Bedwetting: the practical solution

Bedwetting is a normal phenomenon in infants and young children. But after the age of 5 to 6 years, urination should be controlled by children himself or herself. In some cases, the children over that age, adolescents and also in some adults are experiencing such embracing condition that they wet bed during sleep, especially in night and some time in day also.

In Bangladesh, a community based survey done on 2009 by National Institute of Mental Health, Dhaka and revealed that 3% children aged 5-17 years are suffer from bedwetting. It can occur from many causes including organic and also from mental causes.

Most of the cases the hidden causes are mental stress and anxiety. Common cause are-anxiety due to any cause, like academic pressure, pressure from parents, having a family history, mental stress, like bullying at school, loose bondage among family members, separation from mother, birth of new sibling, neglect by parents or society, victim of physical, sexual or verbal abuse or any disorder in urinary system or hormonal problems.

To overcome bedwetting, few to do things for parents are:

• Toilet training from the age of 20 months of age, which can prevent the bed wetting habit.
• Try to understand kid's expression- what she/he want, how they express their desire to void.
• Set alarm during night and wake up the child to void in toilet.
• Include the fiber rich food in their meal, which will prevent constipation as well as bed wetting.
• Avoid excessive drinking water to child before bedtime.
• If the child wets bed, wake up him/her and engage them to change the bed sheet and others, involve them actively to change the wet cloths.
• Arrange some reward method, like put a sticker in calendar on the day of bed wetting and count at the end of the months the dry-day and wet-day; provide some small reward (Chocolate, balloon etc) for each dry day to them.
• Give quality time to child, search any cause which produce anxiety or mental stress to the child and try to mitigate those.
• If need use alarm-bed, which is the special bed made with calling bed which buzz just during the time of wet.
• Take specialist's advice and medication. medication has tremendous role in nocturnal enuresis.

The writer is Assistant Professor of Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka.

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