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Enuresis - bedwetting
Do not worry about bed wetting in children before age 6, unless they were previously well toilet trained and the bed wetting is a new problem.
Do not punish a child who wets. Bed wetting is NOT caused by laziness or rebelliousness. Shaming a child for wetting the bed can lead to poor self-esteem and feelings of low self-worth.
Reassure your child that bed wetting is common and can be helped. You can also have your child take an active part in cleaning up from the bed wetting (such as helping to strip the bed and put the sheets in the laundry).
Start by making sure that your child goes to the bathroom at normal times during the day and evening and does not hold urine for long periods of time. Be sure that the child goes to the bathroom before going to sleep.
You can reduce the amount of fluid the child drinks a few hours before bedtime, but this alone is not a treatment for bed wetting. You should not restrict fluids too much. Avoiding drinks that contain caffeine can also help.
Reward your child for dry nights. Some families use a chart or diary that the child can mark each morning. Although this is unlikely to completely solve the problem, it can help. Try it before you use medicines. It is most useful in children 5 - 8 years old.
See your health care provider to consider the use of alarm systems (such as Wet-stop or Enuretone), or drugs like DDAVP nasal spray or pills. These drugs stop bed wetting in 60 - 75% of children who take them, but they are not a permanent cure (once the medication is stopped, the bed wetting tends to come back).
Click here to see a video about how to stop bedwetting.
Call your doctor if:
The health care provider will take a medical history from the patient and his or her parents (if the patient is a child).
Medical history questions documenting the bed wetting in detail may include:
A complete examination will be performed, with emphasis on the abdomen, rectum, and urinary opening. The health care provider will discuss the available treatment options.
Diagnostic tests will not be done unless your health care provider believes there is a medical problem.
After seeing your health care provider:
If your health care provider made a diagnosis related to bed wetting, you may want to note that diagnosis in your personal medical record.
Boris NW, Dalton R. Vegetative disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 22.
Robson WL. Clinical practice. Evaluation and management of enuresis. N Engl J Med. 2009;360:1429-1436.
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