Nocturnal Enuresis is night time bedwetting in children after the age when control of the bladder at night is expected.
- 15 percent of 5 year olds
- 5 percent of 10 year olds
- 2 percent of 15 year olds
Most children will grow out of bedwetting. About 1 percent of adults may still have occasional problems.
Bedwetting is not considered a problem until the child reaches 7 years of age. This is a good time to introduce a treatment programme, if the child is motivated to do something about it.
The first step is to visit your family doctor for an assessment.
Some practical advice
- Restricting daytime fluid intake is not very effective as a child needs to feel the sensation of a full bladder
- Six evenly spaced drinks through the day may help avoid evening fluid loading and encourage normal daytime toileting habits
- Avoid caffeinated drinks
- Encourage regular voiding every 2 to 3 hours during the day and again just before settling for the night
- Ensure bowel movements are daily, soft and easy to pass
- Ensure easy access to toilet (night light or torch, potty, etc)
- Do not punish your child but encourage them to share responsibility in cleaning up
- Minimise the impact with waterproof mattress covers or absorbent sheets.
Simple behavioural interventions
Rewards and incentives:
- Star charts and reward systems can be effective for some children by using positive reinforcement to encourage a desired behaviour
- If remaining dry is too ambitious, an intermediate goal may be going to the toilet
- Rewards and incentives should be negotiated with the child and family
- The aim is to positively reinforce dry nights and reduce the negative emphasis on wet beds. Unless used with care, a child may feel a failure if a reward is not attained.
Scheduled waking, lifting, and the use of 'Pull-ups':
- Scheduled waking involves waking the child to allow them to get up and urinate. Children may be woken progressively earlier after dry nights until the interval between going to bed and scheduled waking is one hour.
- Can be effective in keeping the bed dry but unlikely to resolve nocturia
- Lifting when the child is asleep can be counterproductive as it encourages urinating without waking. Scheduled waking (using an alarm clock for older children or a parent wakes the child) is a better option
- Pull-ups can be useful when families are struggling to cope with the wetting especially if blame, punishment or arguments are features. The expense can be an issue. However, in some situations funding may be available if the child is eligible for a Disability Allowance
Bed Alarms – an alarm system that goes off when moisture is detected. The alarm wakes the child and helps to teach the child how to recognize the sensation of needing to pass urine and to wake when the bladder is full.