My child is bed wetter – I come because my child has been making bed for years! – The child does not and does not want to get clean – I have already done so much, but my child willfully, out of malice, wet the bed every night, sometimes even during the day in its pants, and it is already 10 years old.
Causes of bed wetting in children
This or similar is what the parents of bed-wetting children and adolescents say. What are the causes and complex of questions behind wetting at night and during the day? Is the clinical picture a congenital ailment or even a hereditary disease, a bladder ailment or a nerve disorder? These and similar questions are also put to the doctor by the parents.
There is no such thing as bed-wetting as a disease of its own. It is always to be understood as a symptom (sign) that can have various causes. The majority of bed-wetting children are those who have neurosis from disturbed relationships with others and the environment.
We know from the studies that neuroses can present themselves in very different manifestations. A neurosis is all the abnormal functions of individual organs or organ systems that are controlled by the nervous system. They almost always arise from disturbed relationships between humans and their environment. Bed-wetting, which sometimes occurs every night, sometimes every couple of nights, or even just every couple of weeks, is the most common form of childhood neurosis.
It is often very difficult to discover the physical or mental (psychological) events that have been processed incorrectly by the child and have now caused these disorders, because the child can of course not express himself as an adult.
Symptoms, ailments & signs
When children wet themselves, the complaints and symptoms are usually relatively clear. This leads to wetting in childhood, which in most cases occurs during sleep and thus at night. Bed-wetting can, however, also occur during the day or in certain situations and have a very negative effect on the quality of life of the person concerned.
Often, bed-wetting in children is also associated with psychological upset or depression. Many of the children also suffer from bullying or teasing and thus have difficulty making friends and socializing. The social life of the child is also considerably restricted and made more difficult by bed-wetting in children.
The symptoms of this disease also depend heavily on the severity, so that bed-wetting can occur very often or only after a stressful and exhausting day. The relationship with the parents can also suffer from this disease, whereby many parents also suffer from psychological complaints or depression and need psychological treatment as a result. If the disease is not treated, there is usually no self-healing.
Social disorders in bed-wetting children
Now what is the child’s fellowship and environment? First and foremost, the parents and the people who constantly deal with the child and who represent the smallest environmental association, the family. So you can actually see a very considerable percentage of bed-wetting children come from disturbed family relationships in which the child does not receive the necessary security and care.
The disturbances in the relationships between mother and child are very much in the foreground, because the ties to the mother are usually the deepest. Nervous overstimulation, overload, discontinuity in the nature of the mother reduce the understanding of the child. But also defiant rejection of the child towards the strict father and similar phenomena must be seen as causes for disturbed relationships. In addition, children often give us credible information without being bothered with suggestive questions or specialized questions.
For example, bed-wetting children occasionally report playing and other child-friendly activities: “Nobody likes me. – Mother just loves my sister. – I am so afraid of being hit. ”If you get to the bottom of these sayings in a consultation with your parents, then these child expressions inevitably fit into the overall event.
A detailed discussion with the parents and also an observation of the child, combined with discussions with him, not only help to clarify the complex of causes for the occurrence of bed-wetting, but also represent a very important part of the treatment.
Treatment of bed-wetting in children
Learning to clean the bed happens by means of a conditioned reflex, ie the child is put on the potty or the toilet at very regular times (and this is very important), whereby the urge to empty the bladder is made by the prompt AA “and the like. is still supported.
The child must first learn to empty the bladder at will and also to feel the fullness of the bladder and then to control it.
That is why it is necessary to get the child to urinate punctually at certain times, and it is just as important that the situation remains as constant as possible, that is, it is not good to have the child urinate once there and once there.
For example, if a child is used to standing on a carpet with their potty, the fact that they occasionally have to put the soles of their feet on the cold floor can cause irregularities when the natural flow of things is already disturbed.
The same applies to the shape of the potty with a wide or narrow rim and similar factors, because a conditioned reflex must be ground in under the same external conditions. Praise for a job well done has a stimulating effect on a normally developed child, while criticism about wet panties or the wet bed should be more cautious the younger the child is.
The best time to urinate on your own
Bed-wetting, based on a neurotic basis, often sets in after a time when the child has already been bed-clean. For example, the third and fourth year of life represent a special danger point, because in this phase of development, when environmental disturbances occur, a disturbance in the already existing conditional-reflective activities is more likely to occur than in the quiet phases of childhood.
If experiences occur that disrupt the child’s relationship to the social environment, and negatively conditioned reflexes are ground in as a result, conditional-reflective (neurotic) bed-wetting can appear.
The 13th to 24th month is particularly suitable for learning the conditional reflexive bladder activity.
It is also not uncommon for children to become dry too late, whose toilet training was in the hands of several or even many people. As we shall understand from the foregoing, what matters is not just that the child is drained, but how this happens.
If the toilet training is missed, mainly due to external reasons, then bed-wetting becomes much more difficult to treat, because now it is important to teach the older child, in whom the wetting occurs habitually, the bladder regulation activities without the child experiencing a so-called organ sensation (i.e. full bladder, urge to urinate) has already possessed.
The difficulty also lies in the fact that the child who has not yet become clean is seen as suffering from bladder disease and is taken to the doctor. And in fact, it is not uncommon for these children to find weaknesses in the bladder muscles, depending on the length of time they have been constantly wetting their beds, because they have not yet learned to use these muscles.
