At least one in five kids wet the bed, but using an alarm at night will cure most cases.

Bed wetting (or nocturnal enuresis or sleep wetting) is involuntary passing of urine while asleep. It is the normal state of affairs in infancy.

Primary enuresis is when the child has never been dry at night or would not sleep dry without being taken to the toilet by another person or has some dry nights but continues to average at least two wet nights a week with no long periods of dryness.

Secondary enuresis occurs when a child goes through an extended period of dryness and begins to experience night-time wetting again.

Secondary enuresis is often caused by emotional stress. The problem affects about 12 percent of those aged between seven and nine and for a small number (1.5-2 percent) it will continue into adulthood.

Most parents mistakenly think it’s a phase that will pass but Dr. Nerli Senior Urologist states that bed-wetting is a multifaceted problem that isn’t always talked about openly enough.

There are also many misconceptions about why it happens and how it should be treated,” He explains “Parents delay seeking help because they think their child is being lazy, they’re too embarrassed to admit there is a problem or they’ve been told their child will grow out of it so they opt to watch and wait”.

However, bed-wetting, also known as nocturnal enuresis, is usually caused by a medical condition and can be treated relatively easily.

Here Dr. Nerli answers the most common questions about the problem and explains how to tackle it.


Causes of bed-wetting? 

1. Three main reasons why children wet the bed.

Their bladder doesn’t stretch enough to hold all the wee they make at night. This could be caused by constipation. If a full bowel is pushing on the child’s bladder, limiting the space it has to stretch and fill, it may cause a day or night-time accidents.

An assessment by a doctor and a laxative treatment is usually needed to address childhood constipation. The child’s bladder may be “overactive” and give an urgent signal to empty before it’s full. An overactive bladder usually holds lower than average amounts of wee. If this is the case any daytime wetting issues should be treated first. 

They produce too much urine at night. The hormone vasopressin tells the kidneys to make less urine at night. If a child doesn’t produce enough vasopressin while they’re asleep, they make wee than their bladder can hold.

Some children just don’t wake up when their bladder signals to them it’s full or they wake just afterward when it’s too late. Although night-time accidents can be caused by one or more of these reasons all are treatable.

Bed-wetting also runs in families so if one parent wet the bed, their child has a 40 percent chance of doing the same. If both parents wet the bed as children, there is a 70 percent chance, suggesting there may be a genetic link. 

Are there any medicines that might help? 

1. When we sleep, a hormone called vasopressin tells kidneys to make less but more concentrated urine. A sign of this hormone not working is if a child wets the bed very soon after going to sleep. A medicine called desmopressin which reduces the amount of urine produced by the kidneys may be prescribed. 

How should parents talk to their child about bed-wetting? 

A BED-WETTING can have an enormous impact on a child’s daily life, affecting self-esteem, emotional wellbeing, social life and achievement at school.

Children and teenagers may feel so embarrassed about their bed-wetting they avoid having sleepovers or going on trips with school or clubs for fear of their “secret” being discovered. It’s important to stay calm and provide lots of reassurance.

About the author: Dr. R. B. NERLI, Director, KLES KIDNEY FOUNDATION Professor & Head Dept. of Urology, KLE University’s JN Medical College, Belagavi – 590 010 Visiting Professor, University of Minnesota, USA.
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