Bed-Wetting
Bed-wetting (nocturnal enuresis) is a common condition in childhood affecting 1 in 10 children around the age of 5 and 1 in 20 children around the age of 10 years.
It is very common for the child to be a heavy sleeper and the main concerns that parents have are the stress generated by the increased amount of laundry and the difficulties of allowing the child to either go away on a school trip or to go to a friends for a sleep-over.
The aims of a referral to hospital are to ensure there are no underlying medical problems that need treating and then to help with the management of the bed wetting.
Fortunately there are a number of strategies that can be implemented to help you deal with your child.
The National institute for Health & Care Excellence (NICE) has issued a number of guidelines specifically for parents and these can be accessed in the treatments section.
Features
It is not uncommon for the child who presents with bed-wetting to be a heavy sleeper.
Parents often want to ensure that there is no underlying medical problem and then want help with the management of the wetting.
This is an extremely important issue as the impact on the child can be significant.
What can parents do?
The National Institute for Health Care Excellence has published some useful guidelines which helps parents to manage this condition at home. It explains the initial steps that can be taken to try and improve the symptoms. These can be accessed by clicking on the following link:
In addition there are some useful resources that are available on the ERIC web-site which parents might find useful.
Treatment
Once the measures that have been suggested in the parental advice published by NICE have been implemented it may be that further intervention is required which will be guided by your paediatrician. The first step in this process may be to use a pad and bell alarm (or equivalent). This has a high chance of success and is one of the most effective strategies. If this fails however, further treatment may be warranted. This may include drug therapy which will be dictated by your paediatrician. Common drugs that are used to help control bed wetting include desmopressin and oxybutinin.
Desmopressin effectively switches off the production of urine and therefore its important to take the medication about an hour before going to bed and not have anything further to drink before going to sleep.
Oxybutinin is a different type of medication. This drug makes the bladder wall less sensitive and is therefore useful if there are signs of daytime urgency.
What is the outlook?
The outlook is very good. Most children will grow out of this condition although in some children it may not be until their teenage years.
