What is enuresis?
Enuresis, in children, is the involuntary loss of urine, in bed or on clothes, at least twice a week for 3 consecutive months, day or night, from the age of 5.
What causes enuresis?
Bedwetting results from several factors:
- Anatomical nervous system immaturity (smaller bladder)
- physiological (higher urine output, deeper sleep)
- genetic (family members with enuresis)
- Psychological
It is more frequent in children who have sleep difficulties and bladder dysfunction.
Are there different types of bedwetting?
Yes, enuresis can be classified into:
- primary, when the child up to 5 years of age, has never acquired the mechanism to control urine during the night
- secondary, when the child wets the bed again after a period of more than 6 months without doing so
Is it normal for children to pee in bed?
Yes, this situation is quite common.
How often can it occur?
This situation can happen:
- Always: Primary enuresis
- may have ceased to exist and come back: secondary enuresis
- It can happen occasionally, for example, associated with emotional or behavioral problems and/or changes
Which children are most affected by bedwetting?
Enuresis occurs in a fifth of 5-year-olds (20%), and the frequency decreases by about 2% around the age of 12, and can extend into adolescence or even adulthood.
It is slightly more common in male children than in female children.
What can cause involuntary urine leakage?
This is out of the child's control. It is not a matter of tantrum or laziness, the incident happens because there is some delay in the development of mechanisms linked to the ability to concentrate and retain urine during sleep, as is the case of:
- smaller bladder
- Production of a large amount of pee during the night
- Deeper sleep than usual
- Genetic factors
What are the consequences of bedwetting?
If the situation is not controlled, it can trigger some consequences in the child's day-to-day life, such as:
- sleep disturbance
- Lower quality of life
- loss of school performance
- Socialization difficulties
- feelings of shame and anxiety
- low self-esteem
What health problems are associated with or can aggravate bedwetting?
There are several health problems that can be associated with or aggravate enuresis, such as:
- constipation: the retention of stool in the intestines by pressing on the bladder decreases the ability to contain urine
- Poor sleep quality: snoring or having nightmares
- neurodevelopmental disorders such as attention deficit hyperactivity disorder
- daytime urine leakage or urgency to urinate
How can I help my child when they have urine leakage?
Faced with evidence of a situation of enuresis, parents should turn to the child's attending physician who will evaluate and monitor the entire process.
However, you should talk to your child calmly and thoughtfully, without ever scolding or blaming them. Bedwetting does not happen on purpose, but because of a lack of control of the body.
Your support at this stage is essential so that the child does not develop problems with self-esteem, socialization and/or school performance.
Is it possible to change habits to improve this condition?
yes. You can choose to change your child's small habits:
- Avoid giving him caffeinated drinks from mid-afternoon (example: Coca-Cola, Ice Tea, chocolate, among others)
- Reduce fluid intake from the end of the afternoon, promoting proper hydration during the day
- encourage you to urinate before going to bed
- stimulate the habit of urinating several times throughout the day
- ask for the child's help in changing the bed linen
- congratulate the child whenever he does not wet the bed
- Make a calendar with a record of the days when the child wakes up dry and agree on a reward scheme
At what stage should medical help be sought?
In the case of primary enuresis, the situation should be reported in the child health surveillance consultation from 5 years of age. The situation can become quite uncomfortable for both the parents and the child, as it leads to:
- Nocturnal awakenings
- Changes of bed linen and pajamas
- feelings of shame and low self-esteem
In the case of secondary enuresis, that is, if your child was already able to control his urine during the night and suddenly wets the bed again or has urine leakage during the day, this situation should be evaluated as soon as possible in a medical consultation.
What types of treatments are available?
If behavioral and emotional measures are not sufficient, it may be necessary to resort to medication to reduce the amount of urine produced during the night.
There are devices that are placed next to the child's underwear and that alarm when they detect urine. The intention is for the child to empty the rest of the urine in the toilet and consequently develop the perception that the bladder is full.
You should follow the instructions of the treating physician.