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 Bed Wetting

Bed-wetting (also called enuresis) is a common problem in children especially in boys. An estimated 5 to 7 million children in the United States wet their beds regularly. Most children stop wetting the bed at night by the time they are 4 or 5. If your child is 6 or 7 and has never been able to stay dry overnight, you may want to speak to your pediatrician or family doctor about whether this is a problem that should be treated. 

What causes bed-wetting?
The causes of bed-wetting are not known for sure. In most cases, no underlying physical problems are found. However, nearly all bed-wetting children do not wake up even though their bladders are full. Recent research suggests that some children who wet the bed may not have enough of a hormone called antidiuretic hormone (ADH) during sleep. This hormone enables the kidney to hold on to more water, resulting in less urine filling the bladder. Not having enough of this hormone during sleep may cause these children to make more urine during the night than their bladders can hold.
 
What treatments are there for bed-wetting?
  • Limiting the amount of fluid the child drinks before going to bed, especially fluids that contain caffeine, such as cola drinks.
  • Waking the child to go to the bathroom periodically during the night so that the child’s bladder never becomes very full.
  • A device called a “moisture alarm” may be used. This sets off a bell or alarm when the child starts to wet the bed. This bell or alarm should wake the child who then gets up to go to the bathroom before going back to sleep. If the child does not wake up when the alarm goes off, the parent should take the child to the bathroom. Eventually, the child will hear the alarm without help.
  • Special exercises to stretch and condition the bladder may be helpful. Your pediatrician or family doctor can give you more information about these exercises.
  • Medications: Two types are currently used for bed-wetting. One of the medicines used relaxes the bladder to allow it to hold more urine. The most commonly used medicine of this type is called imipramine. The other medicine used is a man-made form of the hormone ADH. This man-made form of hormone is called desmopressin acetate, and it is available as a nasal spray and tablet. Both these types of medicines may have some side effects. You should speak to your doctor about whether these medicines would be right for your child.   
  • Hypnotherapy is a new approach to the treatment of bed-wetting that can be helpful in some cases. Children who can benefit from this type of treatment usually show improvement within four to six sessions. It is important to make sure the doctor has been trained in this therapy.
Sometimes a combination of more than one of these treatments may be recommended.
 
Does bed-wetting mean that the child has kidney problems?
No. Most children who wet the bed do not have any kidney problems. The pediatrician or family doctor is the best source for information about bed-wetting and kidney problems in children. The doctor can check your child to make sure he or she does not have a kidney problem. 
 
Will bed-wetting affect my child long-term? How can I help prevent this?
Bed-wetting does not have to mean that children will have serious psychological problems. Because of the embarrassment it causes, bed-wetting can affect the child’s overall self-image and self-confidence if ignored or not addressed appropriately. It is important for parents to realize that the child needs their support and encouragement in overcoming this problem. Punishment or humiliation should be avoided.
 
What if I have more questions?
Your best source of information about bed-wetting is your doctor. You can also contact your local National Kidney Foundation affiliate or the national office at (800) 622-9010, or go to www.bedwetting-nkfonline.org
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