When to seek advice

WHEN SHOULD YOU REACH OUT FOR A HELPING HAND ON YOUR ROAD TO DRY NIGHTS?

If your child is between 5 and 7 years old and has always wet the bed, it is likely that they will become dry at night on their own without the need for treatment or outside intervention. Most cases of primary enuresis are nothing to worry about and simply require your love, support and time.

As your child gets older, it is more and more likely that they will need outside support and treatment to get through this phase, but the good news is that by the age of 12, 97% of children will have stopped wetting the bed.

If your child has previously been dry at night for 6 months or more in the past but has started to wet the bed again, this is medically known as Secondary Nocturnal Enuresis.

When it comes to secondary enuresis, there is a range of physical, emotional and psychological causes, so seeking outside support and expert advice is essential.

What causes bedwetting?

If your child is going through a bedwetting phase, you’re probably wondering what’s causing it. The short answer is that it’s usually down to a minor developmental delay, which will straighten itself out over time. It’s quite rare for bedwetting to be caused by an underlying medical condition. The most common form of bedwetting is called primary nocturnal enuresis. This refers to when a child has never been dry at night. Common causes are things like genetics, a neurological development delay between the bladder and brain, or the underproduction of the antidiuretic hormone ADH that signals to the kidneys to produce less urine at night. The other type of bedwetting is secondary nocturnal enuresis. This refers to a child who has been dry for six months or more, and then starts to wet the bed. This is typical the result of underlying medical issues or by emotional factors. For children with primary nocturnal enuresis, it means your child’s bladder capacity has not developed to the point of being able to hold urine overnight. Children who wet the bed at night may have a nervous system that is slow to process the feeling of a full bladder. So your child does not wake up or respond to the messages sent from their bladder to their brain saying its full and needs emptying. As their body matures the messages sent from the bladder start to get through and your child learns to wake and go to the toilet. Most children who experience bedwetting haven’t reached this developmental stage yet. But don’t worry, they’ll get there soon. While deep sleeping certainly plays a role in bedwetting it is not the primary cause of why it happens in the first place. Deep sleeping just makes it even harder for children to response to the signal sent from their bladder telling them to ‘wake-up’. Secondary nocturnal enuresis is a little more complex. If your child has been dry at night for six months and they relapse back to bedwetting, it’s often a sign of emotional problems or stress. Common catalysts include big events, such as moving house, a new sibling, or starting school. Stressful situations, including tension in the home, death of a family member or pet, or being bullied at school can also cause your child to start wetting the bed again. Other causes of secondary bedwetting include minor medical conditions, such as constipation or a urinary tract infection. In very rare cases, bedwetting can be caused by diabetes. One thing to remember through all of this is that the cause is never laziness. It’s important to remain calm and not to take out any frustration on your child, even though it can be a real pain to change sheets every night. Provide some extra support to your child by using DryNites® Night Time Pants or BedMats. It gives them a little more independence and they’re an effective safety net at night.

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When should you seek advice for Primary Nocturnal Enuresis?

If a child has always wet the bed, it is usually a sign that their bladder and their nervous system simply needs more time to develop. It is perfectly normal for children to continue to wet the bed years after they have successfully completed their day time toilet training.

This said, it is recommended to consult your GP if:

Your child is older than 6 years old and wets the bed twice a week or more
You notice that bedwetting is starting to have a negative impact on their relationships, self-confidence and overall emotional wellbeing
Your child is visibly distressed or disturbed by wetting the bed
They begin to wet their pants during the day
You notice any other physical or emotional disturbances of any kind

If in doubt, it is always recommended to see your doctor for advice. Even if it is just for peace of mind. Once you have gotten the all clear from your doctor, a successful management plan is your next port of call.

Although it can be a challenging time for children and parents, with your loving support, reassurance and some practical tools to stay dry at night, your child will see that bedwetting is just a common phase that they will naturally grow out of.

When should you seek advice for Secondary Nocturnal Enuresis?

If your child is experiencing secondary bedwetting, it is recommended to book an appointment with your GP right away.

Although the majority of cases of secondary bedwetting are caused by emotional stress or a psychological trauma, it is important to first rule out any physical causes.

There are several medical conditions that have been known to cause secondary enuresis including constipation, urinary tract infection (UTI), obstructive sleep apnea (OSA) and juvenile diabetes.

Symptoms for these conditions include:

Urinary tract infection (UTI): your child may report an uncomfortable, stinging or burning feeling when going to the toilet, their urine may be cloudy or have taken on a strong odour or they may be urinating more frequently during the day as well as night. Other symptoms include fever, chills, pain in the back or side, severe tiredness and vomiting.
Diabetes: frequent urination is also a symptom of type 1 diabetes. Other symptoms include excessive thirst, tiredness, blurred vision and weight loss even though your child may have a healthy appetite.
Constipation: your child complaining that it hurts when they do a poo, showing signs of holding on, tummy pain, crossing their legs or avoiding going to the toilet. Other symptoms include not having done a poo for seven days and/or soiling their pants.
Obstructive Sleep Apnea: loud snoring, pauses in breathing and difficulty breathing during sleep. Your child may be tired, have headaches throughout the day or show a loss of appetite.

A secondary bedwetting phase can also be triggered by stress, anxiety, depression, or a one-off event that has unsettled your child. So once you have ruled out any physical conditions, it is wise to seek support from a GP, child psychologist or behaviour specialist to identify any emotional or psychological factors that may be the cause.