Bedwetting in Children : Children can face many challenges

After the age at which it is normal to expect not to bed-wet a person will involuntarily urinate while they are asleep. This condition is known as nighttime incontinence.

A common sight in many homes is a child who is humiliated and has wet bedding and pyjamas. Bed-wetting is not a result of improper toilet training. In many cases, it is just a typical phase of a child's development.

In general, bedwetting before the age of seven is not a problem. At this age, your child may still be working on developing nighttime bladder control.

If bedwetting persists, approach the issue with tolerance and compassion. Bedwetting can be decreased with lifestyle modifications, bladder training, moisture alarms, and occasionally medication.

Causes

Although the exact cause of bedwetting is unknown, a number of variables may contribute:

A small-sized bladder. It is possible that your child's bladder is still developing and will not be able to store nighttime urine.

Being unable to detect a full bladder. A full bladder may not wake your child if the nerves that control the bladder take a long time to develop, especially if your child is a deep sleeper.

Hormone irregularity. Some children do not create enough anti-diuretic hormone (ADH) during childhood, which prevents overnight urination.

Infection in the urinary system. Your child may struggle to regulate their urination as a result of this infection. Bedwetting, daytime accidents, frequent urination, red or pink urine, and pain while urinating are just a few examples of signs and symptoms.

Apneic sleep. Bedwetting can occasionally be a sign of obstructive sleep apnea, which is frequently brought on by inflamed or enlarged tonsils or adenoids, causing the child's breathing to be disrupted while they sleep. Snoring and daytime sleepiness are possible additional symptoms.

Diabetes. Bedwetting may be the initial indication of diabetes in a youngster who generally sleeps dry at night. Other warning signs and symptoms could include sudden urination in big volumes, increased thirst, exhaustion, and weight loss despite a healthy appetite.

Persistent constipation. The muscles that govern urination and bowel movements are the same. Long-term constipation can cause these muscles to become dysfunctional and contribute to nighttime bedwetting.

A system or urinary tract structural issue. Sometimes, bedwetting is connected to a neurological disorder in the child.

How to check if your child has Bedwetting issues?

Some kids need a little assistance, but the majority of kids outgrow bedwetting on their own. In other instances, bedwetting could be an indication of a medical issue that has to be addressed.

If any of the following situations arise, please seek medical assistance:

• After age 7, your child is still wetting the bed.
• After staying dry at night for a few months, your child begins to wet the bed.
• Painful urination, unusual thirst, pink or red urine, firm stools, or snoring are all symptoms of bed-wetting.

Risk Factors

Although bedwetting can happen to anyone, boys are twice as likely as girls to experience it. An increased risk of bedwetting has been linked to a number of factors, including:

Anxiety and stress. Bed-wetting can be brought on by stressful situations including starting a new school, becoming a big brother or sister, or being away from home.

Family background. A child has a good risk of peeing in the bed if one or both of their parents did so when they were young.

Hyperactive/attention-deficit disorder (ADHD). Children with ADHD more frequently wet the bed.

Symptoms

There is really no target age for achieving full bladder control, however, most children are trained to use the toilet by the time they are five. Some kids still experience bedwetting between the ages of 5 and 7. A few kids still wet the bed after becoming 7 years old.

Prevention

The following alterations you can make at home might be helpful:

In the evening, drink fewer fluids. There is no need to restrict how much liquid your youngster consumes each day because it is crucial to obtain enough of it. Encourage children to drink water in the morning and early afternoon, since this may help them feel less thirsty in the evening. However, if your youngster plays in evening sports events or practises, do not restrict their fluid intake.

Avoid foods and beverages that contain caffeine. Children should not consume caffeine-containing beverages at any time of the day. Caffeine should be avoided in the evenings since it can stimulate the bladder.

Encourage two voids before bedtime. Double voiding is the practice of urinating once before starting the bedtime routine and once more right before going to sleep. In the morning and evening, recommend that your child urinate approximately every two hours, or at least frequently enough to prevent a sense of urgency.

Avoid skin rashes. You should assist your youngster in rinsing his or her genital region and bottom each morning to avoid a rash brought on by moist underwear. At night, using a protective moisture barrier lotion or ointment on the affected area may also be beneficial. Consult your child's paediatrician for product suggestions.

Treatments

The majority of kids grow out of bedwetting on their own. If treatment is required, it can be decided after discussing your options with your doctor and determining which course of action is best for you.

Lifestyle adjustments, such as giving up all forms of caffeine and reducing fluid intake in the evening, may be effective if your youngster isn't overly upset or humiliated by the occasional wet night. The child may benefit from additional therapy if lifestyle modifications are unsuccessful or if he or she is scared of wetting the bed.

If discovered, underlying causes, such as constipation or sleep apnea, should be treated before moving on to other forms of therapy.

Moisture alarms and medication are two options for managing bedwetting.

Moisture detectors

These tiny, battery-operated gadgets connect to a moisture-sensitive pad on your child's pyjamas or bedding and are typically accessible without a prescription at pharmacies. The warning sounds when the pad detects moisture.

The wetness alarm should ideally go off just as your child starts to urinate so that you can help them wake up, stop the urine stream, and help them find the bathroom. It could be necessary for someone else to listen to the alarm and rouse your child if they are a heavy sleeper.

Give a moisture alarm plenty of time if you decide to use one. The typical wait time for any kind of reaction is one to three months, and it can take up to 16 weeks to get dry nights. For many kids, moisture detectors work well and pose little risk.

It might offer a better long-term answer than medication in terms of lowering the risk of relapse or negative effects. Insurance usually does not provide coverage for these devices.

Medication

A drug for a brief length of time may be recommended by your child's doctor as a last effort to stop bedwetting. Certain drug kinds can:

Reduce urination at night. Desmopressin (DDAVP), a medication, lowers nighttime urine output. Desmopressin should be avoided if your child has symptoms like fever, diarrhoea, or nausea because drinking too much liquid while taking the drug can have negative effects. Follow the directions for using this medication exactly.

Desmopressin is only prescribed for kids older than 5 years old and is taken orally as a tablet. Due to the potential for major adverse effects, desmopressin (Noctiva, others) is no longer advised as a treatment for bedwetting.

Medication to relax the bladder. An anticholinergic medication like oxybutynin (Ditropan XL) may help decrease bladder contractions and increase bladder capacity if your child has a small bladder, especially if daytime wetness also occurs. When previous therapies have failed, this medicine is typically prescribed in addition to other medications.

Sometimes it's best to take a few different drugs together. However, there are no assurances that taking medication will not make the issue go away. When medication is stopped, bedwetting usually returns until it stops on its own at a different age for every child.

Complications of Bedwetting

Bedwetting without a physical cause does not have any negative health effects. The following problems, however, can arise for your child as a result of bedwetting:

• Low self-esteem can result from guilt and humiliation.
• Reduction in social chances due to the absence of sleepovers and summer camp
•  If your child sleeps in damp underpants, rashes can occur on the child's bottom and genital region

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