and clothing (with a parent’s help if needed)
The child wipes down or replaces the sensor
The child resets the alarm and returns to sleep
Keep a diary of wet and dry nights. Give positive reinforcement for dry nights and for successful use of the alarm sequence.

As alarm therapy begins, some children will not awaken when the alarm goes off. You should wake the child initially, although most children will eventually learn to awaken on their own. It is critical for success of alarm therapy that the child is awake and conscious during the process of going to the bathroom in the middle of the night and not “sleepwalking” through the experience. Use the alarm continuously until the child has three to four weeks of consecutively dry nights. This usually takes three to four months but can range between five weeks and six months. The alarm sequence can be restarted if bedwetting recurs.

Overlearning — Overlearning can help improve the long-term success of enuresis alarms. Overlearning involves use of an enuresis alarm, as described above, until the child is dry for three to four weeks. The child is then allowed to drink 6 ounces (3/4 cup, approximately 200 milliliters) of water in the hour before bedtime. The child then wears the enuresis alarm to sleep. Filling the bladder challenges the child’s ability to awaken before wetting the bed, hence the concept of “overlearning.”

Alarm clocks — You may use a simple alarm clock to treat bedwetting. It can be set to awaken the child after two to three hours of sleep, whether or not the child is wet or needs to void. The waking time also can be adjusted by determining the time that the child is most likely to have a wetting episode and setting the alarm before this time.

Medication for bedwetting — Desmopressin is a medication that is used to treat bedwetting in children. In most cases, motivational therapy and/or bedwetting alarms are tried for three to six months before desmopressin is considered. Medications can be expensive, have side effects, and have a higher relapse rate than behavioral therapies. Medication and behavioral therapies can be used together.

Desmopressin — Desmopressin, also known as DDAVP, is a medication that decreases urine production. It is available as a pill and is taken at bedtime to reduce the amount of urine made during sleep. It is generally recommended for brief periods (eg, overnight camps or sleepovers), although it can be used on a nightly basis.
Serious side effects with desmopressin are uncommon but can occur if the child drinks too much fluid before bedtime. For this reason, children should not drink more than 8 ounces (240 milliliters) of fluid after 5 p.m. on nights when desmopressin will be used. The child should not drink any fluid beginning one hour before and eight hours after taking desmopressin.

Unfortunately, relapse rates are very high with desmopressin; approximately 60 to 70 percent of children have a return of nocturnal enuresis after stopping the medication.

Complementary and alternative therapies — Several complementary and alternative therapies have been tried in children with nocturnal enuresis, including acupuncture, chiropractic maneuvers, and hypnosis. However, there are not enough data from scientific studies to know if these therapies are effective. Complementary and alternative treatments are not currently recommended for children with bedwetting.

WHERE TO GET MORE INFORMATION

Your child’s healthcare provider is the best source of information for questions and concerns related to your child’s medical problem.

This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient information: Bedwetting in children (The Basics)
Patient information: Daytime wetting (The Basics)
Patient information: Night terrors, confusional arousals, and nightmares in children (The Basics)
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient information: Constipation in infants and children (Beyond the Basics)
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Etiology and evaluation of nocturnal enuresis in children
Management of nocturnal enuresis in children
Toilet training

The following organizations also provide reliable health information.
National Institute of Diabetes and Digestive and Kidney Diseases
(http://kidney.niddk.nih.gov/kudiseases/pubs/bedwetting_ez/index.htm)
National Kidney Foundation
(www.kidney.org/patients/bw/BWparents.cfm)
American Academy of Pediatrics
(www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/default.aspx)
Kidshealth
(http://kidshealth.org/parent/general/sleep/enuresis.html)

So as you can see, this article about child bedwetting is extremely comprehensive and you can see it at UpToDate the great thing about this site is there are a large number of related links on the page – the article offers sufficient help to assist parents in formulating how they want to move things forward and with the links providing additional support we hope this is sufficient to make you feel a little more in control.

Child Bedwetting

Wednesday, September 18th, 2013

TREATMENT – just a brief note below from Medicinenet about treatments for child bedwetting.

Child Bedwetting

What Is The Treatment For Secondary Bedwetting?

Therapy of secondary bedwetting is directed at the primary problem causing the symptom of wetting the bed. As expected, cure rates vary depending on the cause of the loss of control.

Bedwetting At A Glance

Bedwetting is also called nocturnal enuresis.

There are two types of bedwetting: primary and secondary.
Primary bedwetting is bedwetting since infancy.
Primary bedwetting is due to a delay in the maturing of the nervous system.
Primary bedwetting is an inability to recognize messages sent by the bladder to the sleeping brain.
The “cure” for primary bedwetting is “tincture (or passage) of time.”
There are a number of interventions including medical and behavioral options.
Secondary bedwetting is wetting after being dry for at least six months.
Secondary bedwetting is due to urine infections, diabetes, and other medical conditions.
All bedwetting is manageable.
Always speak to your child’s physician for guidance.

There are a host of other items about child bedwetting on the page with the above information which can be found at MedicineNet.com and, just for clarity, I’ve listed some of the key terms which are used by practitioners and with this long list of definitions will of course come more knowledge about the various aspects of this condition.