When bed-wetting should mean a trip to the doctor
Bed-wetting is one of the most common bladder function disorders in children, but in many cases these routine accidents lead to embarrassment and raise concerns for children and their families.
It's important to understand when wetting at night is developmentally acceptable for a child, and when it may be best to consider interventions at home or see a urologist or pediatric physician to discuss the condition.
Wetting the bed at night means a child does not yet have full control of their bladder while they sleep. Bladder control and toilet training, like walking, are learned gradually, and every child does so at their own pace. Bed-wetting happens often in children who are very deep sleepers, making it hard for their brain and bladder to communicate well at night. Other health concerns can increase the likelihood of bed-wetting, including pronounced snoring.
Nighttime wetting is generally not diagnosed as a condition or treated in children younger than 5 years old. Even then, up to one in five children still experience bed-wetting at 5 years of age.
If a child wets the bed regularly, there are several things families can do to support them before seeing a pediatric physician.
First, it's important for parents and families to provide reassurance and remind the child that the problem is not their fault, said Dr. Kavita Hodgkins, a nephrologist at Lurie Children's who specializes in bladder and kidney function.
"Kids may feel alone or ashamed when dealing with bed-wetting. Ensuring the child that he or she is not alone, and that it won't last forever, can be encouraging and help change behaviors," Hodgkins said.
Common interventions for bed-wetting include refocusing hydration by encouraging children to drink plenty of fluids throughout the day and limiting fluids closer to bedtime. Children should also be encouraged to urinate regularly throughout the day to help promote bladder health.
Children should always urinate just before bedtime; sometimes there is benefit in voiding twice in a row just before bedtime. Keeping bowel movements soft and regular is also helpful, Hodgkins said.
Still, there are times a medical specialist can and should be involved when a child is wetting the bed.
If a child is experiencing other urinary symptoms, such as daytime wetting, urinary tract infections, or urinary urgency or frequency along with nighttime wetting, it is important to see a urologist or pediatric physician, Hodgkins advises.
Furthermore, if the condition is affecting a child's self-esteem and social development, it is a good time to talk with a professional.
At Lurie Children's, treatments for bed-wetting can include recommending a device attached to a child's pajamas or underwear at night that can detect when wetting begins. The alarm then makes noise to awaken the child from sleep. In most cases, the child eventually remains dry through the night through this conditioning alarm program.
Other evaluation and treatment options are available, and specialists can ensure a treatment plan is right for the child and his or her family.
What is always essential in ending nighttime wetting is a motivated child with a supportive family, Hodgkins said.
Learn more about this condition at luriechildrens.org/wetting.
• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.