Parents seeking an effective treatment for bedwetting, or nocturnal enuresis, should understand that the illness is a medical condition, not a behavioral one. Punishment does not work and can even make the problem worse. While bedwetting can happen at any age, doctors do not consider it a problem unless the child is older than age 6. At that stage of development, most children have the muscle function necessary for bladder control. Only 1 percent of children still have nocturnal enuresis as adults, according to the "American Journal of Nursing.” Still, parents should work with a pediatrician to rule out underlying illness or infection and develop an effective treatment plan for bedwetting.
Treat Underlying Illness
The first step to finding a treatment for bedwetting is to eliminate the possibility that an illness may be causing the disorder. Bedwetting can be an early sign of diabetes. A bladder infection, bowel disorder or simply maturational delay may also be the culprit. Treating the underlying cause will usually result in cessation of the bedwetting. If an underlying illness is not discovered, a doctor may well suggest management rather than treatment. Most children do grow out of the condition. There is a strong genetic component to bedwetting as well. A 2003 report in the journal “American Family Physician” notes that the risk of a child having a bedwetting problem is only 15 percent when both parents have no history of bedwetting.
Alarms
Bed alarms are easy to use, work well and are cost efficient. They work best with children age 7 and older. Strong parental commitment is required as well. When the child wets the bed, the alarm sounds. In the beginning, a parent should wake the child and guide him through the ritual of turning off the alarm, going to the bathroom and then changing the sheets, bed clothes and underwear. Most children experience success within four months, according to “Developmental and Behavioral Pediatrics."
Medication
There are two medications that physicians frequently prescribe for nocturnal enuresis: imipramine and desmopressin acetate. Desmopressin acetate is available as a nasal spray or as nose drops. Imipramine is available as pills or capsules. Both medications are effective, but not recommended for long-term use. Also, both have high rates of relapse after a patient stops taking the medication. For that reason, medication is often used in conjunction with an alarm system.
Bladder Exercises
Some children who experience bedwetting simply have smaller bladders than their peers. Bladder stretching exercises have proven to be moderately effective. The technique involves having a child regularly practice holding her urine for as long as she can. A variation of this technique involves having a child go to the bathroom when she has an urge to do so, holding her urine for as long as possible and then starting and stopping the flow of urine. In his book, “The Overactive Bladder: Evaluation and Management,” Dr. Karl J. Kreder, director of urodynamics and reconstructive urology at the University of Iowa, writes that bladder training increases bladder capacity and improves bladder control.
Double Bubble Technique
The double bubble technique places the responsibility for management firmly into the child’s hands. A parent places a plastic sheet over the mattress under the bed sheets. On top of the bed sheets, another plastic sheet is positioned, followed by another set of bed sheets. A clean set of bed clothes should be placed near the bed. During the night, the child changes his own sheets and clothing. This technique empowers the child and also provides some relief to the primary care giver, thereby diffusing family tension caused by chronic bedwetting.
References
- "American Journal of Nursing”; Helping Children with Nocturnal Enuresis ; Amanda K. Berry M.S.N., R.N., C.R.N.P.; August 2006
- “Journal of the British Association of Urological Surgeons”; Hereditary Phenotypes in Nocturnal Enuresis; Henriette L. Schaumburg, M.D., Ph.D.; June 2008
- “Developmental and Behavioral Pediatrics: a Handbook for Primary Care”; Steven J. Parker, M.D.; September 2004
- “The Overactive Bladder: Evaluation and Management”; Karl J. Kreder, M.D.; July 2007
