Tackling bed-wetting in children

Children battling with bed-wetting

ARUKAINO UMUKORO writes about how parents can help their children overcome bed-wetting

Four-year-old Chidi Agu is often sober and ashen-faced each time he wakes up every morning. Not only does he get scolded and beaten by his parents, the mornings are usually a painful reminder of the constant bed-wetting at night.

It changed for the better when the parents stopped punishing him for bed-wetting every night, and adopted a different method.

“After we spoke to our family doctor, he told us that we should be gentle with him and support him to deal with it effectively. In a few months, we noticed an improvement. Chidi stopped bed-wetting completely,” noted his banker mother, Nkechi Agu.

Experts say that bed-wetting, which is medical known as nocturnal enuresis, is involuntary urination during the night. They also described it as an involuntary action in children which parents must help them to overcome with patience and understanding.

A family physician and paediatrician, Dr. Rotimi Adesanya, described bed-wetting as incontinence that usually happened at night. “Bed-wetting, from the name, means when a child wets the bed at night. The medical name for bedwetting is nocturnal enuresis. About 45 per cent of children wet the bed if one of the parents did same when they were also children, and about 75 per cent of children would do same if both parents experienced similar situation as children. This shows that bed-wetting could be hereditary,” Adesanya explained.

He further said other factors that could cause bed-wetting in children could be emotional, psychological or medical, adding that it was the reason psychotherapy should be seen as effective in dealing with bed-wetting in children.

He said, “It could also be due to an over-active bladder. Parents can help their children overcome this via psychotherapy, using words of encouragement and reassurance to such children. They should not punish them severely; they should help them with soothing words, and let them know that it is not their fault because other children have the same kind of problem.’’

A parent, Mr. Adeoye Seun, said his six-year-old daughter was able to stop bed-wetting at the age of three because he and his wife always let her know she could stop it consciously and encouraged her to do so.

He said, “I did not have any challenges with my children who wet the bed because they were able to overcome it at an early age. My first daughter overcame it at the age two going on three. This was because, I and my wife tried as much as possible to wake them up at night to urinate and ensure they are fully awake while doing so for them to be conscious of their action. And when she wet the bed, we made her understand that it was wrong, and told her that she was too big to do so. The message got to her.’’

For some parents, loving words or reassurance may not do the trick. Like another parent, identified as Mrs. Adeola, discovered. Her son is seven years old but he still wets the bed.

“Please I do not want my child’s name mentioned. He is always sober whenever he wakes up and realises that he could not control his urine at night. As parents, we have done everything we could to help him stop, including punishment, but it continues,” the distraught mother noted.

In such cases, experts say that parents have good reason to be worried.

A public health physician and National President, Association of Medical Officers of Health in Nigeria, Dr. Yahya Disu, said a child should normally stop bed-wetting between the ages of five and seven.

“Bedwetting can either be primary or secondary. Primary bed-wetting is when the child continues to wet the bed from birth; while the secondary one is when the child has stopped, but after a while, starts doing so again. Usually, this secondary type is due to an emotional or medical problem.

“Bed-wetting is involuntary in children. It is something they do not have control over from birth, and they gain control over it over time. Some children stop to bed wet between the ages of two and four. But parents should start getting worried when the child is between ages five and seven and still wets the bed.’’

In such cases, Disu said such parents should immediately seek therapy or, in severe cases, medical treatment, for their children.

He further said a family’s history could contribute to a child’s habits of wetting the bed.

Disu said, “Either of the parents could have experienced the same while they were children. So, if the parents stopped to wet the bed at the age of seven, then they should not embarrass the child or start getting worried. If the parents are too harsh, it could affect the child emotionally and cause friction between them.”

On her part, a child psychologist, Dr. Yemi Ogun, advised that parents should help their children overcome bed-wetting by adopting simple procedures like watching their diet and fluid intake, especially at night.

She also noted that bedwetting could result from a child’s poor toilet habit when the child refuses to urinate during the day, or the child cannot hold urine for a long time through the night.

“We advocate for parents to monitor what their children eat and ensure they do not drink too much water late at night. They should also wake the child up intermittently at night to urinate regularly so he or she does not wet the bed,” she said.

Ogun warned against ridiculing or embarrassing children who wet the bed, because, according to her, it could lead to emotional problems.

She said, “Children should not be ridiculed either by their parents or siblings because they wet the bed. Such children could develop low self-esteem and morale. They will also become isolated, especially if they are in boarding schools. Parents should reassure their children and encourage them to beat the habit.’’

The psychologist further said a reward system should be employed to help the child who still engages in such habit.

“In our part of the world, we expect a child to stop wetting the bed at the age of three, but when this does not happen, we should not lose hope but support the child. When a child is able to stop the habit for a period of time, even for a night, that child should get a sort of reward or pat on the back. This would help boost that child’s self-esteem,” she noted.

Also speaking, a psychiatrist, Dr. Mashudat Bello-Mojeed, echoed Ogun’s views. Bello-Mojeed said how parents respond to a child’s experiences bed-wetting would either help or harm the child.

She said, “Most times in Nigeria, the child is given severe punishment or the parents humiliate the child or use negative words. Some parents and siblings sometimes publicly embarrass the child who experiences nocturnal enuresis. As a result, the child is withdrawn from social activities that children of his ages normally engage in. Also, there is a strain in the relationship with his peers; the child is reluctant to go out for holiday camps or school excursions. Such social problems could lead to bigger ones.

“I would advise parents to help the affected child and let the child know that the habit is not caused by him or her. The child would come out of it eventually, but they need to show him or her love and care. They should let the child know that it is a developmental problem that will go away. They can also help the child by reducing his fluid intake at night and waking up the child at night to urinate. The results will encourage them.”

Similarly, Adesanya advised parents to use a bed-wetting alarm.

He added that, in this case, the alarm could be set off every two or three hours to remind the child to urinate at night.

‘‘This is not common in Nigeria. The most important thing is that parents should learn to be patient with their children because it is a development issue and it is temporary. Medication is usually the last resort,” he said.

Another parent, Mr. Asuquo Joseph, who has two children, aged four and one, agreed with Adesanya’s submissions.

Asuquo said, “It takes some time for children to control their bowels. But my first child stopped bed-wetting at one. Anytime he urinates on the bed or anywhere else, we spanked him. We did so for him to know bed-wetting was wrong. At a point, he stopped. Whenever he wanted to urinate, he usually gave us a sign; by holding his shorts, hiding behind the curtain or telling us. As he grew older, he went to the toilet by himself at night. The problem is that some parents allow their children to wet the bed to the extent that it becomes a habit until they grow older and it becomes harder for them to outgrow it.”