Wetting the Bed Could be All in the Head

Think brain, not bladder, when it comes to your child’s bedwetting problem. It could be that the brain is not sending out the right signals that it’s time to go to the bathroom.

Bedwetting is embarrassing for children, and its reasons are frequently misunderstood by parents. It can be simply out of the child’s control.

A large part of the problem is a delay in the maturity of the central nervous system and interaction between the child’s brain, sleep patterns and bladder-control center.

When children go into a deep sleep, brain patterns change and affect bladder control. At night, the brain secretes a hormone that helps the kidneys retain water so you don’t produce as much urine. Children who are bedwetters seem to make more urine than average children, and their bladders overflow quicker because of that.

Approximately 15 percent of kids still wet the bed at age five, but the rate declines 15 percent every year until the age of 18. Bedwetting is often inherited from other family members. Early in childhood, more boys than girls are likely to wet the bed, but after age seven, the number is about equal for both sexes. There is no way to predict when kids will achieve dryness.

Kids can reduce the chances of wetting the bed by not drinking fluids one hour before bedtime, reducing caffeine intake, and cutting back on food consumption so the bowel doesn’t press against the bladder and lower its capacity for urine. If these fail, other methods may be used, including an alarm attached to the child’s underwear.

The alarm vibrates or rings so the child is startled from sleep. Over time, the fullness of the bladder awakens the child before the alarm goes off. It’s a principle that involves conditioning the body to awaken (when the bladder is full).

While the alarm can help, they can be a nuisance. The alarm sometimes startles the whole household, everybody wakes up, but the deep sleeper who is wetting the bed just sleeps through it.

Some physicians will recommend medications, such as DDAVP (or desmopressin acetate), a synthetic form of a hormone made in the body that signals the kidneys to retain water, so less urine is produced while the child is asleep. This medicine works well in most children who use it. Parents should talk to their care team about whether this medicine is right for their child.

Aside from drugs and other therapies, it’s important to remember that a child has no control over bedwetting, and punishment or negative reactions will not solve the problem. In some cases, positive motivations can help such as receiving an award after achieving dryness for a certain number of nights. It’s about encouraging children to be motivated to take their medication, avoid drinking fluids in excessive amounts before bedtime, and eat a healthier diet that helps their bowel habits.

As children get older, taking responsibility for changing the bed linens and doing the laundry when they have wetting accidents can help kids be active participants in managing their health issues. But it’s important not to make it a form of punishment. After all, there is no magic bullet that cures bedwetting and often it is just a matter of time.

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