Urinary incontinence can be extremely frustrating and embarrassing for families and children. Studies indicate that 20% of all 5-year- old children and 10% of 7-year-olds wet the bed. While it’s not something that should trigger alarm, especially amongst children, it is still relevant to understand what the condition is, how it occurs and how to manage it.
What is urinary incontinence (enuresis)?
This is the loss of bladder control. In children under age three (3), it is normal to not have full bladder control. As children get older, they become more able to control their bladder. When wetting happens in a child who is old enough to control his or her bladder, it is known as enuresis.
There are four (4) types of enuresis. A child may have one or more of these types:
• Diurnal (daytime) enuresis. This is wetting during the day.
• Nocturnal (nighttime) enuresis. Wetting during the night. It’s often called bedwetting, the most common type of enuresis.
• Primary enuresis : occurs when a child has not fully mastered toilet training.
• Secondary enuresis : when a child has a period of dryness, but then returns to having periods of wetting.
What causes enuresis?
Urinary incontinence in children has different causes than in adults. Some possible causes may include one or more of these factors.
• anxiety
• Attention deficit hyperactivity disorder (ADHD)
• Certain genes
• Diabetes. For a child who’s usually dry at night, enuresis may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
• Overactive bladder
• Small bladder
• Urinary tract infection (UTI). This infection can make it difficult for a child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.
• Obstructive sleep apnea (OSA). Sometimes enuresis is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep, often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring and daytime drowsiness.
• Very deep sleep
• Slower physical development
Which children are at risk ?
A child is more at risk if he or she:
• Is constipated
• Does not have regular bathroom habits
• Has physical development problems
• Has anxiety
How is enuresis treated?
In many cases, this condition goes away over time and does not need to be treated. If treatment is needed, many methods can help. These include:
• Changes in fluid intake. It is advised parents give the child less fluids to drink at certain times of day, or in the evening.
• Keeping caffeine out of child’s diet. Caffeine can be found in cola and many sodas. It is also found in black teas, coffee drinks, and chocolate.
• Night waking on a schedule. This means waking the child in the night to go urinate.
• Bladder training. This includes exercises and urinating on a schedule.
• Using a moisture alarm. This uses a sensor that detects wetness and sounds an alarm. Your child then gets up to use the bathroom.
• Medications. Medicines can boost ADH levels or calm bladder muscles.
• Counseling. Working with a counselor can help the child cope with life changes or other stress.
Complications
Although frustrating, enuresis without a physical cause does not pose any health risks. However, enuresis can create some issues for the child, including:
• Guilt and embarrassment, which can lead to low self-esteem
• Loss of opportunities for social activities, such as sleepovers and camp
• Rashes on the child’s bottom and genital area, especially if the child sleeps in wet underwear
Tips for managing urinary incontinence
• A child cannot control the problem without help. Make sure not to scold or blame. Make sure your child is not teased by family or friends
• Keep in mind that many children outgrow enuresis.
• Protect the child’s mattress bed with a fitted plastic sheet.
• Have a change of clothes on hand while out and about.
