Tens of thousands of five-year olds around Australia are about to head off to school for the first time.
It makes for a busy time at the National Continence Helpline, as hundreds of panicked parents phone in asking for help about their child’s bedwetting and occasional daytime “accidents”.
WHY DO SOME CHILDREN WET THE BED?
- Some parents describe their children as such deep sleepers, they don’t wake up to the sensation of a full bladder.
- Some children have overactive bladders. If this is the case, they will usually wet the bed more than once a night, and may have to rush to the toilet at times during the day.
- Some children don’t make enough antidiuretic hormone overnight (which concentrates the urine), so they produce a lot of urine while they sleep.
SOME BASIC MEASURES TO HELP BEDWETTING
If your child still wets the bed occasionally at age five, there are a few simple steps you can take to help - particularly with health professionals agreeing that it’s much easier to treat bedwetting earlier rather than later.
Children’s continence nurse and National Continence Helpline advisor Claire Fyfield offers parents a few basic tips:
1. Make sure your child drinks throughout the day.
“Give your child a warm drink with breakfast, and milk on their cereal. Have them drink plenty during the day so they don’t want to drink at bedtime, and always have them go to the toilet before bed,” Ms Fyfield said.
Some of the cases Ms Fyfield have treated have left her dumbfounded. “One child I saw had been having milo, tea and coffee before bed - just like mum and dad!”
2. Prevent or treat constipation.
Many parents were unaware that constipation is a major contributor to children’s bedwetting accidents, according to Ms Fyfield.
“A full, compacted bowel presses against the bladder, which in turn puts pressure on the bladder, risking leakage.”
But on top of this, straining on the toilet when constipated can weaken the pelvic floor muscles and bladder supports, making urine leakage more likely, she said.
With up to 30 per cent of children constipated at any given time (Catto-Smith, 2005), continence health professionals like Ms Fyfield will always check for constipation when a child presents with a bedwetting problem.
“Avoid constipation by providing adequate fluids and a balanced, fibre-rich diet containing plenty of fruit and vegetables. If it’s still a problem, see your doctor for treatment. Avoiding constipation will often improve or end day and night-time wetting.”
WHEN TO SEEK PROFESSIONAL HELP?
If the child is still wetting the bed regularly at the age of six or seven, or if they suddenly start wetting the bed after having been dry, it’s time to see a children’s continence professional, Ms Fyfield said.
“The family will be asked to chart the child’s food and liquid intake and their bowel and bladder habits. We’ll check for conditions like urinary tract infections, and look at stressful or disruptive situations, such as access weekends, that can affect the child. From this we make a care plan for management.”
SOME PRESCRIBED BEDWETTING TREATMENTS
Bedwetting alarms.
“If everything else is fine – their drinking patterns are good, their bowels are all normal – then parents may try a bedwetting alarm, which has about an 85 per cent success rate,” Ms Fyfield said.
She stressed, however, that it was imperative parents consult a continence health professional beforehand, who can determine if a bedwetting alarm is the best form of treatment.
Medications
Desmopressin acetate, a prescription drug that substitutes a naturally occurring diuretic hormone, can sometimes be prescribed for older children.
“It reduces the amount of urine produced overnight by the kidneys. Your prescribing doctor will talk to you about the correct use of this drug, which can also be useful on occasions for older children or adolescents wanting to go on a sleepover or attend camps,” Ms Fyfleld said