Is she bedwetting?

Ways to help her stop it
‘Parents should remember that children rarely wet on purpose, and usually feel ashamed about the incident,’ Writes Kepha Nyanumba, Nutritionist, AAR Healthcare.

Bedwetting refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting 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 four years of age. Daytime control is usually achieved first while night time control comes later. When a child has a problem with bed-wetting (enuresis) after three to four years, parents may be concerned.

Children can control their bladders during the day, but those who have never been dry at night for at least six months have what is medically known as primary nocturnal enuresis (PNE), the most common form of bed-wetting.
Sadly, most children with PNE feel that there is something wrong with them that causes the problem.Many of them feel that it is as a result of either bad thoughts or bad actions. They feel that somehow bedwetting is a punishment.

Similarly, many parents feel that their children’s bed-wetting is a result of a defect in their parenting. This feeling is heightened by well-meaning friends and relatives who bring up questions of emotional instability as the cause of bed-wetting.

There are a variety of emotional reasons for bed-wetting. For example, when a young child begins
bed-wetting after several months or years of dryness during the night, this may reflect new fears of insecurity.
This may be after an event which makes the child feel insecure. Sometimes, bed-wetting occurs after a period of dryness because the child’s original toilet training was too stressful.

Parents should remember that children rarely wet on purpose, and usually feel ashamed about the incident. Rather than make the child feel naughty or ashamed, parents need to encourage the child and show him or her that he or she will soon be able to enjoy staying dry at night. A paediatrician’s advice on the problem is often very helpful.

Children with PNE need to urinate at night. Not all children do. During the first months of life, babies urinate around-the-clock. Most adults, however, do not need to urinate at night (although a small percentage of the population will need to urinate at night throughout life).

Sometime in mid childhood, most individuals make the transition from urinating around-the-clock, urinating only during waking hours. There are three reasons why individuals continue to urinate at night:

  1. There is an imbalance of the bladder muscles. For example, the muscle that contracts to squeeze the urine out is stronger, at times more than the sphincter muscle that holds the urine in.
  2. They have bladders that are a little too small to hold the normal amount of urine.
  3. They make more urine than their normal-size bladders can hold for several reasons:
  • They may drink too much. Drinking two hours before bed increases night time urine production.
  • They may be consuming a diuretic medication, a substance that directly increases urine output. Usually, these are not prescribed medications. They include caffeinated cola drinks or chocolates.
  • They may make more urine in response to a chronic disease such as diabetes or a chronic urinary tract infection.
  • They may make more urine than average because of their hormonal regulatory systems. Babies make about the same amount of urine around-the clock.
  • Most adults make less urine while sleeping. The reason for this is thought to be a night time surge of a hormone called Anti-Diuretic Hormone (ADH). The levels of ADH found in the blood are higher in the evening and throughout the night.
  • One study on ADH levels in bed-wetters found out that there was a constant low levels of ADH in the them. The night-time surge did not happen. Perhaps this is the reason bed-wetters tend to make more urine at night.

Your patience and love will go a long way in helping a child who wets the bed. Children have no control over this condition; they do not wet the bed on purpose. Making them feel guilty, getting angry or acting disgusted will only delay solving this problem. Try to be understanding and supportive.

To help make life easier for your child and yourself, consider setting an alarm clock two to three hours after your child falls asleep so that he or she can be awakened to go to the bathroom. You should also make sure your child urinates before going to bed.

END: BL 44/ 23

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