Bed wetting is generally considered normal in children until they attain full voluntary control, generally by around 5 years of age. Children generally attain daytime control first at around 2-3 years of age followed by night control.
Bed wetting is considered significant if a child more than 5 years of age voids at night at least 2 times a week for at least 3 months.
All children who have such complaints need to be evaluated with clinical consultation to rule out any underlying causes of the kidney and urinary bladder.
Symptoms in children which should ring alarm bells are
- Daytime incontinence
- Rushing to toilet every time the child wants to void
- Wetting underpants without the sensation or urge to pass urine
- Dribbling of urine continuously day or night
- Associated with incontinence of stools
- Any other systemic illness
- New onset enuresis in a previously continent child
- Frequent urinary tract infections
For children with isolated night time enuresis, the management consists of step wise approach.
- Reduced water intake at night
- Early dinner, voiding just before going to bed
- Assessment and addressing of any psychological or emotional stressors
- Alarms to wake up children at night to void or bed wetting alarms where the alarm rings when the child wets his/her bed.
- Medicines which reduce night urine production are used as adjunct when all other measures fail