Yahoo Lifestyle Bed-wetting in older children
Bed-wetting can have a big impact. While it’s certainly no-one’s fault, kids who wet the bed long after their friends have stopped, as well as their families, often falsely feel a sense of shame or failure. Nipping the issue in the bud is important, though, as we know that bed-wetting past the toddler years can lead to low self-esteem, withdrawal and anxiety, as well as other social and emotional problems. It’s a myth that nothing can be done about it or that all kids will simply grow out of it. However, the effectiveness of treatment will vary greatly from family to family, due to the different causes behind the bed-wetting.
When bed-wetting is a problem
Most toddlers are able to stay dry during the day at around three years of age and are staying dry at night by the time they’re five or six years old. It’s about the age that kids are ready to start school that they become more aware of others and so begin to have strong feelings of shame and failure if they can’t stay dry at night, despite their best efforts. Similarly, sleepovers – even with relatives – can begin to promote emotional problems stemming from embarrassment.
Why does it happen?
It’s absolutely untrue that kids who wet the bed are just lazy or seeking attention. Interestingly, rarely is bed-wetting caused by a psychological problem. The exception to this rule is if your child was dry, then unusually begins bed-wetting again. This can reflect a sudden episode of anxiety, bullying or extreme stress, such as might be experienced if you and your partner start fighting suddenly. In rare cases, it may also be a sign of abuse.
The most common causes of bed-wetting in older toddlers and young kids are an unusually small, ‘twitchy’ bladder, long-term constipation, very deep sleep patterns, poor sensory connection between the bladder and specific centres of the brain, and low production levels of a hormone called vasopressin. The brain normally produces vasopressin during the night, which greatly restricts the amount of urine produced while we sleep, allowing us to have a good night’s rest.
How to help
Whether the cause of prolonged bed-wetting is psychological or physiological (relating to how the body’s organs work), it’s rare for kids simply grow out of it. Waiting for this to happen after six years of age can increase the risk of social and emotional problems, not to mention exhaustion for the whole family. It’s important to see your family doctor or seek other specialist help if bed-wetting has continued beyond this stage, or has suddenly begun again.
Most important is to reassure your child that you understand and that he shouldn’t feel embarrassed or ashamed. A simple explanation can help, such as, “Your brain isn’t good at sending a message to wake you and tell you to go at night, it’s not your fault...” Further, it’s helpful to have a team approach: “You shouldn’t be ashamed, it’s not your fault, but we’re all going to work together and find a way to help your brain send better messages.”
If your child bed wets, keep it as no-fuss as possible and don’t use punishment. Simply bundle up the sheets, head to the shower and reassure your child that no blame exists. Don’t make him clean up after himself. Discreet night-nappies can also help relieve distress.
If the bed-wetting stems from a psychological problem (if it’s started up suddenly and constipation’s been ruled out), you’ll need to seek out the sources of stress. These can range from anxiety over school to outside stresses, such as family battles, that are ‘reflected’ in your child. These stresses need to be professionally addressed and treated.
When it comes to the more common physiological problems, you can also help. Restricting drinks in general isn’t effective, as kids also get fluid from food, but restricting diuretic fluids (those that increase urine production), such as caffeine-containing soft drinks, can help. You can also try increasing drinks during the afternoon and helping your child practise holding in his wee then emptying his bladder, which can help with twitchy bladders.
Bed-wetting is often hereditary, so if it happened to you, disclosing this to your child and focusing on how you learnt to manage it can be reassuring. Some parents find it helpful to wake their child after about an hour of sleep to go to the loo, but this isn’t generally effective with more enduring problems.
Other aids
As there are many different things that can cause bed-wetting, there are a range of different treatments to suit specific circumstances. Some kids respond well to programs that increase awareness of the connection of the bladder and the brain, which are offered through specialist clinics. Others are helped by ‘bell and pad’ or night-alarm systems, which automatically wake a child once the bed is wet, although some children find these scary or shameful. Finally, but rarely, there are medications such as desmopressin, which works like the body’s natural vasopressin to restrict urine production at night.
Bed-wetting can be draining to manage, for all involved, but with good investigation and treatment, most kids are helped through to peaceful, dry nights.
More from our experts:
