When To Seek Help For Bedwetting

There’s no point in seeking help too early for bedwetting.  It might be worth taking your child’s cue, if for example they feel ready and would like to try to achieve being dry at night.  An intervention will need your child to be involved, so there’s not much point seeking a referral before 5 and in fact, many doctors suggest somewhat later, maybe around 7.  Your child might be motivated to become dry because they want to avoid embarrassment during a social activity like a sleep over at a friend’s house or a trip away with the school.  It seems increasingly common for schools to take children away in Year 2 (when they are 6 or 7) and there must be many children who are still experiencing problems with bedwetting at this age.

In the first instance have a word with a GP and they will probably refer you to a bedwetting clinic for assessment.  Some bedwetting clinics may have restrictions on the age of child they see.  Our local clinic likes to have children having their first appointment around the time of their seventh birthday. 

What will happen at a bedwetting clinic?

Bedwetting clinics will carry out an assessment on your child.  At that assessment they will want to check how much a child drinks during the day and how often they go to the toilet.  They will want to know if there are daytime toileting accidents and they will want to know how frequently your child wets the bed.  It’s worth keeping an eye on these things for a few weeks before your appointment so that you can answer the questions accurately.  Daytime accidents will need to be dealt with first before tackling nighttime issues.  They will be able to give you advice on things like toileting habits and fluid intake .  They may suggest a bladder capacity check.  Another common request is to ask for charts to be completed for a few weeks so that your child’s individual behaviours and circumstances can be assessed.

Bedwetting

I’ve talked before about the fact that my son is still in night nappies at 6 years of age.  So I’ve been doing a little research about bedwetting and not being dry at night.
Bedwetting is perhaps more common than you think.  In the UK alone about half a million children (between 5 and 16) wet the bed.  Children are less likely to wet the bed as they get older.  At 4 and a half it is believed that 8% of children wet the bed, but by nine and a half only 1.5% do.  Each year of age reduces the number of those with the problem and only 1% continue into adulthood.  However, the more frequent the bedwetting, the less likely they are to become spontaneously dry.
I think it’s also well known that boys are more likely than girls to wet the bed, but this pattern decreases by teenage years when there is less difference between genders.
There are two types of bedwetting or nocturnal eneresis:

  • Primary Enuresis This is where a child has never been consistently dry at night. This is the most common type.
  • Secondary Enuresis – This is where a child has previously been dry for six months or more and then starts wetting the bed.

In treatment terms both are assessed and treated in the same way.

Causes of Bedwetting

  • Not waking to signals from the bladder. Some children don’t get a strong enough signal from their bladder to help rouse them from their sleep to go to the toilet.  It does not seem to be connected to deepness of sleep.
  • Lack of Vasopressin. Vasopressin is a hormone at that peaks at night and causes the kidneys to reduce the amount of urine that they produce.  If there is not enough vasopressin then their kidneys will continue to produce daytime amounts of urine which will be too much to hold in the bladder.  Vasopressin is more likely to be lacking if a child wets more than once a night or early in the night.
  • Overactive Bladders. Children with an overactive bladder might have some problems during the day too, like damp pants.
  • Constipation. This can make bedwetting worse or even cause it. It can cause difficulties during the day too as if the bowel is full, it can press against the bladder.
  • Anxiety. Stress or change can cause bedwetting particularly for children who have previously been dry.
  • Family History. Bedwetting can run in families.  If one parent wet the bed as a child then there is a 45% likelihood that their child will inherit the problem.  The figures rise if both parents had problems.
  • UTI (Urinary Tract Infection). A UTI can give a child the feeling of always needing to go to the toilet and can cause problems at day and night.

School Book Fair

Don’t get me wrong, I’m all for encouraging reading.  This week J’s school has a book fair and a school book week.  It’s run with Scholastic Books and the school get a cut of any money raised.  So I guess in a way it’s a win win for them.  Encouraging children to read and doing a little fundraising too.  The trouble is that the books are very expensive.  They are much more expensive than buying books online.  Often double the price or more.  If I was to buy my son books, I’d get much more for my money online.  I could probably buy the book online, pay the school the amount they’d get from Scholastic and still have change left.  Therein lies the rub.
We have a bookcase filled to overflowing with books in my son’s room.  It’s regularly supplemented with a big wadge of library books.  I almost dread book week because I know I’ll end up buying something to add to this enormous quantity of books.  We are getting more and more ruthless about the books we keep as adults in our house as we have 3 large full bookcases and don’t really want to buy any more.  My son’s bookcase is culled every now and again and the weaker or outgrown books are weeded out.  We don’t need any more and we certainly don’t need to buy any more at inflated prices.
I guess you could say that it isn’t aimed at us, but to be truthful I’m not sure who it is aimed at.  Those that don’t read much at home may not have the money to spend on overpriced books.  They’d be better directed and encouraged to go to the local library.  As I’ve said you could buy a lot more books for your money online.
We don’t always buy our books online. J quite often gets given book tokens and he enjoys spending them in local bookshops.  Sadly we don’t have a local independent bookseller anymore, so browsing tends to happen in Waterstones.  We often while away half an hour in the children’s section of a bookshop.  Shopping at the school book fair isn’t such a pleasant experience.  For a start there are no comfy chairs (or any chairs at all for that matter).  There are only a very limited selection of books available.  Some of the books are more toys or activities than books and some have some sort of gimmick – I guess this may appeal to some children who don’t read very willingly.  I usually find there are about 5 books that are the right age group and are books that I broadly speaking approve of.  I hope my son picks one of those.  I try to set ground rules before we go.  No toys, no film/TV tie in books, etc.  If he was spending his own money, I’d let him have free rein,but if I am paying I want to buy a decent book. 
You might have gathered that I’m kind of dreading the school book fair.

Embarrassment About Night Nappies

I’ve talked before about the fact that my son is still in night nappies at 6 years of age.  Most of the time this doesn’t cause too much of a practical problem.  We have the nappies in the house, he puts one on at night and unless it leaks (which to be fair it does quite often, say once or twice a week) that is all that is needed.

Last week we had a young guest come to stay and they were to share J’s room.  J had complained about this a few times in the lead up to it happening, but without giving a good reason why they shouldn’t share.  On the evening at bedtime it became very clear that J was embarrassed by the night nappy.  We helped him get it on while the other boy was occupied cleaning his teeth and covered it up with pyjama bottoms.  I promised to help him dispose of it quickly and discretely in the morning.  He seemed happier.

There hasn’t been the same embarrassment when his best friend comes to stay.  But, I wonder if that will start soon.  So far his friend hasn’t teased him.  There’s still no sign of ditching the night nappy despite being over six and a half now.  Just hoping that one day it will all click into place.