IS YOUR CHILD A BED WETTER?

Nothing is physically wrong with my child but he has been wetting his bed for the last couple of months." Sometimes a worried mother presents her apparently healthy looking child with this complaint.
Enuresis means jnvoluntary discharge of urine among children after the age of three years, usually at night and rarely at day time. It is a fairly common problcm. In an epidemiological survey, 5%of the 7-year-OldS~ 2.5% of 10-year- olds and 0.8% of 14-year-Olds were incontinent at least once a week, the frequency being greater in boys than in girls.
CAUSES
Many theories have been advanced to explain "EnureSis". Most children affected have always been bed-wetters but a few have developed control only to lose it subsequently.
1. FAMILY HISTORY:
Sometimes there is a history of one parent, usually the father, having been similarly affected.
2. GENITOURINARY DISORDERS:
In some children a delayed maturation of neurogenic control of bladder may lead to enuresis while in others the urinary infection and diminished functional capacity of bladder may cause the problem.
OTHER DISEASES:
Urinary incontinence occurs in many systemic diseases like epilepsy, juvenile diabetes mellitus and kidney disease. In mentally handi-capped children, bed-wetting is very common.
4. LACK OF TRAINING:
Too late and coercive toilet training by the parents is also an important causative factor.
5. TOO EARLY STRESSFUL EVENTS:
Stressful happenings occurring during the tender age of 3 to 4 year may lead to enuresis. These may be
I. Family break-up;
II. Prolonged separation from mother;
Ill. Birth of a sibling;
IV. Moving home;
V. Hospital admission;
VI. Accidents and Surgery.
6. SOCIAL ASPECTS:
In some children, the bed-wetting has been associated with an unreasonably strict father or rejection by the mother. Some other social aspects like poverty, overcrowding and family break-up are also responsible.
TREATMENT
Many forms of treatments by mechanical means, drugs and psychotherapy have been applied at different stages.
FOR THE PARENTS: Mainly in case of functional enuresis something is wrong from the parents side. The parents should observe the following;
Your child is the nature’s best gift and wealth for you. If you want your child to grow up happily without any psychological upsets like enuresis, immediately stop any punitive measures, previously being employed. Physical punishments and demoralizing indignities during childhood shatter one’s self-confidence in later life. So to build up self-confidence and courage in your child, be friendly and sympathetic with him/her. A confident and happy child seldom lacks urinary control.
2. Encourage, praise and reward your child for a dry night and be sympathetic after a wet one.
3. Advise fluid restriction after the evening and child should be fully awakened to empty his bladder at the parents bedtime.
4. If enuresis is due to some disease, it should be treated accordingly.
5. I do not favour the use of any type of anti-anxiety or antidepressant drugs used in case of enuresis. These drugs with their numerous untoward effects prove too much for the little kids. Simply give your child a happy home, good food and a sympathetic and friendly attitude. This will build up sell-confidence and cure the problem.
CONDITIONED REFLEX
Induction of a conditioned reflex sometimes also proves helpful. In this case a wired pad is placed under the child’s buttocks. The first drop of urine completes an electrical circuit which rings a loud bell in the room, the child is awakened and gets up to empty his bladder. In successful cases the child will begin to awake spontaneously without the bell and he will empty his bladder without wetting the bed.