Education and Advice
Educate the child and family on the prevalence of the disorder. Assure the child that he or she should be ashamed of bedwetting; it is common. Let the families know that most kids will stop wetting the bed with time.
Emphasize that children are not trying to cause frustration or stress. In most cases they are not wetting the bed on purpose. They should never be punished or ridiculed for wet episodes.
You can also provide information to the parents regarding causes of nocturnal enuresis, to dispel any misconceptions that they may have.
Advice can be given to decrease the child's need to void during the night.
- Encourage regular voiding during the day, ex. every two hours
- Avoid drinks containing caffeine, especially at night
- Create a schedule to distribute the amount of fluids that the child drinks. One proposed schedule could be 40% in the morning, 40% in the afternoon, and 20% in the evening.
- Ask the child to urinate before going to bed
- Set a schedule in which the child goes to bed at the same time each night
- Avoid the use of training pants; the child may grow accustomed to having that protection
- Make the bed using alternating waterproof pads and sheets, so that when a wetting episode occurs, you save time only removing one sheet and pad
- Always use a waterproof sheet to avoid urine seeping into and causing an odour in the mattress
As well, parents should use a journal to record bedwetting frequency and other events like the amount of liquids consumed or the number of times the child urinated in a day so that they can track any triggers and track any improvements that may occur.
References:
Gorodzinsky FP. Genitourinary Disorders: Urinary Incontinence in Children. In: e-Therapeutics+. Ottawa, ON: Canadian Pharmacists Association; 2013. https://www.e-therapeutics.ca/tc.showChapter.action?documentId=c0052. Updated May 2011. Accessed Mar 20, 2013.
Ramakrishnan K. Evaluation and treatment of enuresis. Am Fam Physician. 2008;78(4):489-96.
Tu ND, Baskin LS. Management of nocturnal enuresis in children. In: Basow DS, ed. UpToDate. Waltham, MA: UpToDate; 2013. www.uptodate.com. Updated Dec 4, 2012. Accessed Mar 18, 2013.