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Enuresis means bed-wetting during sleep and it is quite a common problem in
children that occurs more in boys than girls. Myths such as drinking too much
water before bedtime cause bed-wetting, it is a mental or behavior problem or
occurs because the child is lazy to go to the bathroom or is trying to irritate
the parents are baseless. Some of the common causes of bed-wetting are:
* Abnormal urethral valves in boys or ureter in girls or boys,
* Abnormalities in the spinal cord,
* Child may not be able to wake up on time,
* Delayed development of the central nervous system reduces the child's control
over his bladder so that he is not able to stop the bladder from emptying at
night,
* Genetic factors in families,
* Lack of anti-diuretic hormone that reduces the amount of urine made by the
kidneys,
* Small bladder that cannot hold urine for a long time, and
* Urinary tract infections.
Children gain bladder control up to the age of five. Bed-wetting by younger
children is not uncommon and need not be treated. If your child is older than
five years and still wets the bed, then you should consult the doctor. Be sure
to tell the doctor about the child's daytime and nighttime bathroom habits,
which may be followed by a physical exam and a urine test called ‘urinalysis’.
The doctor may also check for problems in the urinary tract and the bladder.
Though it is unlikely that bed-wetting in children is related to emotional
upheavals, changes in family life may result in increase in bet-wetting
accidents.
Most children outgrow bed-wetting and do not need treatment but if your doctor
decides that your child does need a treatment, he/she may use medicines or the
behavior therapy to teach the child not to wet the bed. Some of the behavioral
treatments for enuresis are:
* Giving rewards to the child on nights when he or she does not wet the bed.
* An alarm system that rings whenever the bed gets wet, so the child learns to
be more alert and respond to bladder sensations at night.
* Ask your child to change sheets and clean himself when he or she wets, without
shaming him.
* Teach bladder training exercises to the child to make him learn how to hold
his or her urine for longer and longer times.
Children older than seven years who do not respond positively to behavior
therapy may need medicines. However, medicines cannot cure bed-wetting and have
their side effects too. They can just help the bladder hold more urine or the
kidneys to make less urine. Bed-wetting leads to behavior problems such as
feeling of guilt and embarrassment, so you should be careful not to scold the
child and make him feel responsible for it. Child needs training more than
punishment and it may help your child to know that the exact cause of
bed-wetting is unknown and if it tends to run in your family.
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