Nocturnal enuresis or bedwetting: understanding and helping your child

Nocturnal enuresis or bedwetting is a phenomenon that affects 11% of children between the ages of 5 and 7 and 2 to 3% of adolescents*. Between the ages of 2 and 4, toddlers are able to control their bladder during the day, but not systematically at night.Potty training can take several months or even years. As a result, some children may still wet their beds after age 5. But what isbedwetting? And how to cure it? Our investigation.

What is nocturnal enuresis ?

Nocturnal enuresis, commonly called "bedwetting", corresponds to adisorder of involuntary urination which occurs during the night. The child urinates normally but in an unconscious way during his sleep. It is therefore not a childhood illnesslike gastroenteritis or chicken pox.

To speak aboutenuresis before 5 years remains premature. Before this age, we rather refer to a "small accident",since most of the toddlers have not yet acquired the control of their sphincters. It is only when the child is still able to control his bladder that bedwetting can be diagnosed.

This nocturnal urinary incontinence can manifest itself in two forms:

• Primary enuresis, which concerns a child who has never been clean at night;
• Secondary enuresis, which refers to a child who starts to wet the bed again after a period of cleanliness of at least six months.

What causes nighttime bedwetting?

The causes of nighttime bedwetting are diverse. According to the cases, they can be isolated or associated. Primary enuresis is often favoured by a bladder that is too small or an increased production of urine during the night. Other factors of a physiological and psychological nature can also come into play.

Smaller than average bladder

If your child is a bedwetter, he or she may have a small bladder. This small bladder causes violent urges to go to the bathroom. Children with this condition urinate very often during the day. They may also leak into their pants. At night, they may wet the bed several times.

Excessive nighttime urine production

Nocturnal polyuria is an increase in urine production during the night. It results from insufficient secretion ofantidiuretic hormone (ADH) during sleep. This disorder is often hereditary. Children with this condition are very good at going to the bathroom during the day.

Other possible causes

There are other factors that can cause bedwetting in children:

• Enuresis occurs at the end of very deep sleep;
• Genetic predisposition, a hereditary factor;
• Incomplete potty training (need for training)
• A lack of maturity of the sphincters of the bladderas a concern of volume or a reflex contraction (hyperexcitability and hypertonicity of the detrusor, muscle of the bladder);
• A lack of nocturnal secretion of the antidiuretic hormone, vasopressin
• A regressive passage linked to an upsetting event (arrival of a little brother or sister, death of a relative, failure at school, etc.);
• Constipation problems;
• Type 1 diabetes (quite rare).

What are the solutions to accompany your child?

We have seen it,nocturnal enuresis is not an infantile disease. The best solution thus remains toaccompany and to support your child in this stage of his development. If the causes at the origin of this disorder remain of a physiological nature, a medical treatment is however possible.

Enuresis alarm or "pee alarm

Your child is over 6 years old and is embarrassed when he wets his bed? You should know that you can offer him to be equipped with a "pee alarm" to help him to be clean at night.

The principle is simple: a probe placed on the panties, pajamas or mattress triggers a bell as soon as the first drops of urine are emitted. Eventually, this device allows the child to wake up when his bladder is full and togo to the bathroom by himself.

Note, however, that the sound of the alarm may disrupt the sleep of other family members. If your child is sleeping at a friend's house or going to summer camp, this system may not go unnoticed.

Medication treatments

Before committing to medication, you can set up some helpful little rituals. Explain that your child should avoid drinking too much at night and remind him or her to go to the bathroom before bed.

Bedwetting is a condition that usually goes away over time. For this reason, it is not usually treated in children under 6 years of age. If the problem persists beyond that age or your child shows signs of discomfort, you may want to consult a health care professional.

The general practitioner or pediatrician who follows your child will be able to identify the cause of bedwetting and prescribe an appropriate treatment. In case of a bladder that is too small, medication to increase bladder capacity can be administered. In case of too much production of urine at night, your therapist will perhaps recommend the use of desmopressin.

Treatments for isolated primary nocturnal enuresis begin under two conditions:

• If the child is older than 6 years and is motivated;
• If general preventive measures fail for more than
  three months.

How to help your child stop bedwetting?

Your child wets the bed and you would like to help him/her? Here are 4 useful tips to help him/her manage this problem.

1. Support and reassure your child : bedwetting is normal !

Asbedwetting is involuntary, it would be unfair to scold your child for wetting the sheets during his sleep. Instead, adopt a positive attitude and support your child. Waking up soaked in the middle of the night can be frustrating and upsetting. Explain that peeing in the diaper or bed is normal and that it happens to other children as well. Ask your child how his night was, what was different from nights with peeing so that the brain registers the right parameters and continues.

For example: "I see your bed is dry, did you get up during the night to go to the bathroom? if yes, great you managed to feel your bladder calling you. If not, what did you dream about, were you hot? Did you move around a lot?"

And based on what he answers, we can tell him that the nights he pees, he feels the opposite for example.

Here, we give him the keys to his body.

2. Let your child manage the situation independently

It is important that your child be able to remain in control of the situation, whether he is on treatment or not. Encourage your child to be in charge of his or her own body. If your child is still small, you can install a nightlight in his room so he can go to the bathroom by himself at night. If he's old enough, suggest that he write down on the family calendar the nights when he hasn't wet the bed. Finally, offer to help change the sheets, without making him feel like a chore of course!

3. Protect his sleeping space as best you can

To give your child confidence, think about protecting his sleeping space. You can put a waterproof sheet on the mattress or place a bath towel under the fitted sheet to absorb urine. It is not necessary to change a sleeping child who has wet the bed, as this can disrupt sleep. Just make sure they have a change of pajamas on hand that they can easily put on when they wake up.

4. Choose training pants for babies

Potty training is a long and gradual process. Generally, babies become potty trained during the day around age 2. Therefore, avoid putting a disposable diaper on your child at night if he or she no longer needs it during the day.

Use a waterproof diaper cover, put on a training pantsHe will gain in autonomy and confidence. He will be free to go to the potty alone before going to bed and will become more aware of his body and his needs.

The FAQ of nocturnal enuresis

How to treat nocturnal enuresis ?

Should I worry about my child wetting the bed again?

Is it normal to wet the bed after 4 years old?

Is it normal to wet the bed after 8 years old?