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The Bedwetting Blues

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Understanding the Cause

While a small number of bed-wetting cases are due to medical conditions such as a kidney infection or other urological problems, Alan Greene, MD, a San Francisco Bay Area pediatrician, says enuresis is most often a developmental issue. Children who wet the bed simply don't "shut off" urine production at night. This ability normally occurs around the age of 5, when bed-wetting will stop on it's own for 90% of kids, according to the American Academy of Pediatrics.

While babies produce urine around the clock, toddlers start to go to the bathroom on a daytime and nighttime schedule once their bodies start to produce a substance called 'anti-diuretic hormone' (ADH) that inhibits urine production. In addition, as kids mature they become more sensitive to the feeling (produced by stretching of the bladder walls) that they need to urinate.

Children who continue to wet the bed beyond the age of 6 may not be producing enough ADH hormone at appropriate times, or may not yet be attuned to their bodies' signals, or both, says Greene. Parents should start looking into formal treatment sometime between the ages of 6 and 7, according to the National Enuresis Society -- or sooner if the child seems troubled by the bed-wetting.

The first step is to work with the child's doctor to rule out any illness and to develop a safe and effective treatment plan. The two main approaches are behavioral modification and medications that inhibit urine production. "Almost all kids can be dry within about 12 weeks, with treatment," says Greene.

Sensors, Alarms, and Buzzers

One of the simplest methods to cut down on wettings is to limit a child's fluid intake -- especially milk and caffeinated or carbonated drinks -- in the last hour or so before bedtime. Then make sure the child goes to the bathroom before bed. While this will limit the amount of urine in the body and reduce the odds of wetting the bed, it still doesn't shut off the urination switch during sleep.

The most common method to address that issue involves placing a moisture-sensitive sensor on the bed or under the child's pajamas. The system sets off a loud alarm in the presence of fluid. Most bed-wetters urinate while deeply asleep and sleep right through the alarm, sometimes even switching it off without waking up. Because of this, parents also need to get up, wake the child, and take him or her to the bathroom.

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