Bedwetting: Find out why does your child still wet the bed
Your child over 5 years old is still bedwetting? It is a problem that we should try to tackle as soon as possible. Discover in this article what may be the cause for your child to continue wetting the bed. Should you worry? How can I help him? The first thing to do is to identify the focus or center of the problem! In this article we will help you: Discover the possible causes of bedwetting.
The urination reflex is innate, normally children are not aware that they can control it until two or three years of age. This task is not always easy: Between 5 and 10% of consults with pediatricians are related to bedwetting problems or doubts about how to teach children to control the urge to pee.
What is Bedwetting?
Bedwetting is the term used to refer to nighttime incontinence or to urinate while sleeping, at an age when it is expected to no longer happen.
The Egyptians were the first who identified it as a medical problem, around 1550 BC. Over the centuries, folkloric treatments have been implemented to prevent this disorder, such as raising the legs of the bed, restricting fluid intake, administering herbal potions or practicing circumcision. Spontaneous remissions were characteristics of these techniques. Untreated spontaneous remission is a significant factor in urinary incontinence.
The rates of spontaneous remission are 14% between 5 and 9 years and 16% between 10 and 19 years. Only 1% of 18-year-olds are bed wetters and there are practically no girls.
It poses a problem and it’s diagnosed when the child reaches 4 or 5 years of age without ever having adequate control. A child is said to suffer from bedwetting when involuntary urination occurs at least 2 times a month in children 5 and 6 years old, and at least once a month in older children.
This problem ranges from 2.2% to 25% in children, being twice as often in boys than girls.
It may happen during nighttime, daytime or both. Daytime bedwetting that is not accompanied by nocturnal is quite unusual, but approximately 30% of children with nocturnal bedwetting it is also present during the daytime.
In order to acquire bowel and bladder control, your child needs to have control over the sphincter reflex, which usually happens between 9 and 12 months of age, when the myelination process has been completed (process of coating the axons of the neurons) from the nerve pathways to the lower part of your child’s body.
It is important that your child knows how to sit, walk, understand verbal commands, be able to imitate your behavior and contain their impulses. It is believed that most children are physically and psychologically trained over the 18 and 30 months. My advice: It’s best to wait until age 2 to start potty training.
Bedwetting is currently a condition with several causes. However, research suggests that enuresis or urinary incontinence is largely a functional disorder, with less than 10% of cases being caused by physical factors.
Causes of Bedwetting: Why does your child wet the bed?
Several physical and psychological problems are what may be behind this childhood-type disorder.
Physical Causes of Bedwetting:
As stated above, one of the main causes can be due to anatomical and physical causes that are beyond his control. Here is a list of problems that have been investigated and labeled as factors causing enuresis. If your child suffers from any of these, it is very important that you consult your pediatrician.
1. Obstructions and dysfunctions of the urogenital tract
Several anatomical and structural problems in the urogenital tract can cause bedwetting, including congenital weakness of an external sphincter muscle, valve obstruction of the urethra or an abnormally short urethra. Often the presence of enuresis is accompanied by a painful urination or uneven urine stream. The solution is usually surgical.
2. Urinary Tract Infection
A high percentage of bedwetting children, especially girls, have a urinary tract infection. Symptoms of urinary tract infections include fever, pain, frequent or painful urination. My advice is to beware of damp sites and change your children’s drying towels frequently to avoid infections. The most common treatment is with antibiotics.
3. Nervous System Disorders
Some alterations in the EEG (electroencephalogram) can be seen in a very small percentage of bedwetting children. Seizures or epilepsies are usually accompanied by involuntary urination. Only a minority of children need anticonvulsant medications.
4. Vesicular Capacity
Some research has shown that children with urinary incontinence have a smaller bladder than others.
5. Sleep disorders
Evidence suggests that bedwetting children are more difficult to wake up when they are asleep than other children. However, there does not seem to be a clear relationship between bedwetting and sleep stages.
6. Inheritability
Researchers have found that there is a higher incidence of bedwetting in relatives of other bed wetters than others, with approximately 50% of parents or close relatives who had this problem as children.
Psychological Causes of Bedwetting:
1. Intelligence
Although bedwetting is more frequent among children with severe mental retardation than among children with average intelligence, there does not appear to be any relationship between intelligence and bedwetting.
2. Emotional disturbances
20% of the children diagnosed with urinary incontinence show some type of emotional alteration such as low self-esteem, insecurity, child depression.
3. Stress
Stress situations such as moving homes or school might trigger bedwetting. After a long period of urine control, if your child starts peeing again, turn on your alarms! Because something may be happening.
4. Anxiety
Wetting the bed can be a sign that something is not right or that the child or adolescent is going through an adverse period. If your child is under a lot of stress or when there is the death of a relative or divorce or a separation bedwetting might appear again. My advice is to try to talk to him let him express his feelings. Show him security and let the child know he can trust you. Anxiety situations in children can lead to urinary incontinence very quickly. It is very important that you know how to communicate well with your child.
5. Jealousy
Bedwetting might happen as a way to look for your attention. If we add the birth of a new child or a sibling, this behavior may increase. Don’t worry, it will pass but you have to talk to your child and lower his anxiety.
This article is originally in Spanish written by Noemí Vega Ruiz, translated by Alejandra Salazar.
Alejandra is a clinical and health psychologist. She is a child specialist with a diploma in evaluation and intervention in autism. She has worked in different schools with young children and private practice for over 6 years. She is interested in early childhood intervention, emotional intelligence, and attachment styles. As a brain and human behavior enthusiast, she is more than happy to answer your questions and share her experience.