Dr. Peter Anderson
Professor, Department of Urology, Dalhousie University & Staff Physician, IWK Health Centre
Though it’s almost never related to a serious medical ailment, bedwetting can have a huge impact on families. Children with the condition may suffer embarrassment and social anxiety, and parents may struggle to deal with bedtimes that have become fraught with tension and a sense of dread.
“While bedwetting is not life-threatening, for some kids it’s quite debilitating,” explains Dr. Peter Anderson, Professor in the Department of Urology at Dalhousie University and Staff Physician at the IWK Health Centre in Halifax, Nova Scotia. “It affects whether they can go to camp or go on sleepovers. For some children, it really does influence their social development rather significantly.”
It’s important to understand that for most kids the issue of bedwetting naturally resolves itself.Dr. Peter Anderson
Bedwetting is normal
Dr. Anderson is quick to point out that bedwetting in itself is not necessarily a problem. It’s estimated that 15–20% of 5-year olds wet the bed, and this number decreases consistently as a child ages. “It’s important to understand that for most kids the issue of bedwetting naturally resolves itself, and by the age of 15 only one percent of kids are still having issues with nighttime urination,” he explains.
Determining whether bedwetting is a serious condition has a lot to do with a child’s age and how the family is handling the issue. “From a practical perspective, bedwetting becomes a problem when it’s bothering the child. That’s an important distinction, because there are lots of 5-year olds whose parents are concerned, but the child doesn’t care at all. In that case, we evaluate the child and make sure they don’t have a serious underlying condition, which is rare. If the kid is healthy, we reassure the parents their child is, in fact, normal and that 1 in 5 children aged five has this condition.”
Generally, bedwetting becomes a concern for a child around the age of seven or eight. “At this age kids often start saying ‘I wish I wasn’t doing this’, depending on their maturity level and their social circumstances,” says Dr. Anderson.
A variety of solutions
In treating the condition, there are a variety of approaches to consider. “We start with obvious stuff, like how much fluid the child consumes in the evening and whether or not they use the washroom to empty their bladder before they go to bed,” he notes. “These are easy things to control. If the child is just five or six, we might also recommend wearing nighttime bedwetting underwear.”
If, as the child ages, bedwetting is still an issue, the most popular non-medical approach is a conditioning alarm system whereby an alarm goes off when the child wets the bed. “The brain learns over time that if it suppresses the bladder from emptying then that annoying alarm doesn’t go off,” explains Dr. Anderson.
It’s a good option for kids because it’s easy, discreet to take, and kids can also feel confident about going into a social situation like a sleepover.Dr. Peter Anderson
However, in some cases, children may find the diapers to be embarrassing, or families may find the alarm to be disruptive. If this is the case, parents should talk to their children’s doctor about the pharmaceutical option, which is covered by provincial health insurance in most provinces. “The main medical therapy is a synthetic, man-made version of the hormone vasopressin. The medication is taken nightly and reduces the amount of urine that the kidneys actually produce. The bladder doesn’t fill because the kidneys haven’t made much urine, so the bladder doesn’t feel like it needs to empty.”
Dr. Anderson also notes that the medication generally has only minor side effects and comes in an easy-to-use melting formulation. “The tablet melts in your mouth with a mildly pleasant taste, which is wonderful because lots of kids find it difficult to take pills. It also makes it simple to get the dosage correct.”
The medicine can be very useful in the short term until the bedwetting corrects itself. “It’s a good option for kids because it’s easy, discreet to take, and kids can also feel confident about going into a social situation like a sleepover.”
This article was made possible through the support of Ferring Inc. The opinions in this material are those of the authors and do not necessarily reflect the views of the aforementioned party.