The pressure from outside is great: as soon as they start kindergarten, the little ones should be able to do without their diapers at least during the day. If then, despite all attempts, pants or bed are wet again and again, the panic of parents often grows. But usually patience and a portion of composure are enough – and the issue gradually takes care of itself.
Overview
For reassurance, first a few numbers: In Germany, every fifth 5-year-old child and still every tenth 7-year-old child wets regularly or every now and then at night. A lack of bladder control, especially at night, is normal up to a certain age. Pediatricians only speak of enuresis when a child is not dry after his or her 5th birthday – for longer than 3 months at a time and with a certain degree of regularity. If the child wets during the day (“trouser wetting”), the medical profession refers to this as enuresis diurna; if it happens at night (“bed wetting”), it is referred to as enuresis nocturna. By the way, an occasional mishap is completely normal, even among older children. Most children manage to control their bladder around their 3rd birthday, with girls mastering it faster on average than boys. Many children easily manage to be dry during the day, but continue to wet at night for weeks to months (sometimes years).
Causes
The most common cause of bedwetting in children is “antidiuretic hormone” (ADH), which slows urine production during sleep, and whose day-night rhythm must first settle. In one child, this happens more quickly; in another, it simply takes longer. Hereditary influences also seem to play a role. Often, children are affected who are particularly sound sleepers and are therefore not awakened by the signal of a full bladder. Today, it is known that psychological factors play a rather minor role in not becoming dry. Inadequate bladder control – which rarely occurs – can be responsible for wetting during the day – the bladder and muscles then do not work together properly. As a result, the urge to urinate starts very suddenly and strongly, so that the affected children simply do not make it to the toilet in time.
What can you do?
If your child has already celebrated his 5th birthday, you should discuss the situation with your pediatrician. In individual cases, pathological causes such as a malformation of the urinary tract or diabetes may also be behind it. These must be ruled out by a thorough examination. You may then be asked to create a micturition log in which you write down over at least 24 hours how much and when your child drank, when he or she had to go to the toilet and when he or she wet the bed. Organic disorders are treated, insufficient bladder control is treated with special pelvic floor training and possibly medication. However, “simple bedwetting” is almost always present. Regardless of whether and which of the following ways to deal with the situation apply: Almost all children become dry over the years. With a dose of patience, you can ensure that simple bedwetting does not turn into a difficult psychological burden.
- Stay calm, even if it is sometimes difficult. Your child does not want to annoy you, but is probably also suffering from the situation. Therefore, do not scold or punish, but talk. Explain to your child that there is no reason to be ashamed, but that his body simply needs some time to learn everything. Otherwise, don’t make a big fuss about the mishap, put a waterproof pad under the bed sheet and offer your child a diaper for at night. However, do not force him to wear it – some children do not feel more relaxed, but not taken seriously.
- Urinating and waking: a strict ban on drinking from late afternoon does nothing, after supper should be limited fluid intake. Whether urinating before going to bed helps is not proven, nor is the effect of the frequently propagated nightly waking and going to the toilet. Relaxing the latter is neither for the parents nor the child.
- Ringing pants or ringing mat: these set off alarms in case of moisture and, if used consistently, are supposed to train the child’s brain to perceive the full bladder in time. They are worth a try after several months without improvement – but require the motivation of the child and parents.
- Medication: Desmopressin is a prescription substance that acts similarly to the body’s own hormone ADH, supporting it until its rhythm settles. It is taken as a tablet over a few weeks and then slowly reduced. It can also – taken temporarily – allow the child to participate in school trips or sleepovers with friends.
- Medicinal plants: Worth a try: the regular evening tea of fennel, lavender, lime, lemon balm (50 g each) and orange blossom (10 g). Of which 1 tsp with ¼ liter of boiling water pour over and infuse for 10 minutes; in addition, before bedtime a warm foot bath and rubbing your child’s thighs and groin with St. John’s wort oil.
- Homeopathy for bedwetting: At most, a constitutional therapy under the supervision of an experienced therapist is recommended.
