Bed-wetting, also known as nocturnal enuresis, is a relatively common problem among children, especially younger ones. It affects about 15% five-year-olds, with the percentage dropping to about 5% in ten-year-olds. These problems have a variety of causes, both physiological and psychological. Regardless of causes of bed-wettingA child with this condition feels inferior to their peers and may have a tendency to isolate. More often than not, he or she is very distressed by every wetting incident .
Psychological consultation with a child psychologist can be an invaluable support for the whole family in the diagnostic and therapeutic process. The child psychologist helps to build a healthy and open relationship with the parents. It is important for the child to regain self-esteem and to know that he or she is supported, accepted and loved.
What are the causes of bedwetting?
Physiological
1 Urinary immaturity: In some children, the urinary bladder may not yet be fully developed, making it difficult to control wetting.
2 Hormonal: At night, the body produces antidiuretic hormone (ADH), which reduces urine production. Some children may be deficient in this hormone.
3. Heredity: If one parent had bed-wetting problem, it is more likely that their child will also have it.
4 Health problems: Urinary tract infections, diabetes, constipation and other medical problems can lead to bedwetting.
Psychological
1. Stress and anxiety: Problems at school, family tensions, parental divorce or other stressful situations can cause bedwetting.
2. life changes: A move, a new sibling, a change of school - any significant change in a child's life can affect their ability to control their urine at night.
3 Low self-esteem: Children who feel ashamed or guilty about bedwetting may find it difficult to overcome the problem without appropriate support.
How does the diagnosis of bedwetting proceed?
Dear parents! Remember that there is no effective treatment without a correctly and accurately made diagnosis.
Recognition of nocturnal enuresis requires the usual:
- Detailed medical and family history.
- Physical examination to rule out other possible causes.
- Sometimes carrying out additional tests, such as a urine test, to rule out infections or other health problems.
Treatment of bedwetting
Behavioural methods
- Success calendars: Children can receive stickers or other rewards for dry nights, which can reinforce positive behaviour.
- Bedwetting alarms: Special alarm devices can help a child learn to respond to a full bladder at night.
- Limit fluids before bed: Avoiding large quantities of drinks before bed can help reduce the risk of wetting.
Therapies and interventions
- Behavioural therapy: Working with a psychologist on coping strategies for stress and anxiety.
- Pharmacotherapy: In some cases, doctors may prescribe drugs such as desmopressin, which reduces urine production, or anticholinergic drugs, which increase bladder capacity.
- Emotional support: It is important that parents support their child and avoid punishing or shaming them for wetting themselves.
The role of parents and carers in child wetting
- Support and understanding: It is crucial that parents are supportive and understanding. Criticism and punishment can only make things worse.
- Education: Inform the child that bedwetting is not his fault and that many other children have the same problem, can help reduce shame and anxiety.
- Consultation with specialists: If necessary, consulting a paediatrician, a psychologist or a urologist can be key to properly managing the problem.
Bed-wetting is a problem that usually resolves itself over time, but the right therapeutic approach and support can significantly accelerate the process and improve the child's quality of life.
It is a complex problem that requires a comprehensive understanding and support from both the family and professionals. The psychological aspects of this problem are key to successfully addressing it and ensuring the child's healthy emotional development.
Paulina Wisniewska
Child psychologist
