Can nocturnal enuresis indicate a child's emotional difficulty? - Walla! health

2022-02-04T05:49:13.596Z

Bedwetting occurs in many children, but when should you start worrying? And should wetting turn on a red light because of a particular mental problem? Here are all the answers >>

Can nocturnal enuresis indicate a child's emotional difficulty?

Bedwetting occurs in many children, but when should one start worrying and should wetting turn on a red light because of a particular mental problem?

Dr. Hadassah Troan, a pediatrician at United, answers the questions

Walla!

health

04/02/2022

Friday, 04 February 2022, 07:02 Updated: 07:41

Share on Facebook
Share on WhatsApp
Share on Twitter
Share on Email
Share on general
Comments
Comments

If your child also sometimes runs away at night and you are worried that something will happen to him - you are not alone.

About 15 percent of 5-year-olds suffer from wetting problems, and the number of wetting boys is almost double the number of girls.

"Asymptomatic nocturnal enuresis occurs in children at night only and has no other urinary tract-related symptoms. In urination and other symptoms, "explains Dr. Hadassah Troan, a pediatrician at Meuhedet's Keshat clinic in Jerusalem and a graduate of the Goshen Association for Health and Child Welfare in the Community.

Is it worth waking the child at night to pee?

To the full article

Can wetting go even without treatment?

Dr. Troan explains that nocturnal enuresis is a common problem in children, and it will usually go away without treatment. - We are talking about about 2 percent of the population left with the problem of wetting at night.

Is bedwetting hereditary?

There is definitely a hereditary component to overnight wetting.

"If one parent had bedwetting until late in life, then his children have a 50 percent chance that they will also suffer from it. If both parents have a history, the chance of bedwetting in children increases to 75 percent," explains Dr. Troan, "one of the reasons parents "Asked in wetting clinics about family history is because there is a great element of shame around nocturnal enuresis and many times the parents will not share on their own initiative the child in their personal experience or that of people from the extended family."

A common problem in young children.

Wet bed with urine (Photo: ShutterStock)

She added that when the child knows that both the mother and half of the uncles had a problem similar to the one he suffers from, it has a very calming effect - it makes it very tangible that the fact that the child is still wetting does not make him a child with a problem. And there are children who mature more slowly and are still normal children.

"When the child knows that the father also suffered from wetting he experiences less of a sense of failure around something he is really out of control, feels less unusual and also has hope that just as with the father, sister or aunt it went through at some point, it is likely to pass," she said.

When does the need for medical treatment arise in case of nocturnal enuresis?

Although the vast majority of children will stop wetting themselves at night if given enough time, there is still room for treatment.

"The need for treatment is when the wetting causes the child or family distress, when a child suffers shame and frustration around wetting then there is room to try and speed up the process," said Dr. Troan. In children who have already reached adolescence and are still wetting - treatment is needed as at this age the chance of wetting itself decreases.

Should bedwetting turn on a red light because of a particular mental problem?

According to Dr. Troan, in most cases, if there is a mental difficulty then it is usually the result of the wetting itself at night. In fact it has never been dry at night for a long time, so the goal in treatment is not to locate a mental difficulty that caused the wetting but to prevent the development of mental difficulties like insecurity and guilt over the wetting background.

Sometimes there is a feeling of frustration and embarrassment.

Child in bed (Photo: ShutterStock)

Is there a connection between deep sleep and wetting in the child?

Usually, there is no single cause for nocturnal enuresis, but it is the result of interactions between several factors, including deep sleep.

In a minority of cases there are children whose bedwetting is actually secondary to another medical problem, such as disturbed sleep due to a blockage in the upper airways.

It is important to locate these children as they need to address the underlying problem.

Why does a child only wet several nights and not every night in a row?

There is no single factor for wetting but it is about the interactions between different factors and some of them vary from day to day, an example of this is the amount the child drinks and when during the day he drinks.

"Sometimes just by moving most of the drinking to the morning and avoiding drinking in the hours before bed, we can help the child stay dry at night," Dr. Troan explained.

How is wetting treated in a designated clinic?

In a meeting at the clinic, they first try to find out with the child and his parents that it is indeed only a matter of wetting at night - that is, that there are no symptoms during the day and that it is not secondary to another factor.

For starters work on the behavioral change of moving most of the drinking to the morning hours and avoiding drinking two hours before bed and going to the bathroom before bed.

"Children whose behavioral measures do not lead to the desired result actually have two treatment channels: The first is behavioral therapy with a bell. In this treatment the child is 'trained' to wake up when he needs to urinate, it is a treatment that requires a lot of motivation and effort. Using the bell, a significant portion of the children will stay dry, "Dr. Troan explained.

The second treatment is a drug treatment using a drug called Minrin - the drug helps at least urine to form during the night, besides, it is very important not to drink about an hour before taking the drug until morning.

The use of the drug is effective but will not solve the problem fundamentally because once you stop taking it the moisture problem may return.