The pee in bed is a common aspect of childhood that often resolves itself. It is important to have patience, understanding and adopt some practical strategies.
The phenomenon of “pee in bed“Or“night enuresis“It refers to the involuntary loss of urine during sleep, which occurs at least twice a week in children over the age of 5 for at least 3 months. At this age, in fact, over 90% of children are now continent, that is, it is able to retain the urine and empty the bladder in a controlled way, while about 10% is not continent.
This disorder is therefore, therefore, very common in children and is often concerned in families. If we think of the stories of many famous people who have suffered from it, like James Joyce, George Orwell and even Barbara Streisand, it is understood how this disorder has been known in reality for centuries, but unfortunately it is still often considered one sort of social “taboos” And it doesn’t talk enough.
Why does it happen? It is a common aspect of childhood that often resolves itself. With patience, understanding and some practical strategies, it is possible to help the child overcome this phase in a serene way without trauma. In fact, thenight enuresis tends to resolve spontaneously with age in almost all cases, but some patients continue to pee in bed Also as adults, so it is important that it is reported early to the pediatrician, if present, in order to treat it properly.
Why do children pee in bed?
The pee in bed is a fairly common phenomenon, especially in small children. It is important, however, to distinguish between: theprimary enuresis It is the one that occurs in a child who has never reached continence for a continuous period of at least 6 months after 5 years And it is the most widespread; and the enuresis secondary It is the one that has a debut after a period of at least 6 months night.
The disorder involves the more male And there may be a greater incidence of the primary form within the same family. The most recent studies report a prevalence of the symptom, with at least monthly frequency, 10% to 6 years and 5% at 10 years of age. At the Italian level, between 6 and 14 years, a total prevalence of 3.8% of children was found, with a progressive reduction of the disorder from 9.4% at the age of 6 to 2.3% per age 11 years.
The causes of pee in bed they can be varied, including:
- incomplete development of the bladder: In children, the bladder may not yet be large enough or its function that is not completely mature to retain urine overnight. The fact that the phenomenon of pee in bed He tends to disappear naturally in almost all cases, suggests that these children present a greater “slowness” in the full development of the mechanisms that regulate the bladder function;
- reduced night production of vasopressin: It is a hormone that regulates urine production. In children suffering from night enuresis, there may be lack of this hormone with consequent increase in the amount of urine produced at night;
- heredity: as already mentioned, do the pee in bed It is a disorder that could have an inheritance component. If one of the parents had this problem as a child, there is a greater possibility that his son also has it;
- deep sleep: Some children sleep very deeply and do not feel the need to urinate. The presence of sleep disorders or excessive sleepiness, especially if persistent over time, must always be attached to the pediatrician;
- Psychological causes such as stress or anxiety: stressful situations or changes in the life of the child, such as the start of the school or the arrival of a new little brother, can contribute to the night enters;
- Other medical problems: in rare cases, pee in bed can be caused by medical problems such as urinary infections (which also cause burning during urination, pollachuria, urination urgency) or diabetes (high blood sugar in the blood involves an increased load of glucose in the kidneys, which It also ends in the urine), or complex neurological syndromes (spine bifida, malformations against the nervous system), which They alter the neurological mechanisms at the basis of urinary continence.
Pee in bed: until it is normal?
The first question we have to answer is: until when are children pee in bed? In general, in the pediatric field it is considered normal that children do not have a full urinary continence Until the age of 5-6. However, some children can continue to pee in bed occasionally even until the age of 7-8, especially in stressful conditions, such as a family quarrel or a bad vote at school, without this constituting a real problem.
But then, When to worry about the pee in bed? Requires the attention of a pediatrician if:
- The child is more than 7 years old and pees in bed regularly;
- The child peed in bed in the past, stopped for a period and then started again (secondary enuresis);
- There are other symptoms As pain during urination, tiny urgency, excessive thirst (Polyidipsia) or changes in the behavior of the child, especially during sleep.
In the presence of one of these situations, it is appropriate Contact your pediatrician To evaluate any investigations or strategies to be adopted.
Solutions for pee in bed: how to intervene
In this regard, there are different solutions which can help manage and reduce this problem. Let’s start with What to do for the pee in bed:
- Reassurance and support to the child: it is important not to punish or scold your child or daughter for the pee in bed; On the contrary, reassuring him that it is not his fault and that many boys and girls pass through this phase could help him face the problem. It is essential that it feels understood and not guilty;
- Establish a “bathroom routine”: encourage to go to the bathroom before going to bed and, if necessary, wake it up once during the night to make it urinated;
- limit the intake of liquids before going to sleep: Reduce the intake of liquids in the evening, especially drinks such as milk, water or fruit juice, which can increase urine production. These precautions could help decrease the amount of urine produced during the night;
- bed protection: Using waterproof covers can help manage inconvenience and facilitate cleaning. Keeping a reserve kit of sheets already ready for use can facilitate the night gearbox; ù
- positive reinforcement techniques: rewarding the boy or girl for “dry nights” can be motivating, for example, keeping track on a calendar. Likewise, celebrating progress with small rewards or stickers can be a positive reinforcement strategy to motivate the boy or girl;
- medical consultation: as already mentioned, in the event of specific situations or if the phenomenon of pee in bed persists despite appropriate precautions, it would be appropriate to consult your pediatrician, who will evaluate whether it is necessary to proceed with further exams to exclude any medical problems below. In some cases, specific exercises to strengthen the bladder can be useful, after always medical advice.
Let’s see now What not to do if the child pees in bed:
- Do not ignore the problem: to think that the problem will solve itself without any intervention may not be the best solution. It is important to face the situation in a constructive way, involving your pediatrician;
- do not punish or reproach, and above all not humiliate or ridicule the child: This could increase its sense of shame and anxiety, worsening the situation. It is important to avoid making humiliating comments or comparing the child to others who do not have this problem. The night enuresis is often outside the child control. It is therefore important to maintain a positive and understanding attitude;
- do not excessively limit liquids: Limiting the intake of liquids in the evening can be useful, but it is not necessary to do it excessively, since it could lead to dehydration or other problems, especially in the summer. The liquids must be taken normally in the daytime, especially the water. In case of doubts, it is always good to refer to your pediatrician;
- Do not create a stressful environment: trying to reduce the child’s exposure to situations of stress and anxiety, since they can contribute to night ensence;
- Do not use the problem as a threat: avoid threatening the child with punishments in case of pee in bed. This can create fear and guilt;
- Do not use alarms without preparation: several alarm systems have been created to report the night enuresis. For example, wearable alarms, pad -type alarms and wireless alarms, which detect humidity and are activated accordingly, often producing a sound. The wearable ones, the most common, are relatively small and are designed for general comfort during use. The humidity detection unit is positioned on clothing in the pelvic area and a small flexible cable that flows under the clothing connects the sensor to the alarm. They are devices for night enuresis that can be useful, but must be used correctly and with the support of the child. Improper use can cause frustration;
Do not ignore the problem: Even if the pee in bed is common, it should not be ignored. Offering support and looking for practical solutions is important to help the child overcome this phase.
