Talking to your doctor about bedwetting

When your child has a high fever or an unknown rash, you probably don't hesitate to ask your pediatrician for advice. What to do if your child wets the bed at night after it has happened for a long time? Should you be concerned if your child has been potty trained for a year, but can't go through the night without an accident? Are these situations worth seeing a doctor? When to ask for help? Many parents wonder if bedwetting is worth discussing with the pediatrician. The timing is different for every family, depending on the circumstances, but Dr. Michael Ritchey, a pediatric urologist in Houston, Texas, says he doesn't treat bedwetting before age 7 and that parents should instead try different strategies. Before consulting their doctor about bedwetting, many parents try reducing fluids before bedtime or waking the child several hours after they fall asleep, says Dr. Ritchey. Typically, children don't begin treatment until age 7 because it's common for the problem to resolve itself. However, if the child sees bedwetting as a problem and asks their parents for help, then it's worth talking to their pediatrician. Joan Dyer*, a mother of three, says her oldest son hadn't had a nighttime accident for several months. "So when he had a few accidents, I wasn't too worried," she says. Four months and several soaked sheets later, these nighttime accidents had become constant. "We tried cutting down on his evening drinks and waking him up to go to the bathroom, but it wasn't improving," she says. "We decided to talk to his pediatrician at his 5-year checkup." Some children experience secondary enuresis, which means they begin to lose bladder control at night after consistently staying dry. Secondary enuresis can have the same causes that bother children who have always suffered from enuresis, such as excessive nighttime urination or a family history. 'Simple' bedwetting is considered a benign problem that most children outgrow, says Dr. Barry Kogan, a spokesman for the National Kidney Foundation's Pediatric Nephrology/Urology Committee. However, there are some signs that your child may be experiencing something other than normal bedwetting and may need medical attention. According to Dr. Kogan, these signs include: daytime enuresis in addition to nocturnal enuresis; severe constipation; fecal incontinence; urinary tract infections. According to the American Academy of Pediatrics, only 1% of bedwetting cases are related to medical issues, but ruling these out can help you and your child cope better. Additionally, if bedwetting becomes a problem for your child (or you), a visit to the pediatrician can be a comfort to everyone. Prepare the visit If you decide that a doctor's visit is in order, the following information can help with the evaluation: family history of bedwetting; the frequency of bedwetting; habits associated with bedwetting, e.g. it occurs after consuming caffeine or when the child is tired; daytime enuresis in addition to nocturnal enuresis; any unusual aspects of your child's urination (straining or pain) or the appearance of their urine (cloudy or pink); bedwetting developing six months or more after consistently staying dry; the medications your child is taking. Kay Davidson*, a mother of one, decided to talk to her doctor about her son's bedwetting during his 5-year-old checkup. Our pediatrician wanted to wait and see if the problem would go away before initiating treatments, she says. And the doctor was right, because they eventually discovered the culprit was a prescribed allergy medication. In addition to wetting the bed, her son had also started falling behind in school. When he stopped taking his medication, his schoolwork improved, and his sheets stayed dry. Now 7, he stays dry at night, Davidson says. If you suspect a medication is contributing to your child's nighttime accidents or if your child has behavioral issues in addition to bedwetting, discuss it with your pediatrician. During this time If, after a visit to the doctor where all medical problems have been ruled out, the doctor recommends waiting and seeing, what can you do to help your child until the day they stay dry? Dr. Ritchey suggests letting your child wear disposable pads at night. Your child won't suffer from bedwetting any longer because they're wearing [such a product], he says. Patience and empathy may still be the best medicine during this difficult stage. Parents can stop focusing on the bedwetting and instead focus on all the other good things the child is doing, Dr. Kogan says. It's important for the child and the family to realize that the child is doing many good things. * Names have been changed to protect privacy.