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Bedwetting is a common problem in school age children and a frequent cause of worry and stress for families. The good new is that most children grow out of it over time. The fancy word for wetting the bed at night is ‘Nocturnal Enuresis’. It affects approximately 10% of 6 year olds and 5% of 10 year olds so it is important to reassure your child that it is likely other children in their class still wet the bed as well. Daytime bladder control usually occurs by 4 years of age, but bladder control at night takes longer to develop and usually doesn’t occur until your child is 5–7 years of age.

While parents may see bedwetting as a ‘problem’ due to inconvenience or concerns about underlying disease, for most children it is only seen as a problem when it interferes with their ability to socialise with friends.

What causes bedwetting? The exact cause is unknown but some contributing factors may include; ƒ The a bility to wake to a full bladder is not fully developed yet ƒ C hildren tend to produce more urine at night ƒ Some childr en have smaller bladders ƒ Genetic tendency – often one or both parents wet the bed when they were children ƒ C onstipation ƒ Rar ely it can be associated with medical conditions such as urinary tract infection or diabetes (more so if it is a new symptom) ƒ Most children who wet the bed have no physical or emotional problems. As it occurs when the child is asleep it isn’t their fault. It is not caused by laziness or bad behaviour. For most children it is only seen as a problem when it affects their social life e.g. too embarrassed to have sleep overs at a friends house, or they may be anxious about school camp. DR GEORGIA PAGE

You can talk through options with your GP and there are some great online resources and helplines too (*see links) ƒ Reassur ance is the most important thing for your child. It is a common condition and by talking to your child about how their bodies work and that it isn’t their fault is important. Being supportive and patient is important. ƒ Night light – to guide them if the y wake in the middle of the night to go to the toilet or to change their pyjamas if they have an accident. ƒ Fluids – it impor tant to make sure your child has plenty to drink during the day but avoid too many drinks in the evening before bed especially those with caffeine in it e.g. hot chocolate, tea or cola. ƒ Lifting or w aking – lifting your child at night while they are sleeping and taking them to the toilet or waking them at night to do a wee are other options. It can help in the short term but usually doesn’t stop bedwetting long term. ƒ Bedw etting sheets – as well as using a mattress protector, bedwetting sheets are another good option. These go over the bottom bed sheet so makes it easier to quickly change your child’s bed in the middle of the night. ƒ Bed alarms – A bedwetting alarm is a device that makes a noise when your child wets the bed. There are two types – a pad and bell alarm (connected to a rubber mat that goes on the child’s bed) and a personal alarm (attaches to your child’s pants). It works by waking up your child as soon as they start to wet the bed. It teaches the body to recognise when the bladder is full and wake up and go to the toilet. They are not suitable for younger children and usually are recommended for those seven years and older. It can take time (e.g 1–3 months) to respond to the treatment so be patient and if it isn’t effective your child may not be ready and it is worthwhile having a break and try again later. Medication – In some cases your GP may prescribe medication to help with bedwetting. Desmopressin is a naturally occurring hormone that reduces the amount of urine your kidneys produce overnight. It can be used for adolescents for occasions such as sleep overs and camp.

When to see your doctor ƒ If daytime wetting ƒ If your child was dry at night for a long period of time and then starts to wet the bed again ƒ If your child is wetting the bed after the age of seven and it is bothering them. ƒ At y our child’s request.

Take Home Messages ƒ Most children who wet the bed have no physical or emotional problems ƒ It is not your child’s fault ƒ Most childr en grow out of it over time. If the condition is not distressing to the child or parents, treatment is not indicated.

* RESOURCES – National Continence Helpline on freecall 1800 33 00 66. – www.continence.org.au – www.raisingchildren.net.au

Treatment There are many ways to treat bedwetting and it depends on the age of your child and what best suits you and your family.

Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has lovely new rooms and has a fabulous team of Doctors and Nurses, some of whom are accepting new patients. They pride themselves on delivering good quality health care, with that special personal touch. For more information call 4365 4999, check the website www.yourfamilydoctors.com.au or like them on facebook.