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Bed Wetting in Children - Worrying When They Spring a Leak

By Carol Duncan - 30th October 2011

photo by Carol Duncan - all rights reserved

I may or may not have a child who still wets the bed. If I did have a child who still wets the bed, I know I would try not to be concerned about it. At least not until he was 14 or 15 years old. Or 21, and having a sleep-over at the girlfriend’s place.

I may have quietly enquired of our GP a couple of times over the last few years, and been reassured that continuing not to worry, was the correct course of action.

Oh alright, that’s already to hard to keep up.

Mr 8 still leaks. And while I knew not to worry about it, until he worried for things like sleep-overs, I’ve always maintained a vigilant eye to make sure that if he was becoming concerned, I’d know and be able to act on it early.

Mr 8 has always been a big drinker, but so am I. I did ask very early on about possible diabetes given his constant drinking, but he’s just a thirsty kid. Like his mum.

He’s never been concerned about having to wear a ‘night trainer’ and he has a special mat that he sleeps on which is highly absorbent and used in nursing homes with incontinent patients. (I don’t muck around, I was determined to protect his mattress!). It’s called a ‘Kylie’, which I still find very funny.

So. I’ve not worried about his ongoing bed-wetting and neither has he as it is far more common than you might think. The GP had reassured us that in his own good time, he’d become dry at night. But one day, after a spat with his older brother (who took his nappy off at about two years of age and has been dry ever since) who teased him about wearing ‘nappies’ at night, he was amenable to the idea of chatting with the doctor about it. His biggest concern was that Dr Dave might want to look at his penis. I assured him it would be unnecessary.

A local behavioural paediatrician recently held an information evening on bedwetting so I thought I’d head along. It was held at our local library, after work, in a rather large conference room.

And it was packed.

Parents, grandparents and carers had turned out in droves to get more information and I was stunned at the range of the problems they were expressing. Some with teenagers who still wet the bed, some with children with other developmental issues, some with children who wet themselves in class, some whose children are also faecally incontinent.

The night was a real eye-opener.

But I learned a lot about bedwetting, and other forms of incontinence, and realised that when your child is ready there are things that can be done to help.

There are also a few different possible causes for bedwetting, all of which are entirely out of your child’s control, so things like reward charts and so on just don’t work.

Irritable Bladder, Vasopressin and Sluggish Arousal System

The three main things we talked about that night were ‘irritable’ bladders, a hormone called ‘vasopressin’ and the ‘arousal’ ability of the child.

Irritable bladders simply send a message to the brain that they want emptying long before the bladder is actually full.

The hormone vasopressin reduces the amount of urine our kidneys produce at night. If your child isn’t producing enough vasopressin, once your child goes to sleep the kidneys go into overdrive and they end up with a veritable Niagara Falls in their pants.

A sluggish arousal system means that the message from the bladder to the brain that ‘you should wake up now for a wee’ isn’t quite racing along at Formula One speed either.

For some children, it might be one or the other that is going on. Or a bit of all of them. The more the paediatrician talked about how vasopressin works, and the dopey arousal system, the more it sounded like my leaky Mr 8 in that he sleeps liked a log and when he wets the bed it is usually in the first few hours after going to sleep and it is voluminous! (That’s my boy!)

Treatments for Bed Wetting

The two main treatments that are offered for bedwetting are dependent upon your doctor’s assessment of what is causing your child to wet the bed at night. You may be offered a bedwetting alarm in the form of either a mat that they sleep on which detects moisture, or a nifty little moisture sensor on a thin cord that you slip inside their undies (i.e. between two pairs of undies). The cord goes up to a small box that you pin to the collar of the child’s pyjamas and the alarm is in the box. It’s fairly unobtrusive.

The other treatment that may be offered is a medication called ‘desmopressin’. It is taken at bedtime and, at least for us, has been 100% effective.

There are rules about fluid consumption at night when taking desmopressin and while I’m assured the drug is safe, these rules must be adhered to. (Essentially taking the drug and drinking lots at night after taking it can cause fluid overload ... which is not good. Not good at all.) Mr 8 knows he can have his last drink an hour before bedtime.

So. You've still got a leaky kid at your place?

If your child wants to do something about their bedwetting, and is ready to try and take it on, have a chat to your family doctor.

If they’re not fussed, and you’re not fussed, maybe just let nature take its course a bit longer.

P.S: I pride myself on the photographs that I take for your enjoyment on the happychild blog, but I’ve been truly stumped by this one. So, please enjoy Ziggy with an orange on his nose.

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