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It can be an embarrassing experience for children to wake up in bed feeling wet from urination. It can also be very painful for parents to see their children go through this experience. The bedwetting experience is a common condition that is not just physiological but has a psychological impact as well.
Bedwetting or enuresis is a condition where children beyond the age of five years involuntarily urinate in the night. This condition is not accompanied by any disease and affects 15% to 20% of children, 2% to 3% of teenagers while 0.5% to 2% of adults also suffer from this condition.
Bedwetting normally occurs at night during sleep. In general, children with
nocturnal enuresis do not have daytime enuresis. However, 10% to 28% of children tend to have daytime wetting symptoms in addition to nocturnal enuresis.
Children, who have a tendency to wet their bed, rarely realize the involuntary urination. This occurs due to various factors. Some of them are:
Behavioral remedies and complementary and alternative remedies are the two main types of home remedies for bedwetting. Alarms, reward program, homeopathy and acupuncture are some examples.
The home remedies for bedwetting can be classified into two main categories:
There are preventive measures that can be adopted to restrict the habit of bedwetting. Some of the measures include:
Reward program: This is one of the initial measures adopted during the training for bedwetting. Children are rewarded when they have a dry night, which makes them feel encouraged to continue this positive progress. However, the downside is that children may feel disappointed and discouraged if they regress and have a wet night that makes them lose out on their reward.
Urinate twice before going to bed: The child is asked to urinate just before getting ready to go to bed. After the child is ready for bed, the child is asked made to urinate again.
Reduce liquid consumption in the evening (deprivation): The child is encouraged to drink a lot of fluids during the day. However, the consumption of liquids is restricted by evening. This allows the child to empty the bladder before going to bed. Conversely, excessive control may reduce the bladder storage capacity. This reduced capacity may render the bladder incapable of holding the overnight urine that is produced, leading to bedwetting.
Use of a night lamp: Children can be encouraged to use the toilet in the night by keeping a night lamp on. This can help dispel fears of darkness that prevent children from accessing the toilet.
Timed urination: Following a schedule, the child is awakened in the night to urinate. This creates a body clock for the child to get into a routine for urination and prevents bedwetting. Older children, teenagers, and adults use an alarm clock to wake up and urinate. Some parents use a code word with the child while waking them up to ensure the children are awake when they urinate.
Alarms: Children are made to sleep on mattress pads or mats that have electrical alarms set in them to detect urine that falls on them. There are alarms that are attached to the body with sensors in the underwear. The alarms are either light devices or alarms with vibrations or sounds.
Overtraining: Individuals start to drink excess fluids to fill up the bladder before bedtime and utilize the alarm to understand the need to empty the bladder. The alarm training is performed for two weeks to get the body to recognize the change in bladder retention.
Training the bladder: The bladder may be trained to hold large quantities of urine for a long period of time. Children may be trained during the day to drink large quantities of water and prolong the periods between urination.
Carrying the child: Parents try to get the child to urinate and empty the bladder while asleep thus avoiding the consequence of bedwetting. This procedure is known as “Lifting”.
Dry bed training: In this training, on one night, children are woken every hour during the night to urinate. In the case of an accident, 45 minutes is spent in cleaning up (cleanliness practice) and positive training is implemented, where the child goes nearly nine times to urinate. The subsequent days involve waking up the child only once during the night.
Complete home training: This involves a combination of the alarm, overactive training, cleanliness practice, and dry bed training.
Psychotherapy: Children, who have psychological issues, are subjected to psychotherapy The therapist tries to understand the emotional disturbance that causes the child to persistently wet the bed. Measures are taken to modify the factors that may cause this emotional disturbance.
Homeopathy: Children may be treated with homeopathy to relieve the symptoms of bedwetting. Homeopathic medications act by controlling the musculature of the bladder, managing the function and the control of the bladder as well as the sphincter muscles of the urethra. This eliminates involuntary urination and reduces the anxiety in a child. Homeopathic medications are an attractive alternative as they are sweet, natural, and safe to give to children. However, clinical research still needs to verify the effectiveness of this therapy.
Diet: Avoid drinks that contain caffeine. Caffeinated drinks cause a greater chance of bedwetting. More research data is required to understand the effect of some foods on bladder retention. Constipation can also be an underlying cause of bedwetting and the use of stool softeners is recommended.
Acupuncture and chiropractic are other forms of therapy that may be given to deal with bedwetting. However, the effectiveness of such therapies needs to be verified with more research trials.
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