Bedwetting or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence. For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.

The age at which bladder control is expected varies considerably. Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.

Factors that affect the age at which wetting is considered a problem include the following:

The child's gender: Bedwetting is more common in boys.
The child's development and maturity
The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.
Causes

No one knows for sure what causes bed-wetting, but various factors may play a role:

A small bladder: Your child's bladder may not be developed enough to hold urine produced during the night.
Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake your child, especially if your child is a deep sleeper.
A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.
Urinary tract infection: This infection can make it difficult for your child to control urination.
Sleep apnea: Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep.
Diabetes: For a child who's usually dry at night, bed-wetting may be the first sign of diabetes.
A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.

Symptoms

Wetting during the day
Frequency, urgency, or burning on urination
Straining, dribbling, or other unusual symptoms with urination
Cloudy or pinkish urine, or blood stains on underpants or pajamas
Soiling, being unable to control bowel movements
Constipation
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

When to see a doctor: Most children outgrow bed-wetting on their own, but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

Consult your child's doctor if: 

Your child still wets the bed after age 7
Your child starts to wet the bed after a few months or more of being dry at night
Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring
Self-Care at Home-
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful

Reduce evening fluid intake.
The child should urinate in the toilet before bedtime.
A system of sticker charts and rewards works for some children.
Make sure the child has safe and easy access to the toilet.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet.

Bedwetting - 7 Possible Reasons Behind It

Behavior of a child should always be closely monitored during his/her early development. Sometimes signs of several personality disorders tend to show up early in life. Proper monitoring of the child's behavior helps to identify the signs and properly diagnose the condition if the child is suffering from any potential personality disorder. 

Here are a few facts you should keep in mind:

1. You might often find it difficult to differentiate between the normal and abnormal behavior of your child. You might consult the pediatrician in this case to compare the child's general behavioral patterns with that of other children in the same age group.

2. It is very important to understand your child's development process. It helps you to interpret his/her behavior and to identify signs of personality disorder.

3. There are a few common behavior patterns, which tend to act as a guide to understanding the behavior of your child. Some of these patterns should be encouraged as they lead to proper behavioral development of your child while patterns of negative behavior should be discouraged. 

4.  You should also consult a doctor if your child shows negative behavior persistently even after disciplining measures.

5. Being polite, doing chores on a regular basis, following instructions should be encouraged and rewarded as it helps in the proper personality development of your child.

6. Behavioral patterns like an inclination towards defensive, regressive and aggressive behavior should not be encouraged but can be tolerated in certain situations like illness or in times of stress.

7.  Behavioral patterns like an increased inclination to violence or an excessive competitive attitude towards their siblings should never be allowed. 

8.  Prejudice or racism, stealing or inclination towards substance abuse, angry outbursts point towards problems in the child's mental, physical or social well-being. You are also advised to take your child to a psychological expert to find out whether he/she is suffering from any sort of behavioral disorder. 

9.  Your behavior also plays a major role in development of your child and his/her behavioral patterns. It is often seen that if a child is subjected to excessive physical, mental or emotional abuse or is engaged in too many curricular and extracurricular activities, he/she is likely to develop several behavioral disorders over time.

Child Development and Behavior

Asthma is a condition that can flare up anytime; be it at your child's soccer practice or during the middle of the night. Whenever the condition sets in, it leads to your child struggling for breath. For a parent to witness this situation can be hard; but you should know the techniques to keep the situation under control.

Here are a few tips on how to manage the situation:

1. Find out the triggers in your home: Asthma is triggered due to substances that your child may be allergic to. Examples are cigarette smoke, fur of pets and dust. If possible, keep your child away from the known triggers so that the condition does not flare up again.

2. Keep records of the following: It is good to have an action plan ready for your child when the bouts of asthma strike. When you visit the doctor to discuss about your child's condition then make sure that you have these records at hand.

The triggers that caused the bout of asthma
How many times did your child have wheezing episodes?
The number of times your child has been admitted for the same reason
The medications that your child is currently taking, dosage and/or whether they have been changed
How often does he/she need medications if he/she has acute symptoms?
3. Knowledge of the test your child may require: Asthma control test is a type of test that allows parents and children to grade asthma symptoms without a doctor. A pulmonary function test is used to detect the capacity of the lungs and flow of air.

4. See how your child responds to the treatments: You should consider changing the treatments for your child if he/she has recurrent symptoms of asthma attack and require frequent visits to the Emergency Room even after taking medications for an extended duration.

5. Long term treatment plans require patience: Any asthma treatment plan requires patience as they might not immediately cure symptoms.

How to Manage if Your Child Is Suffering From Asthma

In many cases; divorce and separation leads not only to bad blood between the parents, but also in a child alienating himself from one parent. Insulting or belittling one parent without justification or under pressure from the other parent is known as parental alienation syndrome. Parental alienation involves one parent undermining the other and interfering with the child s relationship with the other parent by limiting contact with them, bad mouthing them, forbidding discussion about them etc. This can have a very negative effect on the child s emotional state.

1. Self hatred: For children, hatred is not inborn, but developed by the situations they are in. By bad mouthing a parent and teaching the child to hate the parent, the child himself is harmed. With time, he begins to internalize this hatred and believe that there is something wrong with him that made the alienated parent not want him.

