Bedwetting In Children

Bedwetting (also called nighttime or nocturnal enuresis) is a common childhood problem. Children learn to control daytime urination as they become aware of their bladder filling. Once this occurs, the child then learns to consciously control and coordinate his or her bladder. This generally occurs by four years of age. Nighttime bladder control usually takes longer and is not expected until a child is between five and seven years old. (See "Patient information: Toilet training".)

The number of children with bed wetting varies by age; at five years of age, 16 percent of children have some difficulty staying dry at night. By 15 years of age, only 1 to 2 percent continue to wet the bed. Boys are twice as likely as girls to wet the bed.

Motivational therapy — Motivational therapy involves keeping a record of progress, with bigger rewards for longer periods of dryness. You and the child should agree about the reward in advance and might progress from a sticker on a calendar for each dry night to a favorite book for seven consecutive dry nights.The child should practice a self-awakening routine before bedtime every night. Have the child lie on the bed, pretend it is the middle of the night, and feel that the bladder is full. Ask the child to imagine that his or her bladder is saying, "Wake up before it's too late." The child then goes to the bathroom. 

Bedwetting alarms — Enuresis alarms are the most effective method for controlling bedwetting. They are typically reserved for children older than seven years of age. Alarms are not generally used first since they are moderately priced and require the child and parent to be highly motivated. You may consider trying alarm therapy after three to six months of other behavioral training techniques, before treatment with medication. 

Overlearning — Overlearning can help improve the long-term success of enuresis alarms. Overlearning involves use of an enuresis alarm, as described above, until the child is dry for three to four weeks. The child is then allowed to drink 6 ounces (3/4 cup) of water in the hour before bedtime. The child then wears the enuresis alarm to sleep. By filling the bladder, the child's ability to awaken before wetting the bed is challenged, hence the concept of "overlearning. 

Desmopressin — Desmopressin, also known as DDAVP, is a medication that decreases urine production. It is available as a pill and is taken at bedtime to reduce the amount of urine made during sleep. It is generally recommended for brief periods (eg, overnight camps or sleepovers), although it can be used on a nightly basis.

 Mrs. Anita Chaudhary

(Clinical Psychologist)

Asha USA Mini Medicine Citi