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Enuresis or bedwetting is common in children up to about age 8 years

(at which point about 5% of children wet the bed)‐ hence we rarely treat before this age unless a child or family is upset. While this problem will be self‐resolving some children take much longer than others. This can be difficult at times as a younger sibling is trained at night before an older sibling, or a child will not go to a sleep over or a camp for fear of being ridiculed (again which mostly occurs after age 8 years). There are theoretical causes to
why children wet the bed:

  1. Deep sleep‐ parents often report their child is a very deep sleeper and not easy to wake up.
  2. Small bladder capacity‐ children with smaller bladder sizes may have a tendency to leak at night.
  3. Lacking Anti‐diuretic hormone (ADH) in phase 4 of sleep. The hormone is secreted during sleep and signals the kidneys to retain water while sleeping.
  4. Dysfunctional Bladder – this is often manifested by daytime accidents or children who either urinate very infrequently ( for example don’t urinate for a full hour after waking) or urinate too frequently as such interferes with family or school activities.
  5. Constipation‐ at times plays a role in effecting urination.

What can be done about this:

First remember it is a self‐resolving problem and we have no definitive cure except the
tincture of time. It is almost unheard of in children 12 and older.

  1. Awaking a child before you go to bed and have them urinate plus restricting fluids after dinner can help many children. However some children strongly refuse to be awakened‐ do not force the issue.
  2. For sleepovers (or a child is desperate to be out of pull‐ups) we can trial the medicine DDAVP‐ which is like ADH and comes in pill or nasal spray and works for that one night. Please inform us if your child drinks over 40 ounces of water per day.
  3. If your child is a “camel”‐ i.e., a holder go to www.bedwettingstore.com and consider a vibrating watch to remind them and a sticker chart in the bathroom to keep track.
  4. If your child is a frequent urinator, at times a drug called Ditropan can help with the daytime and nighttime symptoms.
  5. An alarm system is also an option. It requires commitment on the parent and child’s part. Often the alarm will not wake the child but rather the parent and the parent must wake up the child. This is about 50% effective and takes about 3 months.

IF YOUR CHILD WETS THROUGH HIS PULL UPS:

1) Consider restricting fluids after dinner
2) Consider a DEPENDS DIAPER.

If a child has bowel and bladder accidents‐ please let us know.

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