Parents should not blame their children for wetting the bed, a pediatrician in Tainan said, adding that if bed-wetting continues after a child begins elementary school, they should see a pediatric nephrologist for an evaluation.
“Although the urge to urinate is a natural instinct, it is also formed by a series of complex physiological activities,” Chi Mei Medical Center pediatrician Chang Yi-hsin (張藝馨) said on Tuesday last week.
“The bladder is the latest organ to mature as the human body develops,” she said, adding that on average, children do not gain full control of their bladder until the age of six or seven.
Thus, treatment for bed-wetting, or nocturnal enuresis, is not recommended until the child is at least six, she said.
Chang said that if bed-wetting occurs frequently after the age of six, it might be caused by problems with the kidneys, bladder or spinal nerves, or spina bifida.
If the child has been diagnosed with primary nocturnal enuresis and symptoms are also present during the day, they could be caused by other underlying conditions, she said.
Nocturnal polyuria (when the usual day to night ratio of urine production changes), reduced bladder capacity and sleep abnormalities are three major causes of nocturnal enuresis in children, she said.
For some children, bladder control improves as they get older, she said, adding that about 0.5 to 1 percent of patients continue to struggle with bladder control after the age of 15, or even into adulthood.
“Bed-wetting is not the child’s fault,” and blaming them for it “often brings children enormous stress and trauma,” Chang said.
About six months ago, she saw an eight-year-old whose mom said he wet his bed every night, Chang said.
During his visit, the boy appeared embarrassed, she said, adding that he was later diagnosed with isolated primary nocturnal enuresis and that his symptoms are slowly improving with behavioral therapy and medication.
Treatment for nocturnal enuresis begins with observing the child’s daily water intake and urination patterns, she said.
Medication could be considered after behavioral therapy has been attempted and proven ineffective, she said.
The only effective way to solve bed-wetting is to face the problem, cooperate with the doctor in receiving exams and keeping records, take behavioral therapy seriously and follow medication guidelines, she said.
Parents could also help their children by building their confidence and minimizing conflict, she said.
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