My son is nearly five and has just started school. He’s been out of daytime diapers for 18 months now, but continues to wet the bed at night. Should I be worrying? Heidi Svanberg, The Lakes.
Another night, another wet bedsheet and another anxious parent and upset child. Bedwetting (nocturnal enuresis) can be a tough nut to crack and when the child reaches school age, parents can begin to panic, yet often have no clue where to start.
‘One of the important things to remember about bedwetting is that it’s a very common problem, especially in boys,’ explains Dr Rita Kovesdi, a specialist Paediatrician at Health Bay Polyclinic in Umm Suqeim. ‘At five years of age, 16 per cent of children are still bedwetting; at six years, 13 per cent; seven years, 10 per cent; and at 10 years, five per cent.’
Of course, this isn’t much comfort when you’re washing Pooh Bear in vinegar for the umpteenth time to get rid of the stink, but Dr Rita explains that children develop at different rates, and this includes the maturation of your child’s bladder.
‘Up until the age of four, if they’re not dry at night, it’s no big deal. Usually, maturation delay – slow maturation of the bladder and its function – reaches its point by four years of age, but for some children, it can go beyond this,’ she explains.
She stresses that parents should not get too worried, that most bedwetting complaints are usually benign and will resolve themselves, but there are a few things parents can do to help. ‘Refrain from giving your child fluids one hour before bedtime and ensure they use the bathroom before bed so they start the night with a completely empty bladder. Waking the child to visit the bathroom as you’re going to bed is also a good idea.’
Dr Rita also suggests getting your child involved in the issue in a positive way by using a calendar or reward system. ‘Use a chart and give kids a sticker every time they are dry at night,’ she says.
If parents are still concerned – especially if the bedwetting continues until the child is six or seven (the age when they may be invited to sleepovers) – then Dr Rita suggests bringing them in for an assessment.
‘We always like to rule out possible illnesses or causes, such as worms, urinary tract infections, constipation and medical disorders such as diabetes and even psychological issues,’ explains Dr Rita of the assessment, which typically involves a urine and blood test and ultrasound for the kidneys and bladder, as well as a discussion about family history.
‘Family history is crucial as bedwetting can be genetic, while psychological issues may play a part – for example, divorce or a new sibling. It’s also important to know the patterns of bedwetting. For example, how many times per night, the volume, how much the child drinks before bed, and at what times. We ask parents to keep a journal,’ she explains.
There are effective treatments out there, such as a hi-tech diaper device, a battery-operated alarm placed inside the diaper that goes off when it senses urine. ‘This can be a very good and very effective option, though not always of help to deep sleepers,’ says Dr Rita. Another alternative, often successful with deep sleepers, is anti-diuretic hormone tablets which reduce the production of urine during the night, helping to hold back nighttime fluid and increase the bladder’s capacity.
Dr Rita Kovesdi is a Specialist Paediatrician at Health Bay Polyclinic in Umm Suqeim, 04 348 7140; www.healthbaypolyclinic.com.