Remove the shame from bed-wetting

"My five-year-old son is still wetting his bed," a frustrated mother complained as the embarrassed child covered his face. Bed-wetting (enuresis) is a problem for many families. It is common in young children but can extend into the teen years. It is often a normal part of a child's development. Sources indicate that approximately 13 per cent (one in every eight) of six-year-olds wet their bed while about five per cent (one in every 20) of 10-year-olds do so in the USA. Further, bed-wetting is more common in boys and runs in families.

Types of bed-wetting

Primary enuresis: The child has never been consistently dry at night. His/her brain does not respond to the signal that the bladder is full during sleep and so does not awaken to urinate in the toilet.

Secondary enuresis: Children who were dry for at least six months start wetting the bed again. When this happens, one must consider physical or emotional causes, as well as a change in sleep pattern.

Parents often do nothing or punish the child in response to bed-wetting. This does not help the situation. Instead, you should reassure your child that bed-wetting is common and will eventually stop. You may also:

Ensure that your child goes to the bathroom regularly and does not hold urine for prolonged periods.

Encourage the child to urinate at the beginning of the bedtime routine and then again just before falling asleep.

Reduce fluid intake at least two hours before bedtime.

Reward your child for dry nights, for example, using stickers on a calendar.

Avoid the blame game

Parents' attitude towards bed-wetting is very important in motivating the child. You should avoid blaming or punishing the child. The child has no control over bed-wetting, therefore blaming or punishing him/her often results in increased anxiety, and guilt only serves to make the situation worse. You should be patient and supportive each time it happens. Try to enforce a no-teasing rule in the family and do not discuss the problem in front of others. Finally, include the child in the clean-up process, not as a form of punishment, but as part of the process.

Bed-wetting that begins suddenly or is accompanied by other symptoms may not be normal. Consult your doctor if your child:

Starts to wet his or her pants during the day.

Has pain while passing urine.

Has blood in the urine.

Suddenly starts wetting the bed after being consistently dry for at least six months.

Is drinking or eating more than usual.

Has swelling of the feet or ankles.

Is unable to control his or her bowel movements.

Is still wetting the bed often after age seven.

Dr Lisa N.C. Franklin-Banton is the president of the Paediatric Association of Jamaica; email: yourhealth@gleanerjm.com.