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.
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.
- 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
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
- 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.
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