Although it is very common in childhood, it should be examined further after 5 years if the bed is wet for a long time. Bed-wetting is more common in boys ages 4-11 than girls. Most parents think that bed-wetting is due to laziness, which is not the root cause.
The cause can be physical or psychosocial factors. When the child is under a lot of pressure all day, be it from parents or from school. The main reasons are:
- Stressful family life and conflicts between parents
- Bad toilet habits during the day
- Urinary tract infection
- Down syndrome
- Attention Deficit Hyperactivity Disorder
- Deep sleep and arousal disorder
- Congenital malformations of the genitourinary tract
- Chronic constipation, where a full bowel puts pressure on the bladder
- Slow development of bladder control
- The urinalysis is the first step where we check pus cells, protein, casts, and glucose to rule out urinary tract infections and kidney disease.
- Random blood sugar levels are checked to rule out diabetes.
- The urine culture is based on the urinalysis report.
- Children with complicated enuresis may need further evaluation with kidney ultrasound and micturition cystourethrograms.
- Reassurance is the best approach for both the child and the parent.
- Avoid punitive measures that could affect the child’s psychological development.
- Fluid intake should be limited to 60 ml after 6-7 p.m.
- Parents should be sure that the child has a urination before bed.
- Avoiding sugar and caffeine after 4 p.m. can also be helpful.
- Waking children up a few hours after falling asleep can help them wake up dry.
- The child should not be held responsible for bed-wetting.
- Praise the child and give them a star when they wake up dry.
- Some pharmacological measures are intended to provide short-term relief, but can only be recommended by doctors if the above measures do not work.
- If there is an underlying cause such as diabetes or structural abnormalities, treatment will be given first.
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