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  Points to remember
•  Is normal before 5 years.
•  Is not a deliberate act by the child.
•  Needs evaluation by the doctor.
•  Sometimes has an emotional cause, requires a gentle approach.
•  Alarms offer the best treatment option after 6 years.
•  Drugs provide short-term relief. 

What is Enuresis?
“Enuresis” refers to the involuntary passage of urine during sleep when control of urine could be reasonably expected.

What is Normal?
It is a common problem in children up to the age of 5 years. Approximately 40% of 3 year olds wet their beds as do 10% of 5 year olds. Bed-wetting is considered a problem if it persists after 6 years of age. Bed-wetting that occurs after a long period of dryness is called secondary enuresis.

What causes it?
There is usually no obvious cause and most of these children seem to have a delay in development of bladder control. Some may have a small bladder capacity or a sensitive bladder. Boys suffer more and the problem seems to run in families Since most of bedwetting episodes occur during deep sleep, and so the child is helpless.

Is there an underlying disease?
Yes, diseases like urinary infection, diabetes and abnormalities of urinary tract may present as bed-wetting.

Can it be psychological?
Secondary enuresis can be psychological. The cause could be stress and anxiety such as separation from a parent or arrival of a newborn baby in the family.

Is it important to visit the pediatrician?
Yes, this is very important, as it well exclude any underlying physical problem or disease.

Tips for parents
Parents can help the child to adjust to the problem:
Do not restrict daytime fluids but discourage excessive drinking 2 hours before bedtime.
Avoid caffeinated drinks.
Do not scold, blame or punish the child.
Encourage & praise the child appropriately.
Improve access to the toilet at night. Use a night lamp if needed.
Empty the bladder at bedtime.
Avoid diapers but protect the bed with a sheet.
Involve the child in morning clean up and laundry work.
Ensure a shower for the child before going to kindergarten or school.

Seek professional advice if there is:
Continued wetting beyond 6 years.
Day time wetting.
Wetting in a child who was otherwise dry.

What are the treatment options?
Many methods have been used to treat enuresis, but bed-wetting alarms have the highest cure rates (80%). Drugs may be used effectively in some children for short periods of time but do not provide long term cure and have some side effects. These have limited use.

Bed-wetting Alarms- How they help?
Alarms are useful to train a child to wake up when he/she needs to pass urine at night. The moisture sensitive sensor is placed in the underwear that is connected to the noise box with a wire (wireless buzzers also available). A loud noise is produced when urine is passed. The child wakes up, switches off the alarm and goes to the toilet. 8-12 weeks of alarm usage is necessary before the child eventually becomes dry.



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