Bedwetting in children – enuresis

The pressure from outside is great: as soon as they start kindergarten, the little ones should be able to do without their diapers at least during the day. If, despite all attempts, pants or bed keep getting wet, the   parents’ panic often grows. But patience and a dose of composure are usually enough – and the issue will gradually resolve itself.

overview

A few numbers to calm you down: In Germany, every fifth 5-year-old child and at least every tenth 7-year-old child wets at night regularly or from time to time. A lack of bladder control, especially at night, is quite normal up to a certain age.

The pediatricians only speak of wetting when a child is not dry after its 5th birthday – for more than 3 months at a time and with a certain regularity. If it wets during the day (“pants-wetting”), the doctor speaks of enuresis diurna, if it happens at night (“bed-wetting”) of enuresis nocturna.

By the way: An occasional mishap is also completely normal for older people. Most children are able to control their bladders around their 3rd birthday, with girls mastering this faster than boys on average. Many children easily manage to stay dry during the day, but stay wet at night for weeks to months (sometimes years).

causes

The most common cause of bedwetting in children is the “antidiuretic hormone” (ADH), which slows down urine production during sleep and whose day-night rhythm first has to settle down. With one child it is quicker, with the other it just takes longer. Hereditary influences also seem to play a role. Children who sleep particularly soundly and are therefore not awakened by the signal of a full bladder are often affected.

Today we know that psychological factors play a rather minor role in not becoming dry. Inadequate bladder control – which occurs rarely – can be responsible for day-wetting – the bladder and muscles then do not work together properly. As a result, the  urge to urinate  comes on very suddenly and strongly, so that the affected children simply cannot make it to the toilet in time.

What can you do?

If your child has already celebrated their 5th birthday, you should discuss the situation with your pediatrician. In individual cases, pathological causes such as a malformation of the urinary tract or  diabetes can also  be behind it. These must be ruled out by thorough investigation. Perhaps you should then create a urination log in which you write down how much and when your child drank, when they had to go to the toilet and when they wet for at least 24 hours.

Organic disorders are treated, insufficient bladder control is treated with special pelvic floor training and possibly medication. However, “simple bedwetting” is almost always present. Regardless of whether and which of the following options to deal with the situation use: Almost all children become dry over the years. With a bit of patience, you can ensure that simple bedwetting does not turn into a difficult psychological burden.

• Stay calm, even if it’s sometimes difficult. Your child does not want to annoy you, but is probably also suffering from the situation. Therefore: Don’t scold or punish, just talk. Explain to your child that there is nothing to be ashamed of, it just takes time for their body to learn. Otherwise, don’t make a fuss about the mishap, put a waterproof pad under the bed sheet and offer your child a diaper for the night. Don’t force them to wear them, though – some children don’t feel more relaxed about it than they don’t feel taken seriously.
• Urination and wake-up manoeuvres: A strict ban on drinking from the late afternoon does not help, after dinner the liquid intake should be restricted. It has not been proven whether urinating before going to bed helps, nor has the effect of waking up at night and going to the toilet, which is often advocated. The latter is relaxing for neither the parents nor the child.
• Bell pants or bell mat: These trigger an alarm when moisture is present and, if used consistently, should train the child’s brain to perceive the full bladder in good time. They are worth trying after several months without improvement – but they do require the  motivation  of the child and parents.
• Medications : Desmopressin is a prescription substance that works similarly to the body’s hormone ADH, supporting it until its rhythm settles. It is taken as a pill over a few weeks and then slowly reduced. In addition, it can – taken temporarily – enable the child to take part in school trips or overnight stays with friends.
• Medicinal plants: Worth a try: The regular evening tea made from  fennel , lavender, linden, lemon balm (50 g each) and orange blossoms (10 g). Pour ¼ liter of boiling water over 1 teaspoon and let steep for 10 minutes; a warm footbath and rubbing your child’s thighs and groin with St. John’s wort oil before going to bed.
• Homeopathy  for bedwetting: At best, constitutional therapy under the supervision of an experienced therapist is recommended.