By Chioma Obinna

Is bedwetting really a child’s fault?  Are there often reasons why it happens? A Child Psychiatrist at Ladoke Akintola University Teaching Hospital, Ogbomosho, Oyo State, Dr. Suleiman Babatunde said although bedwetting can be a symptom of underlying disease, a large majority of children who wet the bed have no underlying disease that explains their bedwetting.  He said rather, most of the causes could be traced to psychological and emotional trauma. Babatunde, in a chat with Good Health Weekly also identified sexual abuse, Urinary Tract Infections, UTIs, and diabetes in young children as causes of bed wetting.

BEDWETTING: Experts say when infections and diseases are ruled out, the problem could be traced to psychological trauma.

There are two types of bed wetting also known as Enuresis; Noctunal bedwetting, and Diurnal or Mixed Enuresis. While noctunal is bed wetting at night, Diurnal is a combination of the two. That means the child passes urine during waking and sleeping hours. It was gathered that as embarrassing as bed wetting could be, most often an underlying condition is identified in only about 1 percent of children who routinely wet the bed.

Babatunde said a child that is  bedwetting before the age of five, pose no a problem.  “If a three- year- old child still bed wet, there is no problem. Usually we wait till about five years when they are expected to be dry at night. Bedwetting is common in all cultures, and  is usually a developmental issue children are expected to outgrow, Babatunde stated. “But the primary factor for a child aged nine, 10 or 12, is family history. Most of the time, if a child is about eight to nine years and still bed wets,  in 70 percent of cases, there is usually a first degree family member who also had similar problem.   It is a developmental thing because most of the times, some even stopped at age eight.

“Another thing about bedwetting, usually at night also known as Noctunal Enuresis, it is more common in boys than girls.  Apart from having a family member that had the condition sometimes it could be due to infections like urinary tract infection and diabetes. When infections and diseases are ruled out, the problem could be traced to psychological trauma. “For instance, it may be that the child has never become dry or was dry and suddenly starts bedwetting. This may occur in instances where a child is being harrassed in school or the parents are having problems. Anything that can upset a child could manifest as bedwetting in a child who was dry before.”

He advised parents whose children urinate even after age eight to check the family history, test for infection and desist from blaming the child because it would only worsen the situation. “Again, mothers should restrict food intake around bedtime. Any time they are dry, praise them. Any time they are wet, don’t  make them feel ashamed. Majority of the children will outgrow it in the teenage years. Studies have shown that about one percent might persist into adulthood and that is when we might come in with medical treatment.

“Apart from the encouragement, there is also an alarm bell fitted on the underwear. Once there is a tiny drop of urine, the alarm will sound and the child will get up and know he has to go to urinate. It has been very effective. When all these psychological behavioural interventions have failed, you may need to use medication,” he counselled. Babatunde noted that medical treatment should be the last option.  “There are some drugs that can be given to the child to suppress bed wetting.  And this must be after you have ruled out UTIs. Once infection is treated the bed wetting will stop.”

Noting that although bed wetting is rare above 7 years, it can also persist beyond 15 and 21 year –olds. “Consistent sexual abuse and emotional trauma could cause bedwetting in young adults and teenagers. A child who was dry before can start bed wetting after an episode of sexual violence.  This is because sexual abuse might be upsetting the child who could feel that things were not right with her and that will manifest as bed wetting.”