How to deal with a child with nocturnal enuresis

Nocturnal enuresis is a disorder which consists of the involuntary emission of urine while sleeping, generally in children aged five to six years and in the absence of lesions of the urinary tract. It is a fairly frequent phenomenon, as it involves about 10-15% of six-year-old children and usually tends to resolve spontaneously. There are different forms of it and in the most difficult cases it is possible to intervene, as well as with precise and targeted pharmacological and behavioral treatments, through small precautions and strategies that can be implemented by the parents.

Given that the emotional component, especially in secondary enuresis (link to the previous article), is the basis of the disorder, it is advisable to focus attention on the regression of the child who starts wetting the bed again as when he was small, but also on behaviors keep with children suffering from this problem.

Among the most common causes , as already specified in the previous article, there are the birth of a little brother or sister, the separation of the parents and the beginning of the school career. But there are other causes such as a move, prolonged hospitalization and any event that upsets the child’s life, making him insecure and without fixed points, influencing his lifestyle within the family.

How can we parents help a child who suffers from enuresis?

The child needs to feel safe and protected , and when sudden changes undermine his need for security, attention and dependence, the child becomes destabilized and tries, in his own way, to react to this situation.

Most children tend to embarrass themselves about this disorder thus avoiding all those situations that can put them in difficulty, such as attending school trips, sleepovers with friends and weekends at the grandparents’ house. This isolation obviously does not help the child’s development and even worsens the quality of his relational life.

It is also essential to always keep in mind that the parents and all the adults who take care of the child are a very important resource and their response can have a strong influence on the symptom, because they strongly influence the child’s self-esteem level, making him feel more less adequate.

The child should not be ridiculed , let alone blamed or punished , because the problem could only get worse. Therefore, having an understanding attitude towards the child and her discomfort can improve the situation. But being understanding doesn’t mean supporting him.

Given that it can happen that one of the two parents was enuretic as a child, it may be useful to let the child know, as reassurance, knowing that someone understands his state of mind and discomfort is very comforting, above all because the child knows that this problem can be cured.

Waking up the child during the night, on the other hand, is useless , on the contrary it can be stressful for the child and cause irritation and impatience, which is why it is much more advisable to use  absorbent panties to prevent it from getting dirty. It is also important to observe more carefully the child’s behavior during the day associated with sphincter control and possibly teach the child voiding re-education with the support of the paediatrician . In this case, every time the child makes even a small achievement, gratifying him can increase his self-esteem and lead him towards recovery.

Make sure that the child does not swallow water or other excess liquids during the evening and that he has peed before going to bed: this can help not to increase the volume of urine in the bladder too much.

In most cases, infantile enuresis resolves spontaneously, but if this does not happen, various ways can be considered. It may be necessary for the pediatrician to administer medicines that lower urine production by the kidney and therefore reduce the risk of involuntary loss of pee. Or we could think of a psycho-educational psychological intervention with the aim of reducing those behaviors that can aggravate the well-being of the child, looking for the triggering cause of the disorder.