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1993-06-14
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$Unique_ID{PAR00023}
$Pretitle{}
$Title{Medical Advice: Bed-wetting}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Bed-wetting urinary tract infection abnormality abnormalities
diabetes nocturnal urination}
$Log{}
Your Child: A Medical Guide
Bed-wetting
Quick Reference
SYMPTOM
- Frequent bed-wetting after age five
HOME CARE
- First see your doctor to find out if the cause is a physical disorder.
- If there is no physical cause, the best home care is patience,
calmness, and understanding. Try to ignore and avoid the problem as
much as possible.
- Rubber sheets and plastic pants will make housekeeping easier until the
child stops bed-wetting.
PRECAUTIONS
- If a trained child suddenly begins bed-wetting, suspect a physical
illness.
- Do not take a child out of night diapers until he or she consistently
remains dry.
- Do not make a big fuss over daytime training.
- Do not try to shame children into remaining dry at night.
- Do not use devices that awaken the child as urination starts.
- Do not let bed-wetting bring anger and frustration into your
relationship with your child.
- Do not let other children taunt a bed wetter.
Many children cannot remain dry through the night before they are four or
five. About 10 percent of all children over the age of five are bed wetters.
Children of any age may have occasional accidents at night, especially if they
are ill or in exhausted sleep; this is not true bed-wetting.
In 5 to 10 percent of cases, children who are bed wetters have a physical
disease, such as an infection or abnormality of the urinary tract, diabetes,
or a neurologic (nervous system) disorder. If a trained child suddenly begins
bed-wetting, the cause may be physical. If bed-wetting develops a year or
more after night training has been established, or if a child wets himself
both day and night, a physical disease is likely.
However, most cases of bed-wetting are not caused by an identified
physical disorder. Some cases seem to be hereditary, with brothers, sisters,
and parents also having been bed wetters. Some are caused by overemphasis by
the family on toilet training. Others are caused by taking children out of
their night diapers too soon or by waking children to urinate in an effort to
train at night. Some children have emotional problems that cause bed-wetting.
Still, the cause of many cases of bed-wetting remains unknown.
SIGNS AND SYMPTOMS
A child who frequently and consistently wets the bed after age five has a
bed-wetting problem.
HOME CARE
Before beginning any home treatment of bed-wetting, see your doctor. The
doctor can perform tests to determine whether bed-wetting is being caused by a
physical disease, such as a urinary infection or diabetes.
If the doctor finds no physical cause, the best home treatment is to
ignore bed-wetting as much as possible and to try to avoid it. Do not take a
child out of night diapers until the child consistently remains dry. Do not
make a big fuss about daytime training. Do not try to shame a child into
remaining dry at night.
Do not use devices that awaken the child as urination starts.
Withholding liquids during late afternoon and evening hours is not
usually successful and may seem like punishment to the child. Behavior
modification techniques (rewarding success and reacting neutrally toward
failure) rarely work. Rubber sheets and plastic pants are helpful until the
child stops bed-wetting. Until then, patience, calmness, and understanding
may be the best treatment.
PRECAUTIONS
- Do not let a minor problem like bed-wetting become a major destructive
factor in your relationship with your child. Anger and frustration
between parent and child are more costly than extra laundry.
- Do not allow other children to taunt a bed wetter.
MEDICAL TREATMENT
Before planning treatment, your doctor will conduct a physical
examination and order a urinalysis. The doctor may suggest x-ray studies of
the urinary tract or consultation with a urologist. Drug therapy may be
started; imipramine (an antidepressant) may be given by mouth at bedtime for a
trial period, or dextroamphetamine, phenytoin, or caffeine may be prescribed
on a temporary basis. A program of behavior modification may be recommended.
Although these treatments are not always effective, they may be worth a try.
RELATED TOPICS: Diabetes mellitus; Urinary tract infections