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Bedwetting

Bedwetting is common (though not often spoken about) and rarely associated with a significant medical problem. It is extremely common among kids who are under the age of 6, and it can last into the preteen years. Bedwetting is considered a natural part of development. Most children will outgrow the problem. Nonetheless, it can be very disturbing and can affect your child's self-esteem or quality of life.

Intervention Techniques

There are simple interventions that you as a parent can do to help with bedwetting. You may want to remind your child to go to the bathroom one final time before bedtime. Some parents try waking their kids in the middle of the night, but most of the time, that doesn't end the bedwetting.

When your child does wake up with wet sheets, have your child help you change the sheets. Explain that this isn't punishment, but it is a part of the process. It may even help your child feel better knowing that he or she helped out and minimize any possible embarrassment.

When to See a Doctor

In rare cases, such as when bedwetting begins abruptly and is accompanied by other symptoms, bedwetting can be a sign of another medical condition, and you may want to talk with your child's doctor.

The doctor may check for signs of a urinary tract infection, constipation, bladder problems, diabetes, or severe stress.

It's a good idea to call your doctor if your child suddenly starts wetting the bed after being consistently dry for at least 6 months. You may also want to call the doctor if your child begins to wet his or her pants during the day, starts misbehaving at school or at home, or if your child complains of a burning sensation when he or she goes to the bathroom.

What Causes Bedwetting?

Generally, most children do not have an anatomical or physical cause for their bedwetting. Instead, bedwetting occurs when several factors come together - more urine is produced during the night than the bladder size and, at the same time, your child fails to wake up when their bladder is overfilled.

Evaluations

After an initial office evaluation to rule out anatomical or medical problems, the next step in the evaluation is:

• Assess urine output day and night (relates to fluid consumption and salt intake).
• Assess bladder size day and night (a "smaller" bladder is occult and associated with constipation or gas).
• Assess sleep patterns.

Evaluating these patterns is essential. An inadequate evaluation will often lead to unnecessary and/or inadequate treatment. So, this information is very important.

Treatments

Once this information is retrieved with the use of basic evaluations, the best treatment can be identified based on the problem. This includes

• Reducing the amount of overnight urine. This can be done with diet/behavioral changes or medication (or both).
• Increasing the bladder size at night. This can be done with medications.
• Increasing awakening when or before bladder is overfilled. This can be done with behavioral treatments or medications.

Each child/family is different and it is important to take an individualized approach to each child. It is important to obtain the necessary information for evaluation and be compulsive about the treatments.

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