What Should I Do if My Child Wets the Bed?

Many studies have uncovered the reasons behind bedwetting and what can be done for improving the condition in children. A report on bedwetting mentions the common misconceptions about bedwetting and the progress in finding the cause and treatment of this condition.

Darcie Kiddoo, MD, associate professor of pediatric urology at the University of Alberta in Edmonton, Canada, says that the reasons for bedwetting are not as straight forward as is believed. “Most of the parents believe that it can be controlled by the child and this is the biggest myth surrounding the condition," says Kiddoo. According to him, this is not something that can be controlled. “Children should not feel bad about having this condition and rewards may not help in improving the situation," he adds. About 6% of boys and 3% of girls in the US are affected by this condition, and most of them are are between 8-years-old and 11-years-old.

Reasons for bedwetting

Bedwetting should be brought to the notice of the doctor when it starts affecting the child’s life, especially if it causes anxiety or causes the child to miss out on important activities. According to the researchers, to determine the reasons for bedwetting one should note the activities of the child in the day time.

If bedwetting is caused by overactive bladders, children will have daytime symptoms like urgency, frequency, and incontinence. Irregularity in the functioning of the bladder may be caused by hormonal imbalances and may require treatment. But most children who have bedwetting habits do not need any medication.

Another reason for this condition may be sleep disorders, which makes it difficult for the child to wake up whenever there is a sensation to empty the bladder. Gender and genetics also have an impact in the control of bladder sensations and bedwetting. One of the studies showed that the probability of boys wetting the bed is more than twice that of girls. Another study reported that the probability of a child to have bedwetting habit is 3.5 times more if their mother also had the condition.

Stress and important events in the life like a new born baby, a move to a new place, or the loss of a loved one is also linked to bedwetting. This is especially true of children who did not have the habit before. But for many children there are no preceding events which triggered the development of this condition.

Uncommon causes of bedwetting

Some of the causes of bedwetting, including constipation, may be revealed after a thorough physical examination. “Constipation is one of the most common but often overlooked causes of bedwetting," says Pediatric urologist Steve J. Hodges, MD, of Wake Forest University.

“There is a general belief that constipation refers to rare or hard bowel movements, when abnormally large bowel movements is one of the most common symptom of the condition”, says Hodges. Presence of excess stool in the large intestine applies pressure on the urinary bladder and reduces its ability to hold back urine. Presence of stool can be revealed by X-ray or ultrasound examination and treating this with enema or laxatives will help to resolve the issue.

According to a recent study by Hodges, four out of five children in the study had constipation, which was revealed by X-rays. But in these cases, only one in five children had symptoms of constipation. Once constipation was treated by laxatives, 85% of the bedwetting cases resolved on its own that too without any other treatment within three months.

Treatments

Kiddoo feels that once the reason for bedwetting is determined, both parents and the child should be reassured that the condition is not medically serious. 

• Bed alarms – One of the studies show that bed alarms that sound at the first sight of moisture has lasting effect on bedwetting. About 66% of the children who had bed alarms could remain dry for almost two weeks, when compared to the children who did not have any treatment.
• Lifestyle modification – Drinking less fluid just before bedtime and reducing caffeine-containing products will be helpful in controlling this condition.
• Medication – Desmopressin is a drug commonly prescribed for improving the condition in children who wet the bed because of overproduction of urine. But the effects of drug stop once medication is stopped. Tricyclic antidepressants are also useful in controlling bedwetting, especially in teenagers who have symptoms of depression.
• Alternative therapies – Hypnotherapy, acupuncture, chiropractic treatment and psychotherapy are also used to treat bedwetting, but they do not have any evidence to support the treatment.
• No action – About 15% of the children stop bedwetting without any treatment.