2. Low self esteem: When a child is not allowed to speak his mind and has to bottle up his thoughts, he becomes socially withdrawn. Often the child begins to feel that he is the cause for the rift in the family and makes himself responsible for the separation. This intensifies with time and makes the child lose confidence in himself leading to low self esteem.

3. Lack of trust: When a child is suddenly pulled away from one parent and told how that parent is not a  good person  the child is likely to feel betrayed. This creates a sense of doubt in the child s mind and makes it difficult for him to trust other people. As he grows up, this can affect his own adult relationships as well.

4. Depression: Depression is a commonly seen in children from broken homes and this is intensified in cases of parental alienation. It is rooted in the child s feeling unloved by either one of the parents and built up by the separation. Not being given a chance to speak about their feelings or talk about the situation makes them more depressed and they begin to withdraw into themselves. In many cases, it is noted that alienated children have strained relationships with their own children as well.

5. Substance abuse: Depression is one of the most common triggers for substance abuse. Alienated children often feels trapped and that they have no outlet to vent their feelings and frustrations. This often makes them turn towards drugs for relief and can make them victims of substance abuse.

Effects of Parental Alienation Syndrome on Children

Fluoride products for the teeth have immense importance in dentistry. Fluoride is one such chemical, the balance of which is highly required for strong and healthy teeth. However, there is an optimum amount of fluoride needed for teeth. Anything lesser than that or greater than that can cause harm and serious teeth and gum problems and tooth decay. The best option, therefore, is to get a fluoride based toothpaste or mouthwash, which will keep on providing the teeth with the optimum quantity of its daily dose of fluoride.

The benefits of fluoride products
Before delving into the types of fluoride products available, let's have a look at the benefits of fluoride on teeth. Fluorides actually save the teeth from dental caries. It happens such that fluoride makes a certain mineral bonding on the teeth which is called fluorapatite. This is not normally found in human teeth, but when teeth damage is done, then to heal it fast this compound is needed to repair the damages. This adds to the mineral bonding in the teeth and strengthens the teeth.  

The fluoride products
The various fluoride based products, which you may use are as follows:

1. Fluoridated water: Fluoridating water is a simple process where the optimum amount of fluoride is mixed with drinking water so that drinking the water automatically keeps on adding fluoride to the body and keeps in contact with teeth. This therapy alone is enough and needs no more therapies generally. But not all water reserves contain this, and it's not possible to add fluorides to all water reserves. That is why the other fluoride treatments are needed.

2. Fluoride toothpaste: This is one of the most common forms for fluoride treatments. Every common daily use toothpaste contains a 0.22 to 0.312 percent of fluoride, and this is highly beneficial to the teeth for healing of decay and fast repairs. It lets the teeth get stronger. 

3. Mouth Rinses: Fluoride mouth rinses are an option. The sodium fluorides commonly used in the rinses are used in small amounts in the product which is used just like toothpaste and washed off.

4. Fluoride foams and gels: The foam and gel are used when the teeth of the child or adult are under high risk of cavities. The foam or gel is rubbed on the teeth, and kept for a while and then washed off. The typical application time is 30 minutes. 

5. Varnishes: The fluoride varnishes are just like gels, and they are also used on the tooth surface similarly. It's the choice of the dentist or patient as to which one they want to go with. Besides, these slow fluoride releasing devices, medical supplements and lozenges are also there, which slowly release the optimum amount of fluorides to keep the teeth strong and healing.

Use of Fluoride Products for Teeth

Which baby doesn't spit up their food! This is usually not a reason to worry, but if this spitting up is chronic and is accompanied by other symptoms it is known as Gastroesophageal reflux disease or GERD. Severe GERD can cause weight loss and breathing problems and thus, should not be ignored.

Reflux occurs when food is pushed out of the stomach and back up the esophagus. This is usually because the digestive system in babies is not yet fully developed. Vomiting often during the day is one of the most common symptoms of GERD. Other symptoms include:
- A persistent cough
- Choking or gagging while eating
- Refusing to eat
- Crying while feeding
- Heartburn
- Pain in the stomach

Most cases of GERD can be diagnosed by its symptoms and a look at the baby's medical history. In some cases, additional tests may be required, such as:

Barium swallow
The child is given a chalky substance to drink. This highlights the esophagus, stomach and upper part of the small intestines in a special X-ray. It is used to check if there are any blockages in the digestive system.
pH probe

A long, thin tube with a probe at one end is put down the child's throat. This is kept in the esophagus for 24 hours. The probe measures the levels of acidity in the stomach. This test is usually done when the child complains of breathing problems along with reflux.

Upper GI endoscopy
Here the doctor puts a thin, flexible tube down the child's throat. At one end of the tube is a camera that allows the doctor to look into the esophagus, stomach and small intestine.

Gastric emptying study
One of the causes of reflux is the slow emptying of the stomach. To check this, the doctor will mix a radioactive chemical with the baby's milk that allows a special camera to follow its path down the digestive system.

In most cases, GERD can be treated by making a few lifestyle changes. Some of these are:
- Raise the head of the baby's crib
- After feeding the baby, do not let him lie down, but hold him upright for half an hour or so.
- Change his feeding schedule
- Ask your doctor if you can try giving him solid food. Else, check if you can thicken his feed with cereal.
- Make the baby burp after feeding

Most infants outgrow this condition within a year, so do not stress yourself and enjoy life with your baby.

Gastro-Oesophageal Reflux In Babies

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