Bedwetting – When to Seek Treatment

Male doctor sitting and talking with a child her her mother/

Parents experience many sleepless nights worrying about their child and if they should be concerned about bedwetting. Asking questions about why their 10-year old child has never had a dry night or why their 8-year old suddenly started wetting the bed again. There are several possible reasons for urinary incontinence and you can devour the research or read online, but the best course of action to ease your mind is to make an appointment with your pediatrician or pediatric urologist.

When should your child see a doctor for urinary incontinence?

• If your child is still bedwetting at age 7

• Your child was once able to stay dry for a period longer than 6 months

• They experience pain when urinating

• Swelling in their feet and/or ankles

• When having a bowel movement, they are consistently hard or very large stools

What to expect at your appointment

Once you decide to consult your pediatric urologist about bedwetting, it may take several conversations and follow-up visits to assess the underlying causes. Your doctor will be asking you many questions about your child’s daily and nightly habits. Before your appointment, it is a good idea to come armed with information. This will save time and set you up for a successful appointment right away.

• Chart the frequency that they use the bathroom for up to 2 weeks before your appointment

• Take notes on how much your child drinks and when

• Consult your partner about any history of nocturnal enuresis in the family

• Write down all medications, home remedy herbs or supplements your child is taking

• Mark down any major changes within the household to rule out psychological causes of bedwetting

• List out your specific questions for the doctor

Questions to be prepared to answer concerning your child’s urinary incontinence:

• Is there a history of bedwetting in the family?

• How much does your child drink during the day and what time do they stop drinking fluids?

• Has your child ever experienced a length of time when they did not wet the bed?

• How often do they wet the bed? Is it a lot or a little?

• Are there any instances of daytime wetting?

• Does your child complain about having difficulty going to the bathroom or experience pain while urinating?

• Have there been any major life changes in the household?

Possible outcomes from your doctor’s visit about urinary incontinence.

How your pediatrician goes about helping your child with nocturnal enuresis might depend on his/her age. For example, if your child is bedwetting at age 5, they might suggest keeping track of their fluid intake and starting a bathroom diary.

If your child is bedwetting at age 8, they might suggest running a few tests to rule out medical concerns.

Or if your child is 11 they might run ALL of the tests and refer you to a specialist. These specialists might include a pediatric urologist, specialing in the urinary tract; a pediatric nephrologist, specializing in kidney issues; and a child psychologist or psychiatrist who helps older children to stop bedwetting.

If they suspect primary enuresis

(when a child is still developing and has not had any significant amount of dry nights in their lifetime), they will most likely suggest the following:

• A bedwetting alarm is the best option that can help shorten the amount of time your child wets the bed (see our top choices here)

Drinking less water at night (starting at about 1.5 hours before bedtime)

Cut out ALL caffeinated drinks and other sugary foods

Offer a reward chart with stickers for every dry night

If they suspect secondary enuresis

(when a child has demonstrated the ability to stay dry at night for an extended amount of time but then begins to wet the bed frequently), they will most likely do or suggest the following:

Take a urine sample and check for signs of a urinary tract infection. Some symptoms include a burning sensation while urinating, a consistent urge to urinate, upper back pain, fever, shaking and the chills, nausea, and vomiting.

Check for signs of constipation; How many times do they go per week? Are they hard and difficult to pass? Do they experience large stools or pain while going? A squatty potty is an excellent tool to have in ALL of your bathrooms. These put your body in the perfect alignment for moving the bowels easily.

Run urine tests for signs of an infection or diabetes

Schedule an x-ray or ultrasound to view the structure of the urinary tract including the kidneys or bladder

Perform additional imaging tests to review any possible birth defects or blockages in the urinary tract

Conduct biofeedback testing to review how the muscles react when the child is urinating

Ask personal questions to check for signs of stress or anxiety the child might be experiencing

Conclusion

Conversations about urinary incontinence might be embarrassing or uncomfortable for you and your child, but keeping an open line of communication is very important.

No one knows your child better than you.

Most importantly, make your child feel loved and comforted.

They can certainly help with the changing of the sheets and putting the laundry in the washer, but staying positive will ease the stress and anxiety your child is already experiencing.

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