YOU CAN HELP YOUR CHILD SLEEP DRIER

Relax. You're not alone.

Primary nocturnal enuresis, or bed-wetting, is more common than you think. There are approximately 5 million children age 6 or older in the United States who suffer from this problem. While most children outgrow bed-wetting by age 6, and another 15% of older children stop bed-wetting each year without treatment, for many it can continue on for years. This can potentially cause embarrassment and shame that may in turn restrict social interaction and development.

What's more, having a child who wets the bed can put a lot of stress on the family. Night after night of laundry can leave parents feeling exhausted, not to mention frustrated about how to deal with the child's bed-wetting.

Wet sheets are only part of the problem.

Bed-wetting can affect your child's self-esteem. It can make your child subject to teasing and embarrassment.

This can limit your child's participation in certain activities -- like slumber parties, campouts, and summer camp. Since this happens during the years when children are building friendships and developing their self-images, it can be of particular concern.

Encourage your child to talk about feelings -- and correct any misconceptions about bed-wetting. Let your child know that millions of other children also wet the bed.

 

Bed-wetting is no one's fault.

While doctors believe there may be a number of reasons why a child wets the bed, there is one thing about which they agree: It's not your child's fault.

That's why it's important not to punish or humiliate your child after an "accident." However, you may want to teach your child to take responsibility for remaking the bed and changing into dry pajamas.

Some possible reasons for bed-wetting

• Heredity. Bed-wetting has been found to run in families, so if both parents have a history of bed-wetting, their children will have a 77 percent chance of wetting the bed. Even if only one parent wet the bed, a child still has a 44 percent chance of wetting the bed.
• Hormones. Studies suggest some children who wet the bed don't produce enough of a hormone at night. This is called antidiuretic hormone and it helps concentrate urine so that the bladder doesn't overfill.

Before beginning any treatment, your healthcare professional will complete a medical history and physical examination to rule out specific medical problems as the cause of your child's bed-wetting.

Whatever the specific cause for bed-wetting might be, it is not usually caused by serious medical problems

There is help for bed-wetting.

Simple changes in your child's routine or behavior may help your child sleep drier. In addition, there are treatments available. The most common options your doctor may recommend are listed here.

• Dietary Habits: If your child has a history of allergies, a change in diet may be beneficial. In addition, consider limiting beverages after dinner and remind your child to go to the bathroom before bed.
• Conditioning Therapy: Bed-wetting alarm devices attach to pajamas and are activated by moisture. Such products teach a child to wake upon sensing a full bladder. These, too, may provide help.
• Medications: One medication commonly used to treat bed-wetting is DDAVP^® (desmopressin acetate). Available as a nasal spray since 1989, it is available in easy-to-take tablets. Imipramine, in tablet form, is another pharmacologic treatment option. Be sure to follow the advice of your doctor or healthcare professional when using any medication.

Treatment with DDAVP Tablets.

Your doctor may prescribe DDAVP Tablets to help control bed-wetting. Used as directed, DDAVP Tablets have been proven to reduce the number of wet nights. Be sure to follow the advice of your doctor or healthcare professional when using this or any other medication.

Clinical studies in patients 6 years of age and older have proven that DDAVP Tablets help control bed-wetting, enabling children to have more dry nights. It is important to restrict nighttime beverages to avoid overloading fluids, which can lead to significant health consequences. In controlled clinical trials, some patients taking DDAVP Tablets experienced headache (4% DDAVP, 3% sugar pill).

If your child experiences any unusual symptoms while taking this, or any other medicine, be sure to call your doctor or healthcare provider.

How to take DDAVP Tablets.

DDAVP Tablets are small and easy to take. Just follow these simple directions:

• Be sure to take DDAVP Tablets as directed by your doctor.
• If your child has been using DDAVP Nasal Spray, he or she may switch to tablets the next night.
• DDAVP Tablets should be taken with a small amount of liquid at bedtime.
• Once dry nights are achieved, your child should continue to take DDAVP Tablets as directed.

 

To find out about the DDAVP Tablets Prescription Rebate Program call 1-888-DDAVP-23.
* Certain restrictions apply.

DDAVP^® Nasal Spray (desmopressin acetate)

Intranasal DDAVP^® has been available as an effective method for the treatment of bed-wetting in children 6 years and older since 1989.

Some side effects reported in patients using DDAVP Nasal Spray include nasal stuffiness, runny nose, pain in the nostrils, and headaches. These side effects were reported by fewer than 9% of the patients. If your child experiences any side effects, be sure to call your doctor or healthcare provider. If there is nasal congestion, your child may not absorb the medication. To make sure that blood electrolyte levels remain normal, your doctor may want to check your child periodically.

Imipramine

Imipramine is a tricyclic antidepressant available in tablet form. This compound's mechanism of action is unknown, but its effect on the urinary system is thought to be separate from its antidepressant effect.

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Parental Do's and Don'ts

DO:

• If you wet the bed as a child, share your experience. Making sure that your child understands that bed-wetting may be hereditary can ease your child's anxiety and better help him/her cope with the condition.

 

• Try to change your child's habits: Encourage your child to urinate before going to bed; have him/her avoid foods and drinks containing caffeine, which can increase the output of urine.

 

• Discuss available treatment options with your physician.
  
  

DON'T:

• Don't punish or belittle your child as it only adds to the child's embarrassment. Support your child by offering encouraging words.

 

• Try not to reward your child for simply achieving dry nights. Instead, reward your child for compliance with the treatment program you've chosen.

Practical Tips for Parents of Children Who Wet the Bed

While bed-wetting can be stressful for children, it's equally frustrating for their parents. Marc Cendron, M.D., Pediatric Urologist at Dartmouth- Hitchcock Medical Center in Hanover, New Hampshire, offers the following practical tips to help the parents of children who wet the bed.

• Children deserve an explanation of what is happening to them. Many children hide the problem and think something is wrong with them. Children who understand they suffer from a medical problem will understand they are not to blame.

 

• Change your child's habits. Start by allowing only two ounces of liquid after 6 p.m. and avoiding liquids before bedtime. Avoid foods and drinks containing caffeine, a diuretic. Encourage the child to urinate before going to bed.

 

• If your child has never been dry at night since toilet training, mention the problem at each annual physical. Some testing may be done to rule out other medical conditions, such as urinary tract infections.

 

• If your child is constipated, treat the constipation first. This sometimes relieves the bed-wetting problem.

 

• Don't punish or belittle the child. Since bed-wetting is not in their control and really is a problem, blaming will not help and adds to the child's embarrassment.
  
  

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Revised: November 14, 2006