Bedwetting: To treat or not?

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Bedwetting is rarely talked about.

As a parent, it can be one of those issues we hope might just magically disappear as our child grows, and for a lucky few it does. We might try carrying them sleepily to the toilet during the small hours of the night, to try to coax the last remaining drops of urine out of the bladder. However, after a few nights we give up out of sheer exhaustion, resigning ourselves to the ever-growing pile of laundry awaiting us the next day. If the problem does not spontaneously resolve, we can be left feeling the parental guilt of having failed our child in some way.

The International Children’s Continence Society (ICCS) states that bedwetting is not due to anything that you as a parent, or indeed your child, has or has not done in the past. It is no one’s fault.

Bedwetting can happen for lots of reasons. For some kids, there is a lack of a hormone called vasopressin which slows down our urine production at night-time. For others, the bladder may be overactive, forcing urine to empty even before it is full. Some have a high sleep arousal threshold and won’t waken with the bladder’s signalling. In addition, constipation will create an extra pressure on the bladder making it more difficult to hold on. If one parent struggled with bedwetting, their child is 40% more likely to struggle too.

The stats are surprisingly high. They suggest that in a classroom of thirty 6-year-olds, four to five may still be wetting the bed. Spontaneous improvement will happen for 15% of these children per year thereafter, which leaves a significant number whose leaking is non-resolving. At the age of 18, somewhere between 1 – 3% are still bedwetting.

 
Of significance, more than half of all bedwetting children also have other bladder and bowel control issues.
— Debbie Fallows, Clinical Specialist Physiotherapist in Pelvic Rehabilitation
 Debbie Fallows, Clinical Specialist Physiotherapist in Pelvic Rehabilitation

Debbie Fallows, Clinical Specialist Physiotherapist in Pelvic Rehabilitation

Many (up to 25%) also leak urine during the day; a similar number have bowel control issues and/or problems with constipation.

Who is helping these children?

While not viewed as an illness as such, the psychological impact of bedwetting can be severe. An issue like bedwetting can make a child feel an inner sense of shame and sadness. They might conclude that they are different to other children and have failed in some way, or worse again that they are a failure. This might lead to social isolation and not wanting to be part of things that are a normal part of growing up for any child.

The ICCS encourage active treatment to begin from the age of 6.

There are many treatment options.

A pelvic physiotherapist can work with you and your child to help them become dry at night-time as well as during the day. Behaviour modification looks at daily bladder and bowel habits with a view to identifying any irritants that could be making symptoms worse. Simple strategies of change to fluid and fibre intake can often make a big difference. A bladder retraining programme can help to increase the capacity of the bladder to hold more urine. An internationally recognised ‘dry morning programme’ (©Dawn Sandalcidi) can help to reduce and hopefully stop bedwetting altogether. Pelvic floor muscle rehab using a safe, fun and child-friendly approach is another important aspect of treatment. Sometimes using an enuresis alarm or medication aimed at reducing urine production at night-time can help too.

If this is your child, don’t put treatment off any longer.

Contact us at Strive Clinic to make an appointment.

For further information, also check out www.eric.org.uk and www.i-c-c-s.org.


Strive Clinic is located on Level 2 of Briarhill Shopping Centre, Briarhill, Galway (just off the M6 in Galway).