Just last week, my friend who is now a mom shared a rather curious problem with me. Her seven-year-old son, Vardaan, had been peeing in his uniform every third or fourth day.
Naturally, he has been coming back home either crying or not wanting to go back to school.
“I don’t understand why he is peeing in his class? We trained him to use the restroom when he was 4! He had no such problems before. And now he is ridiculed and teased by his friends,” lamented his mom, who is a media professional in Delhi, India.
So what happened to him in these three years that changed his bladder control pattern?
We spoke to Dr. Anjana Rao Kavoor, consultant psychiatrist, Fortis Hospital, Bannerghatta Road, Bengaluru, who shed light on exactly what was happening.
Lack of bladder control past the age of 5
“Passage of urine into a child’s clothes or bed is considered developmentally appropriate among young toddlers. As they are toilet trained with passing years, they attain control and become independent. Most children attain bladder control by the age of 3. But when bedwetting or enuresis persists in children beyond the age of 5 years, it requires attention and treatment,” explains Dr. Kavoor.
She adds that while Vardaan’s case was that of secondary enuresis where the child was already toilet trained and had few dry years before the symptoms recurred; there can be cases of primary enuresis where the child has not attained complete control over his or her bladder at all.
“Bedwetting could either happen without conscious control or intentionally,” she says.
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What causes Enuresis or bedwetting?
Dr. Kavoor explains that there are many triggers of enuresis including external environment and sometimes even genetics.
“Stressors like starting a new school, divorce in parents, moving to a new place, birth of a new sibling or hospitalization at a young age in children are common and remediable causes of enuresis,” she says as she lists some more common causes.
- Urinary tract infection is another common cause of bedwetting in children, which can easily be treated. Structural deformities or any obstructions in the urinary tract can also lead to these symptoms, either by itself or by causing urinary infection, though these are not too common.
- There can be genetic causes in some children who happen to have siblings or parents who have had similar problems. Other uncommon causes can be childhood diabetes, seizures or side effects of certain medications. Sometimes, there might not be an identifiable cause for these spells.
- When the passage of urine in clothes is intentional, the cause for this is almost always a psychological disturbance.
How to treat bedwetting at home
“Many children may spontaneously recover over time, but if the symptoms are causing a hindrance in their day to day functioning, it requires treatment,” says Dr. Kavoor as she further explains the treatments.
- Regularize water intake: Children who were not toilet trained well to begin with may require guidance in undertaking this. Regularizing the water intake of the child to increase it during the day and minimizing it during the night can be useful in some children.
- Increase fiber in diet: Avoiding constipation by increasing fiber in the diet can help in children where constipation contributes to the symptom.
- Avoid night lifting: Waking up the child at night and taking him or her to the toilet at regular intervals, can also be used to train the child.
- Try alarm therapy: This is another commonly used behavioral technique where a pad attached to a battery operated device senses the urine as soon as it passed and awakens the child by triggering an alarm. Over time, the child learns to wake up promptly by himself.
- Use medications as instructed: When bedwetting has serious consequences like low grades in school, low self-esteem, problems in family or social functioning, it may become necessary to use medication. Medications are effective, but the problem can tend to recur when they are stopped.
And remember that not only being aware, but understanding your child is also of utmost importance.
“Blaming or shouting at your child for bedwetting can further aggravate the condition and lower his/her self-esteem and confidence, leading to long term consequences. Seek timely help from a professional, if necessary,” advises Dr. Kavoor.
This article was originally published on theIndusparent.
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