Nocturnal Enuresis in Children: When to Seek Help

Children's nocturnal enuresis issues?

Hello Doctor: My child is 8 years old and does not need to wear diapers during the day and does not wet his pants.
However, we have not been able to completely eliminate the use of diapers at night.
I would like to ask if the following situation requires a medical consultation.
Currently, I have been tracking the situation as follows: I limit water intake before bedtime and ensure he urinates before going to sleep.
About two hours after he falls asleep, I wake him up to urinate, and most of the time he does wake up to urinate, resulting in almost no wet diapers the next day.
Currently, he might wet the diaper only 1-2 times a week, and the amount is very small.
However, we have tried a few times not to wake him up in the middle of the night, and there is a 90% chance he will wet the diaper by the next morning, sometimes with a significant amount.
Should we consider consulting a urologist for this situation? Thank you for your response, Doctor.

Niming, 40~49 year old female. Ask Date: 2024/02/29

Dr. Xiao Kaiwen reply Pediatrics

Children over the age of five who experience involuntary bedwetting at least twice a week for more than six consecutive months can be diagnosed with nocturnal enuresis.
If behavioral treatments have shown limited effectiveness, it is recommended to seek evaluation and management at a hospital, as the treatment options for childhood nocturnal enuresis have become quite advanced.

Reply Date: 2024/02/29

More Info

Nocturnal enuresis, commonly known as bedwetting, is a condition that affects many children, and it can be a source of concern for both parents and the children themselves. In your case, your 8-year-old child is experiencing bedwetting at night, despite being dry during the day. This situation is not uncommon, and it’s important to understand when it might be necessary to seek medical help.

First, it’s essential to recognize that bedwetting is a developmental issue. Many children do not gain nighttime bladder control until they are older. According to the American Academy of Pediatrics, about 15% of 5-year-olds and 5% of 10-year-olds still wet the bed. By age 12, about 1-2% of children may still experience nocturnal enuresis. Therefore, your child’s situation is not unusual, especially since they are dry during the day.

From your description, it seems that you are already taking proactive steps to manage the situation. You are monitoring fluid intake before bedtime, ensuring that your child uses the bathroom before sleeping, and waking them up to urinate during the night. These strategies can be effective in reducing the frequency of bedwetting episodes. The fact that your child is only wetting the bed 1-2 times a week and that the amount is minimal is a positive sign.

However, there are certain circumstances under which it would be advisable to seek medical advice. Here are some indicators that may warrant a visit to a healthcare professional:
1. Age and Persistence: Since your child is 8 years old, and bedwetting persists, it may be worth consulting a pediatrician or a urologist. If a child is still wetting the bed after the age of 7, it is often recommended to seek help.

2. Emotional Impact: If your child expresses feelings of embarrassment, shame, or anxiety related to bedwetting, it’s important to address these emotional aspects. A healthcare provider can offer support and strategies to help your child cope.

3. Changes in Behavior or Health: If you notice any changes in your child’s behavior, such as increased anxiety, changes in appetite, or other health concerns, it’s essential to discuss these with a doctor.

4. Family History: If there is a family history of bedwetting or other urinary issues, it may be beneficial to consult a specialist who can provide tailored advice and treatment options.

5. Physical Symptoms: If your child experiences any pain during urination, blood in the urine, or other unusual symptoms, you should seek medical attention promptly.

6. Ineffective Home Management: If the strategies you are currently using do not seem to be effective over time, or if bedwetting increases in frequency, it may be time to consult a healthcare professional for further evaluation.

In terms of treatment, there are various options available, including behavioral therapies, moisture alarms, and, in some cases, medication. A healthcare provider can help determine the most appropriate course of action based on your child’s specific situation.

In conclusion, while occasional bedwetting is common and often resolves on its own, your child’s age and the persistence of the issue suggest that consulting a healthcare professional could be beneficial. They can provide reassurance, evaluate for any underlying conditions, and offer effective treatment options to help your child achieve nighttime dryness. Remember, it’s important to approach this situation with understanding and support, as bedwetting can be a sensitive issue for children.

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