All about bedwetting?
Causes of bedwetting / Treatment of bedwetting
Although most children stop bedwetting by age five, you are not alone if your child is still wetting their bed after this age. Bed wetting is a common problem in school aged children; 20% of five year olds, 5% of 10 year olds and 1% of 15 year olds still wet their beds.
Causes of bedwetting
In the majority of cases, the child has never completely learned to control their bladder at night, which is called primary bedwetting. Some children become dry at night for a period (at least six months) and then start bed wetting again, called secondary bedwetting. The causes of primary and secondary bedwetting also differ.
Primary bedwetting has a strong genetic link. If both parents were bed wetters, 77% of their children will also be bed wetters, whereas if just one parent was a bed wetter, only 44% of their children will be. In comparison if neither parent were bed wetters, only 15% of their children will be. Recent research has found an association between primary bedwetting and chromosomal abnormalities.
Many children who wet the bed produce more urine at night than others, because they produce less of a hormone called antidiuretic hormone during sleep which normally reduces urine production while asleep. Some children also have difficulty waking up to go to the toilet or sleep too soundly to notice the sensation of a full bladder. In some rare cases, the child’s bladder is small and physically holds less urine.
When secondary bedwetting occurs it is more likely to be due to psychological stress (e.g. divorce, death in the family or starting school), a physical problem (e.g. urinary tract infection) or a change in behaviour or habits (e.g. drinking more before bed or change in sleeping habits). They key to secondary bedwetting is finding out what has changed.
In some situations, the underlying cause of the secondary bedwetting may require further attention and you should seek help. Did you realise research has shown that the relationship between your child and their psychologist is one of the most important elements for a successful outcome in treatment? Select Counsellors can help you find a psychologist who is the best fit for you and your child
Bedwetting will often resolve naturally on its own. From age seven, primary bedwetting resolves on its own at a rate of 15% per year. However, there are also some techniques that can be used to help bedwetting.
Bedwetting alarm. One of the most effective ways of treating either primary or secondary bedwetting is a bedwetting alarm. The alarm consists of a rubber mat that is placed in the bed under where the child's bottom will be, and it is connected by a wire to a box with a battery powered alarm bell. Don’t worry, the alarm system operates at low voltage and there is no risk to your child. When the child wets the bed, a loud alarm will ring to wake the child up. The child then gets out of bed as quickly as possible and turns off the alarm and goes to the toilet to finish emptying his/her bladder. Research has found that more than 80% of children will become dry within 6-8 weeks and most will stay dry.
For the bedwetting alarm to be successful, the child needs to be involved in the process and desire the outcome of a dry bed. Also, remember, children will have some good and some not so good days. Be very positive on the good days, and try not to be negative on the not so good ones.
Reinforcement. Although most children don't need rewards to promote dryness as the prospect of a regular dry bed is usually enough, some small treats along the way may be a good idea. However, give rewards as surprises when progress is made during the process, rather than one large reward at the end. Also, don't offer big rewards, such as a new toy or something they really want if they become dry as this can add to the stress associated bedwetting and lead to disappointment for the child if they don’t become dry.
Changing habits is also important. Children should drink plenty of fluids throughout the day. Don’t restrict the amount of fluid they drink in the evening as this may delay the process of getting to dry nights and/or cause a reoccurrence of bed wetting when normal consumption resumes. Do eliminate any caffeinated drinks late at night as these have a diuretic effect.
Stop putting a nappy on your child if you want them to stop wetting the bed. It is less likely that a child will start to develop the self control and awareness of bedwetting with a nappy on as it is easy to urinate in and there is little sensation of the wetness.
Exercises. Developing bladder control can also help bedwetting. Bladder awareness exercises include learning to squeeze the bladder muscle, learning to resist the immediate urge to urinate, and stopping and starting the urine flow midstream.
Mattress protection. Mattress protection of the bed and pillow is a good idea while in the learning process of preventing bedwetting.
Therapy and medication. Generally speaking, children who are bedwetting do not need therapy or medication. However, in some cases of secondary bedwetting the underlying cause may require therapy. Medication for bedwetting is generally not recommended because although it may reduce the occurrence of bedwetting, once the medication discontinues, the bedwetting often returns.
In some situations, the underlying cause of the secondary bedwetting may require further attention and you should seek help. Did you realise research has shown that the relationship between your child and their psychologist is one of the most important elements for a successful outcome in treatment? How do you know if the therapist you find will be the best fit for you and your child?
Select Counsellors provides a unique client counsellor matching service to ensure you see the right therapist for your child, first time. We have a pool of highly trained Sydney based counsellors, psychologists, psychotherapists and psychiatrists and will match you with the right therapist based on important information collected in a personalised assessment about your child and their needs. At Select Counsellors our key priority is Finding you the One. To book an assessment click here or call on 1300 123 680 to speak in person with a Select Counsellor.
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