Once our children outgrow diapers, we all hope that they will enjoy comfortable nights of sleep in a dry bed. Also, more practically, we want them to be able to sleep over at friends’ houses or in a hotel bed without worry that they will soil the bed or suffer embarrassment. But what about the child who, despite diligent night-training, continues to sleep right through the urge to use the bathroom. Is it his fault? Is it ours?
The following is written by Washington University In St. Louis.
Nighttime bedwetting, or primary nocturnal enuresis, is a common condition in children, and most outgrow it. About 15 percent of five-year-olds and about 5 percent of 10-year-olds wet the bed involuntarily unrelated to an underlying medical condition. The condition happens more often in boys than in girls and tends to run in families. Nighttime bedwetting becomes a real problem when it starts affecting children’s socialization – when they can’t go on sleepovers or attend camp.
Bedwetting is not due to a behavioral or mental problem or laziness of the child, says Paul Austin, M.D., associate professor of surgery at Washington University in St. Louis and a pediatric urologist at St. Louis Children’s Hospital. Rather, some of the most common causes of bedwetting include:
• Genetic factors: Children with one or both parents who wet the bed as children have a much higher risk of wetting the bed.
• Problems with the kidney: lack of a hormone that is produced at night. The hormone, anti-diuretic hormone (ADH) or vasopressin, is produced normally at night to limit the formation of urine during sleep.
• Problems with the brain: a full bladder fails to wake up the child.
• Problems with the bladder: the bladder is too small for his or her age. The bladder should hold, in ounces, the child’s age plus two.
All of these common causes are temporary and resolve as the child matures. Parents should exercise patience with their child and understand that their child is not wetting the bed on purpose. In addition, parents should encourage the child and let him or her know that they will eventually be able to stay dry at night, Austin says.
Some other steps parents can take include:
• Limiting liquids two hours before bedtime.
• Encouraging the child to go to the bathroom before bed.
• Waking the child during the night to go to the bathroom.
• Making sure the child gets enough rest and doesn’t get overtired.
• Avoiding foods before bed that may cause sensitivity or increase urine production, such as dairy, carbonated drinks, caffeine, chocolate, artificially colored drinks, candy, licorice, citrus and melons.
Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.