What is it about ?
The involuntary loss of urine in a child is called “bedwetting”. Until the age of about 12 months, when the bladder is full, it empties reflexively or uncontrollably. Bladder control develops later, usually before the age of 4.
Bladder control is a complex skill. This is why many children have delayed or impaired bladder control. Often times, stress, exciting events and life changes play a role. Sometimes the problem is due to an underlying UTI or constipation. Bedwetting is trying, but it’s not a disease.
What is its frequency?
Two out of three children are clean around the age of 3 to 4. By primary school age, just over 10% of children experience involuntary urine loss, about 5% regularly. Just under 1% of adolescents continue to have involuntary urine loss, and in about 0.5% this continues into adulthood.
How to recognize it?
Most children get their bladder in control by the age of 4 to 6, but there are big differences. Bedwetting should not be treated in children under 5 or 6 years old.
How can the doctor recognize it?
The doctor makes the diagnosis of bedwetting based on the parents’ story, a physical examination and additional tests such as a urinalysis or an ultrasound of the kidneys and possibly a measurement of the urine output. The advice of a specialist is necessary in the case of involuntary urine loss during the day.
What can you do ?
Begin potty training at a quiet time, when the child stays dry for 2 hour periods. The apprenticeship preferably begins at home at the same time as it takes place at the nursery. It is important to have a good little pot. Don’t be disappointed or angry if it doesn’t work right away. If after a week your child is still having difficulty, it is better to stop learning for a few weeks.
A child will stay dry at night if he is dry for several months during the day. Until the age of 7, it is not abnormal for the child to wet the bed. Encourage your child after a dry night.
In the event of unintentional loss of urine, the recommended method is a bedwetting alarm or wetting alarm. The doctor will prescribe it for you if necessary. To apply this method, it is important that both the child and the parents are sufficiently motivated.
The alarm sensor is placed in the bed or in the child’s clothes and sounds a doorbell when the sensor gets wet. In this way, the child wakes up and learns to stop wetting the bed. After waking up, wet sheets and clothes are changed. It is useful to have a second bedwetting alarm in reserve. You can then use it again immediately. Try to make the bed with your child, and show him how you set up the alarm. He thus understands how it works.
It is also helpful to keep a urine diary. This will give you an overview of the number of alarms. If after 6 weeks the bedwetting alarm has not given any results, do not use it for a few months. You can ask the doctor if a medication would be indicated. After 4-6 months, you can use the bedwetting alarm again. Ask the doctor to check the newspaper.
What can the doctor do?
The doctor will explain to you in detail what toilet training is; he can prescribe a bedwetting alarm. It is generally used at night. It is important that the doctor clearly explains to you how to use the alarm correctly.
If the bedwetting alarm does not work, your doctor may prescribe medicine (desmopressin). In case of involuntary urine loss during the day, the advice of a specialist (urologist) is necessary. He will always carry out additional examinations, in particular an ultrasound of the kidneys and an X-ray examination. He will also give instructions for good urinary behavior. Depending on the results of additional examinations, he may prescribe a drug (oxybutin).
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