How to handle a late bed wetter

IT can become frustrating when your child keeps wetting the bed at night, long after you have achieved daytime potty training. What might feel even worse is when the child stays dry for months or years, and then suddenly has a relapse.

Consultant paediatrician Dr Anona Griffith says the condition is known as nocturnal enuresis, and that it affects about 15 per cent of five-year-olds and less than five per cent of children older than age eight. The condition is known as primary enuresis if the child has never had a long period of dryness, or secondary enuresis, which happens when the child has stayed dry for more than six months and then starts wetting the bed again.

“The condition resolves with time,” Dr Griffith reassures parents. “It is twice as common in boys as girls, and children with conditions such as ADHD and learning disorders may also be late bed-wetters.”

While noting that the causes of late bed-wetting may vary, she gives these tips for handling a late bed-wetter:

1. Reassure the child that it is normal

“It is important to let children know that their bodies develop at different rates,” she says. “Even those who do not wet the bed on a regular basis have accidents. It is nothing to be ashamed of, and they can cope with the problem until it stops.”

She also pointed out that late bedwetting is often inherited, so it may be special to the family. Older people who suffered from the condition will therefore be able to relate to the situation.

2. Be sensitive to the child’s feelings

“If they decline to speak of it in public, respect that. If they complain about being bullied, address it with words of affirmation. Also, try to identify the perpetrators and have a discussion with their caregiver if it is a peer, or with any adult involved to minimise the negative impact on the child,” Dr Griffith says.

She also advises that you try to find out if there are triggers that are causing the child to be wetting the bed, especially if the child had stopped and relapsed. Some triggers may be changes to routine, anxiety about an upcoming event, being bullied or abused, or anything that the child may find stressful. You might also want to abstain from sleepovers until the issue is resolved.

3. Monitor fluid intake and diet

“Have them drink during the earlier part of the day stopping at least two hours before bedtime,” she recommends. “Also, eliminate caffeine-containing products, including chocolate, and encourage urination just before bedtime.”

She also recommends covering the child’s mattress with a plastic cover to prevent the urine from soaking through, and setting an alarm to remind the child to wake up and use the bathroom at a certain time each night.

4. Celebrate achievements

Just as it is with basic potty training, celebrating when a child stays dry can help to boost his/her confidence, and encourage the positive results. It is important to remember, however, that nocturnal enuresis is involuntary, so you should not punish the child for wetting the bed, as it was done unconsciously.

“Have them assist in the clean-up process, but do not let it become a burden,” Dr Griffith advises.

5. Look out for other symptoms

Late bedwetting can be a symptom of a more serious condition, so it is important to check for other signs that could indicate that your child needs medical attention.

“A bladder infection or urinary tract infection has symptoms such as a fever, frequent passage of urine, pain when urinating, and lower abdominal pain,” she explains. “Diabetes comes with an increase in appetite and thirst.”

Constipation and sleep apnoea (cessation of breathing during sleep) may also cause a child to wet the bed. Seek medical assistance if you think your child’s bed-wetting is abnormal, as other treatment options are available.