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Helping your child overcome bedwetting: Tips from a paediatric urology expert

Bedwetting, medically known as nocturnal enuresis, is a common yet distressing condition affecting a significant percentage of children worldwide. Pee Paediatric Services (PeePS), founded by Cheryl Jennings, an expert Clinical Nurse Practitioner in Paediatric Urology, specialises in providing expert treatment for children grappling with lower urinary tract dysfunction, including bedwetting.


A young girl is sleeping in bed with bedside lamp switched on.

Addressing bedwetting in children is not just about managing a physical symptom; it's about safeguarding their emotional and psychological wellbeing. Cheryl brings over 20 years of experience, with more than a decade dedicated to leading and specialising in the care of children facing lower urinary tract dysfunction. Her expertise ensures that families receive compassionate, effective and evidence-based support through PeePS.


The impact of bedwetting extends beyond the child, affecting the entire family dynamic. Sleep disruption, social stigma and psychological distress are just a few of the challenges families may encounter. By acknowledging and addressing bedwetting early on, PeePS aims to alleviate these burdens and empower children to live their lives fully.


Understanding paediatric bedwetting


Bedwetting, clinically referred to as nocturnal enuresis, is characterised by involuntary urination during sleep, occurring beyond the age at which bladder control is typically expected. This condition can manifest as either primary enuresis, where a child has never achieved consistent night-time dryness, or secondary enuresis, where a child regresses to bedwetting after a period of dryness.


Several factors contribute to paediatric bedwetting, including physiological, psychological and genetic elements. Common causes include:


Delayed development: Some children may simply have a slower maturation of the nerves that control bladder function, leading to difficulties in achieving night-time dryness.


Overproduction of urine: Children who produce an excess amount of urine during the night may struggle to hold it until morning, resulting in bedwetting.


Reduced bladder capacity: A smaller-than-average bladder capacity can contribute to frequent urination and bedwetting episodes.


Hormonal imbalances: Inadequate levels of antidiuretic hormone (ADH), which helps regulate urine production at night, can lead to increased urine output and bedwetting.


Psychological factors: Stressful life events, anxiety or emotional upset can exacerbate bedwetting in some children.


Bedwetting is not uncommon and can affect children across a wide age range. It is estimated that approximately 5-10 per cent of seven-year-olds experience bedwetting, with prevalence decreasing as children grow older. However, bedwetting can persist into adolescence and even adulthood, albeit at lower rates. Recognising the multifaceted nature of bedwetting and its potential impact on children's wellbeing is crucial for effective management and support.


Recognising the signs and symptoms


Recognising the signs of paediatric bedwetting is essential for timely intervention and support. 


Here are key indicators to watch for:


  • Frequent bedwetting episodes: Children experiencing bedwetting may wet the bed multiple times per week, or even nightly, despite attempts to control bladder function.


  • Persistent wetness in bedding: Parents or caregivers may notice consistently wet bedding or the presence of urine odour in the child's bedroom.


  • Daytime symptoms: In some cases, bedwetting may be accompanied by daytime symptoms such as urgency, frequency or accidents during waking hours.


  • Emotional distress: Children struggling with bedwetting may exhibit signs of embarrassment, shame or frustration related to their inability to stay dry at night.


Distinguishing between primary and secondary enuresis


Primary enuresis refers to bedwetting in children who have never achieved consistent night-time dryness, whereas secondary enuresis occurs when a child who has previously been dry regresses to bedwetting. Distinguishing between primary and secondary enuresis is important as it can provide insights into potential underlying causes or contributing factors.


Impact on the child's emotional and psychological health


The impact of bedwetting extends beyond physical discomfort, affecting the child's emotional and psychological wellbeing. Children experiencing bedwetting may grapple with feelings of embarrassment, shame or low self-esteem. They may also fear social stigma or ridicule from peers, leading to social withdrawal or avoidance of activities such as sleepovers or school trips.


Persistent bedwetting can disrupt the child's sleep patterns, resulting in daytime tiredness, irritability and difficulties concentrating at school. Over time, untreated bedwetting can erode the child's confidence, impacting their overall quality of life.


