Bedwetting in children: When to worry
Bedwetting can be worrying and frustrating for parents. Bedwetting, medically called enuresis is considered when children repeatedly urinate into clothes or bed at least twice a week for at least 3 consecutive months. It is normal until 5 years of age. Bed wetting often runs in families. There may history of over active bladder, constipation and sleep disorder. Reduced anti diuretic hormone (a hormone that retain water in the body), urinary tract infection are also responsible for enuresis. If physical examination and kidney function are normal, psychological factors are considered as next factor for enuresis. The simplest initial measure is motivational therapy and includes a star chart for dry nights. Waking children a few hours after they go to sleep to have them void often allows them to awaken dry. Some have recommended that children try holding their urine for longer periods during the day. Fluid intake should be restricted to 2 oz. after 6 or 7 pm. The parents should be certain that the child voids at bedtime. Avoiding extraneous sugar and caffeine after 4 pm also is beneficial. If the child snores and the adenoids are enlarged, referral to an otolaryngologist (ENT specialist) should be considered, because adenoidectomy can cure the enuresis. Medical treatments are not usually recommended for children under the age of five as it is common to wet the bed at this. The best approach to treatment is to reassure the child and parents that the condition is self-limited and to avoid punitive measures that can affect the child's psychological development adversely. Although bedwetting does not pose a threat to a child's physical health, it can have a considerable psychological impact on their self-esteem and confidence, particularly in older children. So if your child is experiencing frequent bedwetting, it is recommended that you consult a child specialist for advice.
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