Bed wetting is taken as normal till age 5 after which we diagnose the child is having a problem called ‘Enuresis’.
Enuresis can be ‘Primary’ if the child has never been dry before, and ‘Secondary’ if it is precipitated after some time of being completely dry. Enuresis can be of many types and often the choice of treatment is based on a very good history taking.
A child may wet only once around early morning, or many time during nights, and sleep through the wetting. While it is a very common problem in young children, it needs to be addressed as soon as possible after 5 years of age to avoid the chronicity and psychological effects on child’s development and Socialisation needs.
What are the reasons for wetting?
The reasons mostly are due to lack of co-ordination between bladder & brain, but sometimes it can due to lack of a hormone called ‘Vasopression’ required to suppress urine production at night, and less commonly due to an overactive bladder which is often combined with day time problems as well.
How is it diagnosed?
The diagnosis is mostly based on a good history taking, only in selected case s there may be need of further investigations with Ultrasound for Kidney/Bladder or bladder voiding studies.
How is it treated?
Primary Enuresis is commonly treated with Behaviour modification, Star charts, Enuresis alarms, a water sensitive alarm which buzzes one comes in touch with urine, or medication simulating the Vasopresion. The choice of treatment is based on the history and diagnosis.
Sometimes there may be need of additional medications especially if there are sign of over activity/irritability of bladder.
What should I do to prevent/improve?
A regular liquid take and bladder habit is very important to synergise the bladder functions. Your child should be encouraged to drink at least 6-8 classes of clear liquid /day, and empty bladder regularly during day time. School Health nurses can often provide guidance and help towards this.
Many parents try to lift their child few hours after going to bed. This is not recommended and can be more disruptive to the child’s sleep. Stopping drinks few hours before bed, and going to toilet does help.
A good hygiene is very important to avoid any super-imposed infections around the private parts as the area can be moist often.