Bed-wetting while sleeping
Very often the deep sleep of the child is blamed as the sole cause of bedwetting. It is well known that the healthy child sleeps carefree deeply after a happy and exuberant, but also well-balanced day, while the child who is physically and mentally disturbed sleeps restlessly for various reasons. It is the same with children who are afflicted with difficult experiences.
Based on research, we know that the brains of humans and children do not sleep evenly, but that so-called waking points (better guardian points), which form in the cerebral cortex around the age of 2, watch over the maintenance of vital functions and thus also make the urge to urinate become conscious.
As a result, the reflection causes waking up when the bubbles are full. When wetting the bed, a weakening of the waking functions plays an important role. The cause of bed-wetting is not deep sleep, but a reduction in the waking functions in the brain as a result of a neurotic inhibition process. We therefore do not consider it justified to tear bed-wetting children out of their sleep several times. Taking a child under the age of two out at night does not do any harm, because the watch functions are not yet properly trained.
If you wake bed-wetting children too often at night and, unfortunately, often very drastically, they become restless, anxious and insecure and go to bed fearfully in the evening, they sleep correspondingly restlessly, and bed-wetting happens more often in restless sleep than in calm, balanced sleep. Most of the time, these children are also calm and withdrawn during the day, sad and tired, because they have not been able to find the necessary rest and refreshment due to the interrupted sleep.
When should you go to the doctor?
Bed-wetting in children is so common that it is not generally an occurrence, which must be clarified immediately by a doctor. Occasional bed-wetting is more the rule than the exception, especially when small children have only just gotten dry or have to wait in line for the first few nights without a diaper. Even children who are basically already reliably dry can have relapses. These can just occur for no particular reason. Sometimes, however, they are also related to infections, special physical strain or special living conditions.
Many parents are familiar with the phenomenon that with the birth of a second child, the first one starts over again. Sometimes this happens unconsciously, but it can also be used purposefully to point the parents to yourself. Often there is also a child’s overstrain with a certain situation behind it.
If this subsides after a few days and appropriate discussions and a lot of attention, a doctor does not necessarily have to be consulted. However, if bed-wetting persists for many days, a pediatrician should be called in. This also applies if older children who have left the diaper behind for a long time suddenly start wetting their bed.
Going to the doctor is also advisable if unusual neurological symptoms such as unsteady gait, slurred speech, etc. occur. The pediatrician is always the first point of contact for children who become wet and can refer to specialists if necessary.
Treatment and therapy of bedwetting in children
In the case of neurotic bed-wetting, various types of psychotherapeutic measures are in the foreground of the treatment. General educational measures, which are mainly based on praise and recognition and give the child the necessary security, support the medical measures considerably. It should be particularly pointed out that it is completely wrong if the child is repeatedly portrayed and degraded as a bed-wetter on all possible occasions.
Whether additional drug treatment is necessary will depend on the individual case. For bed-wetting, dehydration in the evening means at most that you tell the child: “You have now had little or nothing to drink and therefore you will not need to wet the bed.”.
This means that one should not cruelly torment the child with thirst disorders, because experience has shown that thirsty children also wet the bed, precisely because this phenomenon, to put it simply, depends much less on the kidneys and much more on the brain.
There is no general and universal recipe for such a diverse appearance as bed-wetting in childhood. Individually adapted treatment measures, which the doctor can advise, of course taking into account the social context, are required.
Outlook & forecast
Bed-wetting in children is considered a natural course of development and growth. This process has a very good prognosis, since in almost all cases a full recovery occurs. The exception are patients with diseases of the urinary tract, muscles or other deficits.
Under normal circumstances, every child experiences bed-wetting. The activity of the sphincter muscles must be learned, as this is not an innate ability. The duration of the learning process is individual and can last weeks, months or years. Children who have already learned not to wet themselves at night can also relapse. Stress, changed living conditions or illnesses very often lead to bedwetting again. This can also occur in adulthood.
With calm, patience and a good regulation of the amount of fluid, a renewed alleviation and later healing of the complaints is achieved. It is helpful to go to the toilet right before going to bed and to drink little fluids just before going to bed. During the learning process, the child can be woken up again for some time at night to prevent it from getting wet. This is a temporary measure, as with sufficient training and control of the sphincter muscle, bed-wetting will cease.
Follow-up care only makes sense if bed-wetting occurs again after months of subsidence or if it is still present after the age of five. It is not uncommon for toddlers to urinate in bed at night. They must first learn to control their bladder. A good third of all boys and girls cannot sleep dry between the ages of four and five.
From a statistical point of view, their number then decreases sharply. If bed-wetting disappears in children, it is unlikely to recur. There is then no aftercare. If, on the other hand, the symptoms reappear after they have subsided for a long time, follow-up care is necessary. A consultation with a doctor clarifies the situation. Possible causes can be analyzed. It is not uncommon for stress or problems to cause bedwetting.
One of the main tasks of follow-up care is to avoid possible complications. However, these are generally low for bed-wetting people. Contrary to what many people think, emptying the bladder at night is not an abnormal disease. It can be countered in everyday life with suitable pads and bed linen.
Rather, the aim of aftercare is to provide information on practical tips and to create a relaxed atmosphere for the child. For example, parents can install reward systems or an electronic wake-up system. Sometimes medication helps at times.