It's slightly more common in children with psychological problems, and more so in those with kidney or urinary tract disorders. However, bed-wetting in a healthy child after a prolonged period of dryness following toilet training needs investigating. Stress or anxiety may be the cause, or perhaps an infection or other symptomless illness. But remember: children do not wet the bed on purpose, and have no control over what they feel is an embarrassing phenomenon.
Bed-wetting happens mostly because a child's nervous system isn't up to total bladder control. Stress, anxiety, fever, infections and food intolerances can trigger episodes. Maize, cow's milk, cocoa, cola, citrus fruit and food colourings are common causes, as are inhaled antigens (Crook WG. 'Genitourinary Allergy', in Speer F, ed. Allergy and Immunology in Children. Springfield, IL: Charles C Thomas, 1973: 690-4).
Many children have unseen allergies. (The only overt effect in some cases of 'masked' food allergies may be an attention-deficit disorder.) Many allergic reactions involve the retention of fluid drawn from the blood, resulting in thirst, so the child drinks more than he should. As symptoms subside, all that stored fluid causes an urgency to pass urine. This can be a problem during sleep, as urination may be woven into a dream, with the child still within the grip of sleep.
Although bed-wetting is often related to stress, symptomless urinary infections, diabetes and food sensitivities all still need to be ruled out. Urine tests with a reagent strip can rule out an infection. Other causes include malformations of the urinary organs.
The following advice may also be helpful.
- Never scold a child for wetting the bed.
- Praise the child for dry nights.
- Ensure that the child never drinks within two hours of bedtime.
- Encourage the child to urinate before going to bed.
- Wake the child after two hours of sleep to empty the bladder once more.
- Avoid caffeinated drinks such as coffee, tea, cola, cocoa and Red Bull.
- Attempt to institute bladder training, with voluntary postponement of voiding during the day, and alter the conditioned sleep pattern, using a bell that rings when a special sensor pad in the bed is wet (obtainable through some of the larger pharmacies).
Other successful treatments
Homeopathy can help, providing there is no physical cause, so consider Plantago Major, Equisetum Hyemale, Kreosotum and Ilex Paraguayensis at potency 6CH, four pilules every night half an hour before bedtime, for three weeks. If there is no improvement, then use higher potencies until the problem is resolved. Professor William Boericke recommends five-drop doses of the mother tincture of Verbascum Thapsus morning and night (Boericke W. Homoeopathic Materia Medica, 9th edn. Philadelphia, PA: Boericke & Runyon, 1927: 671).
The techniques of manual medicine (osteopathy, chiropractic and cranial osteop-athy) can correct any structural problem in the spine or pelvic basin that may be putting pressure on the nerves to the bladder (J Am Osteopath Assoc, 1994; 94: 606-9).
An important agent in traditional Chinese medicine is praying mantis egg cases, commonly used in powders or pills, usually in a dry-fried form. Good-quality egg cases are dry, yellow, lightweight and intact, and should be administered in 3-g doses (Bensky D, Gamble A. Chinese Herbal Medicine Materia Medica, revised edn. Seattle, WA: Eastland Press, 1993: 393-4).
There have also been reports of cases where bed-wetting teenagers have benefited from hypnotherapy. Younger children, unfortunately, aren't usually the best subjects for this form of therapy.