Introduction
The decision of when to involve your health-care provider can be difficult. If the child displays only night time wetting without any other symptoms, then when to seek medical treatment is up to the family.
When the child is aged between 5 to7 years is probably a good time to seek medical help.
Referral to an enuresis clinic is likely not needed for most children with no other symptoms.
If the child have a physical and any other problem related to health, then immediately rush for medical check-up .
Self-Care at Home
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful.
Reduce evening fluid intake. The child should try to not take any fluids, chocolate, caffeine, carbonation, or citrus after 3 p.m.
The child should urinate in the toilet before bedtime.
Make it a point for the kid to get up at night to use the restroom. Help the youngster realize that getting up every night to use the bathroom is more vital than trying to make it through the night dry.
For some kids, a system of rewards and sticker charts works. For each night they stay dry, the youngster receives a sticker on the chart. A prize is obtained by amassing a predetermined amount of stickers.
Ensure that the child can easily access the bathroom. Install nightlights and clear the passage from his or her bed to the bathroom. If needed, provide a portable restroom.
Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet.
Others contend that pull-ups provide the child a sense of independence and self-assurance. Many parents reserve their use for sleepovers or camping trips.
The parents' attitude toward the bedwetting is all-important in motivating the child.
Focus on the problem: bedwetting. Avoid blaming or punishing the child. The child cannot control the bedwetting, and blaming and punishing just make the problem worse.
Be patient and supportive. Reassure and encourage the child often. Do not make an issue out the bedwetting each time it happens.
Set a "no teasing" edict for the family. No one, not even members of the child's close family, is permitted to make fun of the child for peeing the bed. Avoid bringing up the bedwetting in front of your family.
Help the youngster realize that it is his or her job, not the parents', to remain dry. Assure the child that you want to assist in solving the issue.
The young person should participate in the cleanup effort.
Use washable absorbent sheets, waterproof bed covers, and room deodorizers to improve comfort and minimize damage.
Children who are capable of waking up in the middle of the night to use the restroom but do not appear to grasp its value can benefit from self-awakening programs.
One technique is to have the child rehearse the sequence of events involved in getting up from bed to use the toilet during the night prior to going to bed each night.
Another strategy is daytime rehearsal. When the child feels the urge to urinate, he or she should go to bed and pretend he or she is sleeping. He or she should then wait a few minutes and get out of bed to use the toilet.
Parent-awakening programs can be used if self-awakening programs fail. These programs should only be used at the child's request.
The parent should awaken the child, typically at the parents' bedtime.
The child must then locate the bathroom on his or her own for this to be productive. The child needs to be gradually conditioned to awaken easily with sound only.
When this is done for seven nights in a row, the child is either cured or ready for self-awakening programs or alarms.
Bedwetting alarms have become the mainstay of treatment.
Up to 70% of children stop bedwetting after using these alarms for 12-16 weeks.
About 20-30% start wetting the bed again later (relapse), but with persistence, this method works for 50-70% in the long run.
The alarms take some time to operate. Before concluding that the alarm is a failure, the child should use it for a few weeks or perhaps months.
Alarms come in two flavors: audio and tactile (buzzing).
Alarms come in two flavors: audio and tactile (buzzing).
According to the theory, the dampness of the urine fills up a gap in the sensor, triggering the alert.
The child then gets out of bed, turns off the alarm, finishes using the restroom, goes back to the bedroom, changes into new clothes and bedding, cleans the sensor, switches on the alarm once more, and goes back to sleep.
Alarms are preferred to medications for children because they have no side effects.
The overwhelming consensus is that all children aged 7 and older should be given a trial of an alarm.
For the alarm to be effective, the child must desire to use it. Both the child and parents need to be highly motivated.
Beware of devices or other treatments that promise a quick "cure" for bedwetting. There really is no such thing. Stopping bedwetting is, for most children, a matter of patience, motivation, and time.
Other Therapy
Bladder training exercises: These are useful for adults with bedwetting or other types of urinary incontinence. They do not usually work for children.
Follow-up
For a child with an underlying medical or emotional cause for the bedwetting, the health-care provider will recommend an appropriate treatment for the underlying condition.
If the treatment recommendations of the provider are followed closely, the bedwetting will stop in most cases.
Keep in mind that for some underlying conditions, such as anatomical problems or emotional problems, the treatment may be complex and take some time.
Children with uncomplicated bedwetting usually "grow out of it" on their own.
If you decide to try treatment, try to follow the recommendations of the child's health-care provider. Relapse rates can be high, but retreatment is typically successful.
Your child's health-care provider will monitor the child's progress periodically. How often depends on how quickly the bedwetting improves and your comfort level with that rate. Commitment and motivation are needed if the treatment is to be successful.
Prevention
There really is no way to prevent bedwetting.
Outlook
Bedwetting can damage the child's self-image and confidence. The best way to prevent this is to be supportive. Parents should reassure the child that bedwetting is a common problem and that they, the parents, are confident that the child will overcome the problem.
Every year, 15% of school-aged children who wet the bed become dry without specific treatment.
Although 15-20% of 5-year-old children wet their beds, only 7% of 8-year-old children wet the bed.
It is estimated that 1% of adults wet their bed regularly.
It is difficult to estimate the effectiveness of treatment, but cure rates range from 10-60% with drugs to 70-90% with alarms and parent awakening.
Nearly all bedwetting problems can be cured with single or combination therapy.
Some people do, however, need to have long-term drug therapy.