Recognising the emotional and psychological toll of bedwetting underscores the importance of providing compassionate support and effective interventions to help children overcome this challenge. By addressing bedwetting proactively and sensitively, we can give children the chance to regain control of their bladder function and thrive emotionally and socially.


Paediatric bladder health


Ensuring optimal bladder health is paramount for children's overall wellbeing and quality of life. 


The importance of maintaining bladder health in children 


A healthy bladder is essential for maintaining urinary continence and preventing issues such as urinary tract infections (UTIs) and bladder dysfunction. Proper bladder function allows children to maintain control over their urination, contributing to their comfort, confidence and ability to engage in daily activities without interruption or discomfort.


Factors affecting childhood bladder control 


Several factors can influence bladder control in children:


Developmental stage: Bladder control develops gradually as children grow, with milestones in bladder maturation varying from child to child.


Fluid intake: Adequate hydration is crucial for overall health, but excessive fluid intake, especially close to bedtime, can increase the likelihood of bedwetting episodes.


Dietary habits: Certain foods and beverages, such as acidic or spicy foods, may irritate the bladder and contribute to urinary urgency or frequency.


Voiding habits: Irregular voiding patterns or holding urine for extended periods can affect bladder function and increase the risk of UTIs.


Underlying medical conditions: Conditions such as constipation, urinary tract abnormalities or neurological disorders can impact bladder control and require specialised management.


Tips for promoting bladder health in children 


  1. Encourage hydration - Ensure children consume an appropriate amount of water-based fluids according to their age and activity level to support healthy bladder function.

  2. Establish routine: Encourage regular bathroom breaks throughout the day to prevent bladder overdistention and promote timely voiding.

  3. Limit irritants: Minimize consumption of caffeinated beverages and bladder irritants, opting for water or non-acidic alternatives instead.

  4. Promote healthy toilet habits: Encourage proper toileting techniques, including adequate wiping and washing, to prevent UTIs and maintain urinary tract health.

  5. Address constipation: Manage constipation effectively, as it can exacerbate bladder dysfunction and contribute to urinary urgency or incontinence.


Suggested intake of water-based drinks for children and young people

Age

Total water-based fluid intake/day*

4-8 years

1000-1400ml (both female and male)

9-13 years

1200-2100ml (female) 1400 – 2300ml (male)

14-18 years

1400-2500ml (female) 2100-3200ml (male)


By promoting bladder health through mindful hydration, dietary adjustments and healthy toileting habits, parents and caregivers can help children maintain optimal bladder function and minimise the risk of urinary issues. Additionally, consulting with paediatric urology experts like PeePS can provide personalised guidance and support for addressing specific bladder health concerns in children.


Paediatric bladder treatment options 


At PeePS, we offer a comprehensive range of treatment options tailored to meet the unique needs of each child struggling with bladder dysfunction. From behavioural techniques to medical interventions, our goal is to provide effective solutions that promote bladder health and enhance quality of life. Here's an overview of the treatment options available:


Behavioural techniques and lifestyle modifications


Behavioural techniques and lifestyle modifications play a crucial role in managing paediatric bladder issues. These strategies focus on empowering children with practical tools to improve bladder control and reduce the frequency of bedwetting episodes. Some common behavioural techniques include:


  • Bladder training: Teaching children to recognise and respond to bladder cues, such as urgency and gradually increasing the intervals between voids.

  • Fluid management: Implementing strategies to regulate fluid intake, such as limiting beverages before bedtime and ensuring adequate hydration throughout the day.

  • Toilet routine: Establishing a consistent toileting schedule to encourage regular voiding and minimise bladder overdistention.

  • Bedtime rituals: Incorporating pre-bedtime rituals, such as voiding before sleep and using protective bedding, to reduce the likelihood of night-time accidents.


Medical interventions and pharmacological treatments


In cases where behavioural techniques alone may not provide sufficient relief, medical interventions and pharmacological treatments may be recommended. These options aim to address underlying physiological factors contributing to bladder dysfunction and may include:


  • Bladder retraining devices: Using devices such as bedwetting alarms to condition children to awaken in response to bladder fullness and eventually achieve night-time dryness.

  • Medication: Prescribing medications to regulate urine production, increase bladder capacity or reduce bladder contractions.

