What you need to know:
- Most children attain some level of bladder control around the age of four.
- If the child is diabetic, there is a high chance that she may suffer continuous bed-wetting.
- Do not make your bed-wetting child feel guilty, neither should you act angry, incensed, or disgusted.
Purity Mwende watched as her friends’ children quit bedwetting while her daughter was still bedwetting at age 7. “Some stopped bedwetting when they were as young as five years old, but my daughter didn’t stop,” she says. By age eleven, nothing had changed. “She wet her bed almost every night.” Ironically, Purity’s six-year-old son rarely wet his bed.
In an attempt to stop her daughter from bedwetting, Purity began to reprimand, shame, and rebuke her. “I thought that she did it on purpose, and by putting my foot down, I would scare her out of it,” she says. She began to spank her whenever she wet the bed at night. In turn, her daughter felt guilty and slowly withdrew from both her mother and brother. “She became depressed and distant.” Her school performance deteriorated. And the bedwetting continued.
Little did Purity know that her daughter was suffering from Primary Nocturnal Enuresis (PNE). “Sometimes, no matter how hard I try, I wake up wet at night,” says the fifteen-year-old girl. “But I am learning to gain control over it, one step at a time.”
According to child psychologist Florence Kamau, children who hardly have dry nights are prone to suffer low emotional moments. “A child with PNE will suffer constant bouts of insecurity if she relapses after several months or years of dry nights.” Relapse usually occurs if the initial toilet training was too stressful.
PNE is the involuntary discharge of urine at night by children who are old enough to have bladder control. There are two forms of PNE, primary which occurs when the child has never attained bladder control, and secondary PNE which occurs when the inability to control the bladder reoccurs after at least six months of having bladder control at night.
PNE is often considered the result of maturational delay, decreased nighttime secretion of the antidiuretic hormone, genetic influence, and reduced ability to wake up or respond positively to the urge to urinate.
Most children attain some level of bladder control around the age of four. Usually, they begin by having dry day periods which are later followed by dry nights. “In mid-childhood, most children shift from urinating around the clock to urinating during waking hours only.” Nevertheless, there are children who never stop to bed-wet and continue with the problem to adulthood. Nicholas Ikanyi, a 28-year-old businessman in Nakuru is an example. He has avoided marriage in fear that no woman will handle his constant bedwetting. “I do not want to lose face in case she finds out, walks away, and decides to show my wet lines to the public,” Nicholas says.
Reasons for continuous bedwetting
Bedwetting in children persists if they have an imbalance in the bladder muscles. “The muscle that contracts to squeeze the urine out may be stronger than the sphincter muscle that holds the urine in,” says Florence. Similarly, the child’s bladder may be too small to hold the normal amount of urine, especially when the body excretes more than the usual amount that the bladder is used to holding. “If the child is diabetic, there is a high chance that she may suffer continuous bed-wetting,” Florence says. In the same breath, consuming caffeinated cola drinks and chocolates will directly increase urine output.
Helping your child to stop bedwetting
- If she urinates frequently during the day, encourage her to try and have some control, and or postpone going to the loo.
- Do not make your bed-wetting child feel guilty, neither should you act angry, incensed, or disgusted. This will bounce back on them, stifling the minor efforts they may be making to quit.
- Set an alarm about two to three hours after the child falls asleep to wake them for short calls. Remember, taking liquids two hours before bedtime increases nighttime urine production.
- Make sure that your child urinates before going to bed.
- Praise her when she wakes up dry. However, do not be too hard on her when she wets. Make sure your child understands that a wet night is not her fault, show support, and let her know that she can still have dry nights.
Teaching your child to wake up when their bladder feels full
- Lie on your bed with your eyes closed.
- Pretend it's the middle of the night.
- Pretend your bladder is full.
- Pretend it's starting to hurt
- Pretend it's trying to wake you up.
- Pretend it's saying: "Get up before it's too late".
- Then run to the bathroom and empty your bladder.
- Remind yourself to get up like this during the night.
What to look out for
- Determine what type of wetting problem your child has.
- Consider any psychological complications, and establish if you have a family history of bedwetting.
- Measure your child’s functional bladder capacity.
- Record how often your child urinates and moves his bowels.
- Consider whether your child may have any food sensitivities.