Bedwetting in medical terminology is called “Enurisis”. It is an involuntary passage of urine in bed clothes or under garments, 90% of children bed-wet at night. Daytime bed-wetting is less common, and is usually secondary to emotional stress. How big is the problem? 50 million children around the world suffer from bed-wetting. Does it run in families? If both parents were bed-wetters, there is 75% chance of having a child with the same problem. If one parent was affected, chances decrease to 40%. However, 1st degree cousin may be also affected. At what age should it stop? At the age of 5 years, bed-wetting should disappear. Apparently, incidence decreases and bedwetting may stop without any treatment. 1 in 6 children wet their beds at the age of 5 years. By the age of 10 years 1:15 wet their beds and the adult rate is 1:100. This condition is attributed to delays in maturation in sleep, arousal mechanisms or delay in development of increased bladder capacity. Other causes has to be ruled out by doctors, who should exclude urinary tract infections, diabetes, whether mellitus or insipidus, bladder dysfunction or any renal causes. This can be done through simple tests. Advice can be given, regarding the treatment of this condition with or without drugs. What advice can we offer to parents? Some parents are too shy to discuss this problem; seeking advice when your child is five years old is recommended. The problem has to be managed with sympathy, encouragement and explanation. Something that should be mentioned is that this condition is a common one that is beyond conscious control. Therefore parents have to stop any punitive action as they are counter productive. Star charts can be a very useful tool in resolving this problem. The child earns a star each morning if his bed is dry. Supporting and praising bed wetter's effort to stay dry helps, as well as ignoring any bed wettings that might occur and not holding the child responsible. Bedwetting lowers self esteem and determination, perseverance gives rewarding results. Bedwetting and improper handling may affect children's normal development, leaving them with social damages that peak whenever they have to spend the night outside. A simple yet efficient advice would be to avoid giving water, tea, drinks and beverages after late evening. Children should be taken to the toilet before going to sleep. They may also be awaken every 3 hours and assisted to the toilet at least two or three times in a single night, walking decreases the threshold of the deep sleep A special alarm that starts ringing as soon as the bedwetting starts can be found in the market. It wakes children up and encourages them to control their body function, getting them used to completely empty their bladders in the toilet. Alarm takes several weeks to achieve dryness, but it is effective in most cases. Children and parents need motivation and proper explanation before beginning any therapeutic procedure. Drugs are to be used in treatment of this condition, only under medical supervision. By reducing the amount of urine produced overnight, the results are gratifying, but failure and relapses occur. * The writer is a pediatrician with an M.B.B.S, DcH (DUBLIN) IRELAND __
