Understanding Bed-wetting

Sleeping siblings

Bed-wetting or Enuresis is defined as urinary incontinence (loss of bladder control) beyond the age of 4 years for daytime & 6 years for night time; or as the loss of continence after at least 3 months of dryness. 
The diagnosis of enuresis is made when wetting occurs twice a week for 3 consecutive months.

HOW COMMON IS IT?
At 5yrs:          7% of boys, 3% girls
At 10yrs:        3% boys, 2% Girls 
At 18yrs:        1% boys & rarely in girls

Children with ADHD (Attention Deficit Hyperactivity Disorder) are more commonly enuretic.

TYPES OF BEDWETTING:
NOCTURNAL:
1. PRIMARY ENURESIS: comprising 90% of enuretic cases. Children who can control their bladder during the day, but who have never been dry at night for at least 6months.
2. SECONDARY ENURESIS-  are completely dry at night for a period of 6 months & then begin to bed-wet again.
DIURNAL: 
involuntarily voiding of urine when awake
POLYSYMPTOMATIC /COMPLICATED ENURESIS
While most children who wet the bed have no other health troubles, it is wise to rule out associated symptoms that might point to deeper issues: daytime symptoms such as urgency, chronic constipation.

WHY DOES MY CHILD BED-WET?
The cause maybe a combination of genetic, physiological & psychological factors.
•    GENETIC – Risk of nocturnal enuresis in a child is 40% if 1 parent had it & 70% if both parents had it in their childhoods.
•    PHYSIOLOGICAL FACTORS: Some kids don’t produce enough antidiuretic hormone to slow down urine production. A medical examination is advised.
•    PSYCHOLOGICAL FACTORS: stressors such as becoming a big brother/sister, starting a new school or sleeping away from home or the parents room.
•    URINARY TRACT INFECTION: can make it difficult for child to control urination.
•    POLYURIA: Diabetes Mellitus /Insipidus can present as secondary enuresis.
•    Structural problems in urinary tract or nervous system.

DIAGNOSIS
The child will need a physical examination. Depending on the circumstances, the physician may recommend a urine test to check for infection or diabetes. X –rays or other imaging tests of the kidneys or bladder if a structural problem is suspected.

WHAT CAN I DO AS A PARENT?
MOTIVATIONAL THERAPY
     Help your child keep a diary of wet & dry nights.
     Encourage them to urinate before going to bed.
     Restrict fluids, especially caffeinated drinks like tea, coffee & soda in the evening.
     Avoid punishments & angry responses at all costs. 
     Reward your child for being dry at night. But also lovingly accept the non-dry nights.
ALARM THERAPY
A bed-wetting alarm is a mini or body-worn device that rings when it gets wet. The alarm has a sensor which is worn in the pajamas or pants. The sensor is linked to an alarm (bell or vibration alarm). If the sensor gets wet, it immediately activates the alarm.  The child wakes up and learns reflex inhibition of urination. After a period of 4-6 months the child starts wakening up to the sensation of full bladder. 
A combination of both the therapies is successful in up to 60-70% of children. 14 consecutive dry nights is considered as a cured case. However, be aware that continuous dry nights develop gradually. If there is absolutely no improvement using both these methods in 5 weeks; your child needs to see a physician.
HOMEOPATHIC MANAGEMENT
Homeopathy has been found very successful in treating bedwetting. The medicines used are perfectly safe even in young children. 
The goal of homoeopathic treatment is to strengthen the nervous system of the body. This allows the child to gain control over their bladder. It also effectively resolves psychological stressors that might cause the child to bed-wet. A child who has been urinating in bed for years is usually able to keep the bed dry within a matter of a couple of weeks. Medicines like Belladona, Benzoic-a, Calcarea-c, Causticum, Cina, Equisitum, Kreosote, Sepia have commonly been used to treat enuresis. However, please know that they are NOT a ready-guide to prescribe for your child. A homoeopathic prescription of an individualized remedy is best made after a detailed enquiry into your child’s case. Please consult a qualified Homoeopath before taking any homeopathic remedy.