Host: A very common problem, presented to pediatricians, my child is bed-wetting. First of all is bed-wetting a problem or it's a just about little delay in maturation?
Guest: Bed-wetting is not a disease. It is a common situation or a common problem, which occurs in approximately 15% of five year olds, and approximately 12% of six years old. It does vary with families and if one parent does have bed-wetting, there's a very high incidence that your children will have bed-wetting.
Every year 15% of children that bed wet will cease or stop bed-wetting spontaneously.
Host: Okay if a child is bed-wetting, when do you consider a problem?
Guest: Most of the children that wet the bed are not even concerned about this issue until approximately five or six years of age. It's usually the parents that are more concerned than the child. If the child has a good day time control, but just wets the bed at night, I would not consider a treatment or making this an issue until approximately five-and-half or six years old.
Host: If a child day wets and bed wets, that is a problem. Is that true?
Guest: That is true, that is one of the red flags that we look for in the interview process. If there is daytime symptom of wetting, frequency, urgency, these are signs that indicate further investigation would be necessary.
Host: Each time your patients ask this question. My kids go into an overnight camp and he bed wets and he is sort of like hesitant to go in camp as he might be a little bit embarrassed. Is that anything you could suggest to do to make that the experience in camp won't be so traumatic.
Guest: Well there is treatment options. One is a short term treatment, with medication and one is a long term behavior modification. If child does need a rapid fix for going to camp or sleep over in a school trip, there is medication called DDAVP. This is FDA approved and has been used for bed-wetting or nocturnal enuresis for the past 15 years.
Host: Is it safe?
Guest: It's very safe. There have been very rare reported side effects, but if used according to instructions, it is extremely safe.
Host: What was that real side effect?
Guest: If your child has a drinking issue where he drinks many, many glasses of water before bed and taking a medication it can lead to a chemical abnormalities in the blood. Otherwise if your child can limit his fluid intake an hour to before bedtime, it is very safe medication.
Host: These kids have intensely the over hydrating at the bedtime?
Guest: We are not certain but there seems to be relationship between drinking a lot after dinner and bed-wetting. But that is first simple step of treatment, stopping fluid intake few hours before bedtime.
Host: What would be the limit in terms of age where you really have concerned would it be 10, 12, 15 or thing like that?
Guest: There is really no age limit, we do know that, as I mentioned that every year more and more children do cease bed-wetting. But I have seen in few cases that going to the teenage years invariably 99.9% were resolved by adulthood.
Host: Well bed-wetting and bladder control are two different things. Some women especially later in life lose bladder control. Those are two different issues, is that true?
Guest: Absolutely, they are completely unrelated and have different ideologies and causes.
Host: And also you shouldn't scold, get mad at the child if he wet accidentally, now is that true?
Guest: This is beyond the child's control. It is not a behavior issue. And the worst thing one parent can do or one adult can do is to punish the children for this. The children do want to be dry at night and it's beyond their control, it's a maturation issue of the nervous system of the body.
Host: If you try bed-behavior modification -- there are some devices out there, anyone really works?
Guest: Yes behavior modification does work but it is a little intensive, it takes longer to see the effects. Children usually, we wouldn't recommend trying behavior modification before the age of seven. You need a highly motivated child and you need a highly motivated family and there are several devices out in the market, which range to $50 to $100 and it can be ordered online and are very simple to use.
Host: Thank you very much.
Guest: Thank You.
