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Sunday, October 5, 2014

Top preventions and tips for Bedwetting

Bedwetting is the most common pediatric problem. About 10% of the 10 year olds have the problem of wetting their bed. It is a developmental issue. Bedwetting is none other than involuntary urination during the night. It is more common in boys than girls. Bedwetting before the age of 7 is not a concern.
bed wet
Causes for bedwetting:
  • Small bladder: If the child’s bladder is not developed enough to hold urine produced during the night
  • Inability to recognize full bladder: If the nerves that carry signals to the brain about a full bladder are slow to mature
  • Hormonal imbalance: If there is a decrease in the concentration of antidiuretic hormone which conserves body water by reducing the loss of water in urine
  • Stress incontinence: Stress involuntary urination is pressure on the bladder that occurs during an activity such as coughing, sneezing, laughing or other movements
  • Urinary tract infection: An infection which affects the upper urinary tract (pyelonephritis) or lower urinary tract (cystitis) which causes painful urination, frequent urination or the urge to urinate
  • Sleep apnea: A disorder which causes one or more pauses in breathing or shallow breaths while sleeping. A less common symptom of sleep apnea is waking up frequently with a desperate need to urinate or under other circumstances, the person does not arouse from sleep, but the bladder empties anyway
  • Type 1 diabetes mellitus: The lack of insulin in this condition leads to increased blood and urine glucose. One of the classical symptoms is polyuria (frequent urination)
  • Chronic constipation: It can cause pressure on the bladder which leads to voluntary or involuntary urination
When to seek medical help:
  • If the bedwetting continues after the age of seven or eight or occurs frequently
  • If the child suddenly starts wetting the bed
  • If the bedwetting upsets the child causing anger or frustration
  • If the bedwetting is associated with pain during urination or burning sensation while urinating or both
  • Behavioral changes in the child
  • Double voiding: Urinating before going to bed and just before falling asleep
Medication that can be taken:
  • Desmopressin: It increases the concentration of the antidiuretic hormone which slows down the production of urine and makes the body produce less urine during the night.
  • Antidepressants like Imipramine provide relief from bedwetting by changing the child’s sleeping and waking pattern. It also increases the duration of time a child can hold urine or reduce the quantity of urine produced.
  • Anticholinergics, like Oxybutynin, help reduce bladder contraction and increase bladder capacity.
Points to remember:
  • Normal, healthy children may wet the bed.
  • Bedwetting may be a sign of infection or other problems.
  • Many children are dry at night by the time they are 5 years old. Others take longer to stay dry.
  • Scolding and punishment do not help a child to stop bedwetting
  • If your child is 7 or older and wets the bed more than two or three times a week, a doctor may be able to help
  • Treatments include bladder training, alarms and medicines help.
  • Limit liquid intake before bed time.
  • Encourage the child to hold the urine for a long time during the day
  • Moisture alarms - These are small, battery operated devices available at pharmacies. Connect it to the moisture sensitive pad on the child’s undergarment or pajamas. When it senses wetness, the alarm goes on and makes the child wake up, stop the urine and go to the toilet
It is a condition which most children grow out of.

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