Bedwetting

The most important thing to remember about bedwetting is that it is a benign disorder and not a willful act. Punishment is never an answer. Between five million and seven million children suffer from bedwetting; the majority are boys. 
Don't be unduly concerned about bedwetting unless your child is older than six. Before then, your child's body may not have developed enough to control bladder actions at night. Time usually cures the problem: Most children resolve any difficulties on their own by the age of seven. 

Symptoms: 
It is not unusual for children under the age of six to have trouble controlling their bladders at night. You should be concerned about bedwetting only if: 
Your child is older than six and has never been dry at night or continues to wet the bed twice a month or more.
Your child suddenly starts wetting at night after a period of having been dry through the night 

Causes :
Why bedwetting occurs is not fully understood, although most cases seem to result from some kind of developmental delay. Some experts think bedwetting is purely a behavioral issue, others believe its origins are physiological, and still others think both physiological and behavioral factors play a role. Only 2 percent of cases can be traced to neurological problems (often caused by structural spinal abnormalities) or specific diseases such as diabetes or bladder infections. 
Alternative therapists believe that a misalignment of muscles and joints around the pelvis can affect the activity of the sphincter muscle that controls urine release. 

Any new, stressful situation may cause a child to revert to bedwetting. Once your child adjusts to the situation, the problem should resolve itself. If your child does not improve, the treatments listed here should help. In addition, you will want your child to talk through his fears. 

Treatment :
To rule out a disease-related problem, your pediatrician will perform a blood or urine test. If the test reveals diabetes or an infection, your pediatrician will treat that condition first. The doctor will also test your child to rule out nervous system problems. 

There are three primary ways to treat bedwetting in an otherwise healthy child: waiting for spontaneous resolution, employing behavioral conditioning, and undertaking drug therapy. 

Waiting, though often the preferred course, may make your child anxious. However, if he is old enough to benefit from motivational counseling to learn about the condition and participate in its management he and the rest of your family will be better able to cope. One form of motivation is to have your child place a star on a chart or calendar to mark dry nights. 

Behavioral conditioning utilizing a device with a sensor that detects wetness and sets off an alarm has proved very effective. The child begins associating bladder distention with being awakened and in time "learns" to awaken before losing control. 

Drug therapy is considered less effective because most children relapse after stopping medication. It has its place, however. For short-term help when your child sleeps at a friend's, for example desmopressin, an antidiuretic, works well. Doctors are moving away from the antidepressant imipramine because of side effects.

 


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