Bedwetting can have a deep physical and psychological impact on your child's health and development. Not only the child, but it leads to frustration among all the family members. This article discusses various causes of bedwetting in your child and what questions should be answered by the caregiver for proper evaluation of the problem.
Bedwetting is a common condition in newborns and many young children. They involuntarily pass urine during sleep. At the age of 6, about 15 percent of the children still wet their beds. You can go for expert advice only if the child is more than 6 years old. Many children may gain control automatically, and treatment is usually not indicated before the age of 6.
There are two types of bedwetting:
Primary means bedwetting that has been continuing since early childhood without a break. The causes of primary bedwetting can occur when:
The child cannot further hold the urine for the entire night.
The child does not wake when its bladder is full.
The child has poor daytime toilet habits.
Children who are habitually ignoring the urge to urinate.
Children who are producing a large amount of urine during the evening and night hours.
Secondary bedwetting usually begins after the child has been dry at night for a significant period, at least six months.
Common causes of secondary bedwetting are:
Urinary Tract Infection: Infections can cause pain or irritation while urination, an urge to urinate (urgency), and frequent urination (frequency).
Diabetes: In children with diabetes who have a high level of sugar in their blood, the body might increase the urine output to get rid of the sugar. Frequent urination is a common symptom of diabetes.
Structural or Anatomical Abnormality: Any abnormalities in the organs, muscles, or nerves associated with urination can cause incontinence, or other urinary problems can lead to bedwetting.
Neurological Problems: Abnormalities in the nervous system, like any injury or disease of the nervous system, can affect the delicate nerves that control urination.
Emotional Problems: A stressful home life, parents' conflict and changes, like starting a school, moving to a new home, or a new baby, can cause bedwetting.
Children who are being abused physically or sexually can also sometimes start bedwetting.
General Causes Of Bedwetting:
1. Heavy Sleeper: The child does not wake up to the stimulation to void.
2. Nocturnal Polyuria: The urine production is more than 130% of EBC (expected bladder capacity). EBC = 30 ml + (age in years x 30). It is common in sleep-disordered breathing (SDB), heart ailments, metabolic problems, and excess nocturnal fluid and solute intake.
3. Small Bladder Capacity: Look for maximum voided volume during the day, which will be less than 50 % of EBC. In this case, the caregiver should avoid providing dairy products to the child.
4. Overactive Bladder or Neurogenic Bladder: A very small percentage of children may have this in practice.
5. Genetic: If one of the parents had a similar illness, 50 % of the children would have it. If both parents have a similar history, 75 % of the children will have it.
Bedwetting is an inherited condition that tends to run in families. Usually, a parent, aunt, uncle, grandparent, or other family members will have had the condition. There are possibilities for parents who wet the bed to get children who have bedwetting habits. Most of these children stop their bedwetting habits on their own at about the same age their parents did.
Do not give your child any fluid up to one and a half hours before bed.
Make it a habit to void the bladder before putting your child to bed.
Do not mock the child for wetting his bed or allow others to do so.
Discuss this issue with your child's pediatrician so that they can rule out physical causes like constipation, urinary tract infection, or diabetes.
Rewarding them with a treat for staying dry for 7 or 10 consecutive days can motivate them.
Parents should consult the doctor for their child's bedwetting:
When the child is between the ages 6 and 7.
If the child seems troubled by bedwetting.
If the child has the urge to urinate more frequently.
When the child has a burning sensation when they pee.
The child suddenly starts wetting the bed at night or during the daytime after a consistent dry period of at least six months.
When the child snores loudly or has gaps or gasps in breathing most nights.
When the child is drinking or eating more than usual.
When the child has swelling of the feet or ankles.
Questions That Doctor Might Ask You:
How frequently does the child wet the bed?
Has there been a dry period of six months or more?
What does the child consume a few hours before sleep? Does it include fluids?
Does your child have problems with increased frequency of urination during daytime or burning sensation during urination?
Is it associated with dribbling of urine or incomplete emptying?
Is there a history of constipation?
Is there a history of snoring?
Is there a family history?
Any signiﬁcant psychological stressors in the child's life?
Do you think it is affecting your child's development?
Bed-wetting can affect anyone, and both the girls and boys are equally affected. The factors associated with an increased risk of bedwetting include:
Family History: If one or both the parents has the habit of wetting the bed during their childhood, they are more likely to get a child with a bedwetting habit.
