ENURESIS

Bedwetting by young children is not unusual, and the age by when they remain regularly dry throughout the night can vary greatly from child to child. Sometimes children from as early as two years old can begin to be dry throughout the night, whereas other children may be as old as six or more, even in their teens. The period between two and five years old is a sensitive period for the learning of bladder control. Adverse life events occurring during this time may therefore disrupt the learning of bladder control. Boys generally find it more difficult than girls to gain bladder control.

Some children may be dry throughout the night for long periods, then, for no apparent reason, they will start wetting again. Clearly, there will be a reason why a child is regularly wet at night, particularly if the child is more than five years old. Although the most common reason for bedwetting is worry or anxiety, in girls it is often associated with infections of the urinary tract. Reasons can also be associated with delays in the maturation of the nervous system, leading to delayed bladder control. In both boys and girls a medical examination is important to exclude possible organic factors.

Failure to establish night time bladder control is often associated with emotional problems which can be due to such things as; Starting school; Being bullied; Going into hospital; A minor accident; The loss of someone close; Feelings of insecurity; Not getting enough attention from parents; Arguments and fights between parents; Divorce or separation; Child abuse. There are many more reasons.

It is always helpful to know what is causing your child to be wet at night so that you can deal with whatever is causing the worry or anxiety. However, it is not essential, because the treatment of bedwetting does not necessarily require that we know the reasons why the child is wetting. Unless of course, there are medical reasons.

There are three important points that need to be kept in mind when trying to encourage a child to become dry throughout the night. They are as follows:-

With these three points in mind the following programme will enable you to maintain your attempts at encouraging your child to become and remain dry throughout the night.

Sit down quietly with your child on the evening you have decided to commence this programme and show him the Star Chart I have included at the end of this web page. Without making a fuss, tell him you are going to give him a star to stick on the chart each morning he is dry. If he is presently wet most mornings, tell him that when he has one star on his chart in a week, you will give him a special treat. You can ask what he would like the treat to be, or you can choose something you know he will like. Only you will know what will please him and what you can afford - perhaps an afternoon at the swimming baths, a Mac Donald's, a trip to the Ice Rink, renting his favourite video, a book, a game, a £1.00 coin, etc.

When he is at home during the day try to make sure (without nagging!) that he goes regularly to the toilet and doesn't get into a habit of having a full bladder. Your child must use the toilet immediately before you put him to bed each night. If he takes a long time getting to sleep, or wakes up in the night, take him to the toilet again. When you go to bed yourself, gently wake him and take him to the toilet whether he is wet or not. Make sure you have his bed well protected with a plastic cover.

If he is wet in the morning do not shout at him, show any anger, or disappointment. Never complain about the extra washing or the smell, simply don't make any comments about him being wet. You must also stop other members of the family making negative comments.

If ever he comes and tells you he has wet the bed, do not make a fuss. Just tell him in a relaxed manner that you know he tried his best to stay dry, and try to show confidence that he will soon get it right. Never dwell on the matter.

Whenever he is wet, without making a fuss, ask him to bath, shower, or wash. If he smells of urine in school he will get unkind comments from other youngsters and this will increase his anxiety.

If he is dry in the morning, make a big fuss of him. Congratulate him, give him a hug and a kiss, and tell him how well he has done. Give him the star to stick on his chart and tell him he has earned his special treat. The important message here is to really let him know how pleased you are with him.

Do not worry if months go by without your child becoming dry, and do not worry if he suddenly wets again after he has been dry for several weeks. Just continue with the programme.

As improvements take place, and he is regularly having at least one dry night a week, you can gradually increase the number of stars he needs to have on his chart before earning his special treat. You should continue the programme until your child has been regularly dry for six months.