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Bedwetting in children BEDWETTING IN CHILDREN
Many children cannot remain dry through the night before they are four or five. About 10 percent of all children over the age of five are bedwetters. Children of any age may have occasional accidents at night, especially if ill or in exhausted sleep—conditions that do not represent true bedwetting.
Five to 10 percent of children who bed-wet have a physical disease, such as an infection or abnormality of the urinary tract, diabetes, or a neurological (nervous system) disorder. If a trained child suddenly begins bedwetting, the cause may be physical. If bedwetting develops a year or more after night training has been established, or if a child wets himself both day and night, a physical disease is likely.
However, most cases of bedwetting are not caused by an identified physical disorder. Some cases seem to be hereditary, with brothers, sisters, and parents also having been bedwetters. Some are caused by overemphasis by the family on toilet training. Others are caused by taking children out of their night nappies too soon or by waking children to urinate in an effort to train at night. Some children have emotional problems that cause bedwetting. Still, the cause of many cases of bedwetting remains unknown.
Signs and symptoms
A child who frequently and consistently wets the bed after age five has a bedwetting problem.
Home care
Before beginning any home treatment of bedwetting, see your doctor. The doctor can perform tests to determine whether bedwetting is being caused by a physical disease, such as a urinary infection or diabetes.
If the doctor finds no physical cause, then the best home treatment is to ignore bedwetting as much as possible and to try to avoid it. Do not take a child out of night nappies until the child consistently remains dry. Do not make a big fuss about daytime training. Do not try to shame a child into remaining dry at night.
Consult your doctor before using devices which awaken the child as urination starts. Withholding liquids during late afternoon and evening hours is not usually successful and may seem like punishment to the child. Behavior modification techniques (rewarding success and reacting neutrally toward failure) rarely work. Rubber sheets and plastic pants are helpful until the child stops bedwetting. Until then, patience, calmness, and understanding may be the best treatment.
Precautions
• Do not let a minor problem like bedwetting become a major destructive factor in your relationship with your child. Anger and frustration between parent and child are more costly than extra laundry.
• Do not allow other children to taunt a bedwetter.
Medical treatment
Your doctor will insist first upon conducting a physical examination and urinalysis. The doctor may suggest X rays of the urinary tract or consultation with an urologist; imipramine (an antidepressant) by mouth at bedtime for a trial period; dextroamphetamine, phenytoin, or caffeine also on a temporary basis; or a program of behavior modification. Although many of these treatments are not always effective, they may be worth a try.
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GENERAL HEALTH
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