Stress and anxiety: Stressful events like starting a new school or sleeping away from home can trigger bedwetting.
Attention-Deficit or Hyperactivity Disorder (ADHD): Bed-wetting habit is more commonly seen in children with ADHD.
The onset of bedwetting can be a symptom of urinary tract infection, sleep disorder (deep sleep), constipation, increased urine output, a family history that makes bedwetting more likely, learning disability, small bladder capacity, overactive bladder, insecurity, attention deficit hyperactivity disorder (ADHD), an immature bladder, due to some hormones which concentrate urine at night, fear, sleep apnoea, neurological disorders or it can be due to structural issues such as enlarged prostate or bladder cancer.
When a child wets the bed at night while sleeping after 5 years of age is known as enuresis or nocturnal enuresis. After 5 years of age, about 15% of children wet the bed, and by 10 years of age, 95% of children are dry at night. Bedwetting can occur every night or a few times a week. So if a child is wetting a bed after 10 years of age, visit a doctor.
Attention deficit hyperactivity disorder (ADHD) is a common problem (mental disorder) in children, and bedwetting is a common problem in these children. They are three times more likely to have trouble with bedwetting when compared to other children. It can be due to a link between bedwetting and ADHD, which delays the central nervous system development. When one or both of that child's parents wet the bed, their child can have bedwetting.
Psychological problems or emotional stress caused by the disturbance in the traumatic events interrupt the child's habitual behavior, such as sleep disturbances, including fear of sleep, nightmares, life changes, stressful events, trauma, and these results in bedwetting.
Bedwetting which is also known as nocturnal enuresis is a common problem in the pediatric population. It is most commonly seen in children with autism spectrum disorders. Autistic children usually undergo late toilet training, bedwetting, and difficulties with toilet training.
We can prevent a child from wetting the bed by reducing the intake of liquids during or before bed, urination schedule in children during the day and before bed, do not give chocolate milk or cocoa, citrus juices, artificial flavorings, and sweeteners at night, relieve the child from constipation factor, do not wake up the child randomly at night to urinate this causes frustration and sleeplessness and do not punish a child for bedwetting.
The normal age for a child to stop bedwetting is between 5 to 6 years of age, and mostly 85% of children stop bedwetting at this age. A child should be toilet trained between 2 to 4 years of age, but some children still bed wet until 10 or 12 years, and bedwetting is more common in boys and also in deep sleepers.
The psychological reasons for bedwetting are stress due to trauma, abuse, a fight between the parents, or hospitalization. Also, emotional stress, which is a psychological factor, results in bedwetting due to moving to a new house, the death of a lovable person, and enrolling in a new school.
Constipation causes bedwetting, where a bowel that is full of stools puts pressure on the urinary bladder, increasing the urge to urinate and shrinking the bladder. As a result, the child cannot hold the urine throughout the night, and constipation could also be a reason for accidental daytime wetting.
There is no medication to stop wetting the bed, and the drugs such as Tofranil (Imipramine) and DDAVP (Desmopressin acetate) treat only the symptoms and reduces urine production at night. When the drug is stopped, the child will return with bedwetting unless it has naturally gone better. The doctor prescribes the medicines only for a short period to stop bedwetting.
Foods with high water content cause bedwetting in children. Foods such as soup, fresh fruits, cucumbers, coffee, and cocoa products increase with bedwetting. But also, do not drink too little fluid, which can lead to the formation of toxins in the bladder, which irritates the bladder and worsens the bedwetting.
Neurological disorders include diseases of the brain and spine such as Parkinson's disease, multiple sclerosis, seizure disorder, bladder and prostate cancer causes bedwetting. Also, diabetes, urinary tract infection, urinary tract stones, neurological disorders, anatomical abnormalities, urinary tract calculi, prostate cancer, prostate enlargement, bladder cancer, or obstructive sleep apnea cause bedwetting in adults.
Diabetes mellitus causes bedwetting as the body does not produce glucose properly, which results in more significant amounts of urine. This increased urine production in children and adults wets the bed. So, eliminate more sugary, more water-based foods and fizzy drinks from the child's diet.
Last reviewed at:
23 Sep 2022 - 4 min read
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