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Bedwetting

 

NICE GUIDELINES

In October 2010 the National Institute for Clincial Excellence issued guidelines for the treatment of Nocturnal Enuresis.

The Parents Guide part of this guideline is in the pdf at the bottom of this page

The role of the bladder

The bladder is like a stretchy bag. Its muscle walls relax, to allow it to gradually fill with urine from the kidneys (and therefore become larger), and to contract and squeeze out its contents. Everyones bladder has a usual maximum level of filling before contractions start - and this varies in volume from person to person. When the maximum level is reached, the bladder sends messages to the brain via the nervous system, resulting in feelings of discomfort or fullness. It is this that tells children that they need to go to the toilet. When the toilet is reached (or wetting occurs!), the contractions squeeze the urine out, emptying the bladder.

Food and drink

Children should be encouraged to drink at regular intervals during the course of the whole waking day (6-8 glasses). It is a myth that cutting back on drinks helps to reduce the possibility of bedwetting - less fluid means that the bladder adjusts and holds less. Some drinks, such as fizzy drinks, tea and coffee, last thing at night can stimulate the kidneys to produce a greater amount of urine. Try to prevent your child becoming constipated as this may irritate the bladder and result in more frequent urination

The first steps

Potty training

Being relaxed about potty training is more likely to achieve bladder control. Sitting your child on the potty to play or read can create a more peaceful approach to training, combined with praise for using the potty correctly. Children learn potty training at their own pace and parents can help through giving guidance and encouragement.

Becoming dry at night

If your children are between 3 and 4 years of age and are dry during the day it is possible to find out from them if they are ready to come out of nappies at night by simple indication of displeasure at having a wet nappy or bed. If they are interested, put them in ordinary pants, leave a potty within sight and protect the bedding with absorbent bed mats and washable duvet and mattress. Again, as with potty training, it is importnat to provide planty of encouragement even if the number of fry nights is few. If your child continues to wet the bed for a period of 3 weeks or more, they may not be ready, so it is advisable to try again in 3-4 months time.

Five years old

Still not dry? What parents can do.

If your child is not dry by the age of 5, dont panic! A small number of children may have a physical problem such as an overactive bladder or urine infection. If this is the case you should consult your GP. Some children may not have learnt to hold on at night- or to wake up to the sensation of a full bladder and use the potty or toilet during the night.

The following are a few suggestions:

  • Is the toilet easily accessible?
  • Use a bottom rather than a top bunk
  • If your child is afraid of the dark, keep a soft light on, or position the bed near a light switch.

 Seven years and older

Still not dry? What parents can do.

Discussing the fact that your child is wetting the bed with them can uncover a fear or anxiety which is triggering the problem. It may also be comforting for your child to know that they are not alone! You could find out whether your child really weants to be dry at night and discuss with them what method they can try. If they are disinterested, perhaps it is best not to pressurise them at this stage.

How professionals can help

It is very commn for parents and children to reach a state of frustration and anger at the situation. Talking to a professional can provide re-assurance and a fresh start to tackling the problem. This will enable the most suitable treatment method or combination of methos to help your child become dry at night. Bedwetting alarms are the most effective treatment for enuresis.

The extent of the problem

Bedwetting (nocturnal enuresis) is a common childhood problem. It is estimated that in the United Kingdom alone, over half a million children between the ages of 5 and 16 years regularly wet the bed. The problem ism ore common in boys than girls up to the age of 12 years, but is reviserd for the older grop (12-16 years). A child can feel very conscious that they are the only one affected by bedwetting, which can exasperate the problem, but it may give them comfort to know that in the average class of 30 7-9 year olds, there is likely to be at least one other chid experiencing the same problem.

What might cause bedwetting?

If bedwetting continues beyond eight years old it may be as a result of a number of factors:

  • The bladder holds lower than average amounts of urine before providing a singal to the brain that it is full. It may also be overactive giving an urgent signal to empty before it is full.
  • The signal from the bladder to the brain to wake up and hold on at night isnt getting through. This is NOT under conscious control.
  • Anxieties or stress in the childs life.
  • It is also believed that there is a large genetic nfluance and that bedwetting runs strongly in families.
  • Other contributory factors include constipation, urinary tract infection, and occasionally diabetes or kidney failure
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DOWNLOAD N.I.C.E. PARENTS GUIDANCE

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