Bedwetting: at what age should you ask for help?

Up to 500,000 children wet the bed in France and 7 million in the United States.

However, bedwetting is not considered abnormal until the child reaches the age of 5. If the child is still wetting the bed at the age of 6, the parents should seek help.

When to intervene?

Children over the age of six who participate in sleepovers often want to be treated for social reasons, and this is a good reason to begin treatment. It may not be medically necessary to treat bedwetting after the age of six, but peer pressure plays a significant role in a child's behavior. It is around the age of six that social factors begin to have a greater impact on a child's life.

How can I help?

Because currently prescribed medications for bedwetting can have side effects, urologists and pediatricians recommend a change in the child's routine. Experts say the safest and most effective form of therapy is to modify habits to promote a dry bed. Dean Cloward, a child psychologist practicing in Rigby, Idaho, offers some suggestions. Parents can start by limiting fluids after dinner. This may be enough for some children, but even if it doesn't work, it's wise to continue this routine once other treatments have begun.

The child should also empty their bladder just before bedtime.

Waking the child at night to take them to the bathroom can help, but only if it doesn't disrupt the parent's and child's sleep patterns. The child wets the bed around the same time every night. You might want to wake the child just before that time to take them to the bathroom. Often the child sleeps too soundly to be woken, and sometimes they sleep too soundly to get up to urinate, but this works for some. Other approaches can be devised, but they should be created and initiated by a child psychologist. This is to ensure that other harmful effects of bedwetting don't affect the child and that the intervention helps instead of harms.

In extreme cases, it may also be necessary to find a child psychologist specializing in bedwetting. Positive reinforcement can help children focus on staying dry, but it doesn't work in every situation. Some children need to be taught how to control their bladder. In these cases, reinforcement is the best approach. Creating a chart where the child can add a sticker each morning without an accident is a good start. It can be helpful to use disposable underwear while addressing bedwetting. This underwear, which looks like regular underwear, spares the child the embarrassment of waking up in wet sheets and saves parents from constantly doing laundry. Not feeling the shame of being wet can boost the child's self-esteem.

Medications as a last resort

Some families who have exhausted less drastic approaches to treating bedwetting may want to try medication. There are currently three recommended medications on the market. Using one type of antidepressant can help slightly more than 10% of children. Side effects can include mood swings and nightmares, and according to Dr. Cummings, there can be more serious side effects such as poor sleep and irritability.

There is also a risk of cardiac arrhythmia.

A bladder antispasmodic is also effective for about half of children, but it can cause facial flushing, irritability, and even heat exhaustion. Children taking medication should drink plenty of water during the summer months. Doctors may also prescribe a synthetic version of vasopressin, an important regulatory hormone that our bodies normally produce. This medication recycles water from the urine into the bloodstream so the child produces less urine at night. Children should be closely monitored while taking either of these medications, and dosages should not be increased without a doctor's instructions. Dr. Loening-Baucke believes parents would be better off trying to change their children's routines before giving them any medication.

When therapy fails

A failed therapy does not indicate major problems, since none of these therapies are effective more than 50 to 60% of the time. The concerning symptoms to look for in children with enuresis are:

• Daytime incontinence
• The appearance of symptoms after a long period without problems
• The presence of a urinary tract infection

If your child has experienced these kinds of problems, it is recommended that they be examined by a urologist. Parents and children dealing with bedwetting may be reassured to know that young bladders develop slowly. Every year, five to seven million children experience this problem, which they overcome as they grow up. One day, the child will wake up dry. Until then, stay calm, make a few adjustments, and focus on what matters most in life—your family.