Helping
Bed-Wetters
Overcome the Habit
Excerpt
By Nancy A. Melville, HealthScoutNews
(HealthScoutNews) -- Bed-wetting is an issue that neither kids
nor their parents even want to think about, much less talk about.
That's probably why many don't realize it can be effectively treated
and cured in a relatively short period of time.
The lack of understanding and communication about the issue
were a central focus of a panel discussion on bed-wetting that
was featured in a recent issue of Infectious Diseases in Children.
Medically referred to as "primary nocturnal enuresis,"
bed-wetting typically is considered a problem if children are
unable to stay dry through the night after about age 5 or 6. The
problem is more common in boys than in girls.
But unless the bed-wetting started after a child had been dry
through the night for at least six months, experts say that the
problem is probably not behavioral.
"Most parents feel bed-wetting is behaviorally or emotionally
grounded, and they try to address the issue on that level. But,
[if there hasn't been a prior period of staying dry at night],
it's not the case, medically" explains Dr. Alan Greene, a
pediatrician and assistant clinical professor at Stanford University
School of Medicine.
The condition is, in fact, believed to be largely hereditary
and has even been linked with the 13th chromosome, says Dr. Mark
R. Zaontz, head of the Section of Pediatric Urology at the Children's
Regional Hospital in the Cooper Health System in Camden, N. J.
"We know that if both . . . parents wet the bed when they
were young, there's about a 77 percent chance that one of their
children will have the problem, too. If one parent had the problem,
you have about a 44 percent chance that a child will. And if neither
parent had bed-wetting problems, you have about a 15 percent chance,"
Zaontz explains. "So there's a very strong hereditary component."
According to Greene, experts understand that bed-wetting is
specifically caused by a combination of two important developmental
components: kids needing to urinate at night more than is normal,
and their undeveloped internal signals, which wake up most adults
at night when they have to urinate.
"As we get older, people stop making as much urine at night,
and we also tend to become more aware of external signals to wake
up more easily," says Greene.
"There are some people who will have the greater need to
urinate at night but who are awakened by the internal signals,
and there are some people who are deep sleepers but who don't
have that increased need to urinate at night," Greene adds.
"But it's the combination of both of those things that causes
bed-wetting" in children.
The two treatments that doctors say are the most effective,
however, treat the two bed-wetting components separately.
One approach helps develop the internal signals, through use
of underwear or pajama linings equipped with a moisture sensor
that triggers an alarm when even a drop of moisture is present.
Because the bed-wetting child is still a deep sleeper, the alarm
at first usually only awakens an adult in the house, who then
can take the child to the bathroom.
But the routine of being awakened and taken to the bathroom
night after night can help children develop the internal signals
to wake themselves up when necessary.
"It's like when you start a new job and have to wake up
much earlier," says Zaontz.
"At first, you'll need an alarm clock to wake you up, but
over a short period of time of being awoken by the alarm at the
same time, you'll probably start naturally waking up just a few
minutes before that alarm goes off," he says. "So these
devices work on that same principle, and after about 12 weeks,
kids can establish more attentive waking patterns."
Another popular approach is to address the need to urinate with
medication that works to reduce the amount of urine a child produces
overnight.
The medication, called DDAVP, is a synthetic form of a hormone,
called vasopressin, that naturally reduces the amount of urine
the body produces at night.
"(DDAVP) has been shown to be very effective," says
Greene. "The child makes less urine at night, and if they're
on the medication, just the rhythm of staying dry can get them
in a permanent habit until they grow out of the problem."
Although the two methods are the most popular choices recommended
by doctors, they are not the most common exercised by most parents.
"Punishment is one of the most common things people do
in response to their childrens' bed-wetting, and all that does
is makes things worse," says Greene.
Even those who try more sensitive approaches, like positive
enforcement charts, are addressing the issue on a behavioral level
that probably won't work, Greene adds.
"If the positive reinforcement charts haven't work in two
weeks, they're likely not going to work at all and tend to instead
leave kids feeling even more discouraged and powerless,"
he says.
Both experts say parents and doctors need to take more responsibility
in discussing potential bed-wetting problems.
"There are many kids out there with bed-wetting problems,
but if the parent doesn't volunteer the information and the physician
doesn't ask, the child is probably not going to get the proper
treatment," Zaontz says.
Greene adds that parents -- and kids -- shouldn't be shamed
into silence, because bed-wetting is a widespread problem.
"There are, in fact, an estimated 5 million to 7 million
children over the age of 6 in this country alone who suffer from
bed-wetting problems," Greene says.
What To Do
The American Academy of Pediatrics offers this helpful information
on bed-wetting
and school aged children.
Read more about bed-wetting at the American Academy of Family
Physicians familydoctor.org.
Reference
Source 101
For more information on how to prevent other diseases, use
PreventDisease.com's "Quick
Prevention Resources".
|