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By: Anjana Shah, RN, MSN, APRN; Director Kid’s ABC (Advanced Bladder Care) Program
Having a child who wets the bed at night can evoke feelings of frustration, embarrassment, surprise and exhaustion. Many parents make sure their child uses the restroom before they go to sleep, only to find them in a puddle of urine when they wake up. This results in multiple, urine soaked loads of laundry, that are difficult to wash. Did you know that up to 25% of 5 year olds and up to 8% of 12 year olds wet the bed at night?
Bedwetting is a real, and common concern, but is often a topic that is not discussed openly due to many reasons. Night time accidents may not be a part of routine questioning during a well-child health visit, so may not come up at the doctors office. Families who have members who wet the bed when they were younger may be hopeful that their child will “out grow” the night time accidents. Yet others may have sought help and not found a long term solution.
Having a child who wets the bed on occasion may not feel burdensome. However, having a child who wets the bed 3 or more nights per week can be taxing on the entire family. The cost of night time protective underwear, special sheets and bedding, and daily loads of laundry add up. Most importantly, the bedwetting accidents can have a significant emotional impact on the child. Many children feel frustrated by nightly bedwetting accidents and the inability to wake up to use the restroom at night. Vacations and sleep overs can also get complicated and embarrassing for a child who wears protective underwear at night. The overall burden on the child and parents make seeking treatment very worthwhile.
Finding a treatment solution for bedwetting begins with a thorough assessment and accurate diagnosis. There are two types of nocturnal enuresis, the medical term for a bedwetting diagnosis, primary and secondary. Primary nocturnal enuresis occurs when a child who has achieved toilet training during the daytime has accidents while sleeping at night without ever having a 6 month period of total dryness at night. Secondary enuresis occurs when a child who is toilet trained during the day and dry at night, suddenly begins to wet the bed. Both diagnoses are typically made after the age of 5 when day time urine accidents stop for most children.
Many factors are considered when making a diagnosis of either primary or secondary nocturnal enuresis. Pediatric urologists and nurse practitioners are specialists who treat bladder and kidney concerns in children. An appointment with a pediatric urology specialist will first involve taking a thorough medical and family history. It is particularly important for the medical provider to not only focus on nighttime accidents, but also to consider daytime urine habits such as prolonging urination or urinary frequency. Urine infections and birth defects involving the bladder and kidneys are also important to know. Co-existing diagnoses such as ADD and ADHD and daily medications also play in important role in determining appropriate treatment for bedwetting. Next, in-office urine testing can shed some light on bladder function and urine composition. Finally, after an exam to rule out physical abnormalities that can cause bladder dysfunction, a treatment plan that best suits the family is determined.
Treatment for bedwetting can involve behavioral, medical and non-medication treatment options. These treatments are based on decades of research and expertise. Behavioral modifications are very specific to the needs of each child. Medications have been used to treat bedwetting for many years. Many research studies have shown their efficacy and safety in children who have bedwetting accidents. A non-medication treatment option that is well researched is a bed wetting alarm. When used correctly, a bedwetting alarm is a highly effective, long-term treatment solution.
Seeking care from a qualified professional who will consider all of the factors involved in bladder care and uses research-tested treatment strategies is truly worthwhile. Achieving nighttime dryness can tremendously increase child self-confidence and decrease feelings of frustration. Urology experts are available for consultation in two metro locations, Frisco (5680 Frisco Square Blvd Suite #2300) and Southlake (731 E. Southlake Blvd, just past the town square). For more information about who we are, please take a look at our website parcurology.com
Anjana Shah, RN, MSN, APRN
Director Kid’s ABC (Advanced Bladder Care) Program