  • Biofeedback therapy: Employing biofeedback techniques to help children gain awareness and control over pelvic floor muscles, improving bladder function and continence.


At PeePS, our multidisciplinary approach integrates behavioural, medical and surgical interventions as needed, ensuring comprehensive and individual care for each child. By combining expertise with empathy, we strive to empower children and families to overcome bladder challenges and enjoy improved bladder health and wellbeing. If you're seeking support for your child's bladder issues, schedule a 15-minute FREE discovery call with Cheryl at PeePS to explore your treatment options and embark on the journey toward improved bladder health.


Overcoming overactive bladder in children 


Overactive bladder (OAB) is a common condition characterised by urinary urgency, frequency, and sometimes, urge incontinence in children. At PeePS, we understand the challenges associated with OAB and offer specialised care to help children overcome these symptoms. 


Understanding overactive bladder 


An overactive bladder occurs when the bladder muscles contract involuntarily, leading to sudden and uncontrollable urges to urinate. In children, OAB can manifest as frequent trips to the bathroom, urgency to urinate and occasional accidents due to an inability to hold urine. While the exact cause of OAB in children can vary, factors such as neurological conditions, bladder infections or psychological stressors may contribute to its development.



Strategies for managing OAB symptoms


Managing OAB symptoms in children often involves a combination of behavioural strategies and medical interventions to alleviate discomfort and improve bladder control. Some effective strategies for managing OAB symptoms include bladder training, fluid management, pelvic floor exercises and medication. 


The role of PeePS in providing specialised care for OAB in children


At PeePS, we recognise the unique challenges faced by children with OAB and offer specialised care to address their specific needs. We develop personalised treatment plans tailored to each child's unique circumstances. Whether through behavioural interventions or medication management, we strive to empower children with OAB to regain control over their bladder function and enjoy an improved quality of life.


Tips from a paediatric urology expert


As an experienced Clinical Nurse Practitioner in paediatricuUrology, Cheryl Jennings understands the challenges families face when dealing with bedwetting in children. Here, she shares her expert advice on managing bedwetting and offers practical tips for parents and caregivers to support their children through this journey:


Normalise the experience: Remind your child that bedwetting is a common and treatable condition, reassuring them that they are not alone.


Open communication: Foster an environment where your child feels comfortable discussing their feelings and experiences with bedwetting, encouraging open dialogue and offering emotional support.


Establish a bedtime routine: Implement a consistent bedtime routine that includes voiding before sleep, limiting fluid intake before bedtime and using protective bedding to minimise the impact of accidents.


Encourage self-care: Encourage your child to take an active role in managing their bedwetting by teaching them strategies such as bladder training and recognising bladder cues.


Celebrate progress: Acknowledge and celebrate small victories along the way, praising your child for their efforts and progress towards achieving night-time dryness.


The importance of seeking professional help and support 


While bedwetting is often a transient phase in childhood development, persistent or severe cases may require professional intervention. Seeking timely assistance from paediatric specialists ensures that your child receives a comprehensive evaluation and tailored treatment options to address underlying causes and promote bladder health.


Professional help and support can alleviate the emotional burden and practical challenges associated with bedwetting, allowing both children and families to navigate this journey towards improved bladder control and enhanced quality of life.


If you're seeking support for your child's bedwetting, schedule a 15-minute free discovery call with Cheryl at PeePS. Together, we can develop a personalised plan to help your child overcome bedwetting and regain confidence in their bladder function.


Final thoughts…


As parents and caregivers, navigating the challenges of bedwetting in children can be overwhelming. However, it's essential to remember that you are not alone in this journey. With the right support and guidance, your child can overcome bedwetting and enjoy improved bladder health and overall wellbeing.


Seeking timely assistance from paediatric specialists like PeePS is key to addressing your child's specific needs and concerns. Our expertise and compassionate approach ensure that your child receives personalised care and support tailored to their unique circumstances.


Don't hesitate to reach out for help. Call Cheryl on 07714 024779 to schedule a 15-minute free discovery call to discuss your child's bedwetting concerns.


Take the first step towards a brighter, drier future for your child today.


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