The nocturnal enuresis is the nocturnal, involuntary and functionally normal urination What happens when the child has been controlling sphincters for a long time during the day, but is unable to do the same at night, despite the fact that by age (between four and six years) he should have already achieved it.
This fact usually generates many doubts and anguish, both in the child and in the parents, who do not know how to approach the situation. Recently, the Symposium "Novelties in nocturnal enuresis" took place, held within the framework of the Annual Congress of the Spanish Society of Outpatient Pediatrics (SEPEAP). We tell you what guidelines offered by pediatricians to address this problem.
A disorder that affects 16% of five-year-olds
The nocturnal enuresis is a disorder that motivates numerous consultations to the pediatrician because it is relatively frequent in childhood. Not surprisingly, it affects 16% of five-year-olds, 10% of six-year-olds, and 7.5% of ten-year-olds. After 15 years, the problem still persists in 1-3% of adolescents.
"The enuresis is a multifactorial problem, whose main consequence is the shame and low self-esteem suffered by the child who suffers it" - said during the Symposium Dr. Víctor Manuel García Nieto, pediatric nephrologist at the Hospital Nuestra Señora de la Candelaria.
In Babies and more My son has enuresis, should I worry? According to experts, enuresis is a disorder, possibly underdiagnosed and infringed, to which many parents do not give importance because they ignore that there are medical treatments to solve it.In fact, it is estimated that only two out of five parents consider nocturnal enuresis a problem, and downplay the fact that their son wets the bed thinking that "it will pass by him alone". But in these cases, the most advisable thing is that the pediatrician assesses the situation, because early diagnosis is very important to prevent the problem from getting worse or lengthening over time.
Nocturnal enuresis and urinary incontinence
Until recently, the term "enuresis" was applied every time a leak of urine occurred when the child already controlled sphincters, regardless of whether it took place during the day or night.
In Babies and more The "escapes" of pee when the child is leaving the diaperHowever, currently preferred use this term only to designate night escapes, reserving the term "urinary incontinence" for daytime, or daytime and nighttime leaks with organic implications and abnormal urination.
In contrast, at night enuresis, urination is complete and normal, although unconscious.
What criteria should be given to talk about nocturnal enuresis?
According to experts, to diagnose nocturnal enuresis, the following criteria must be met:
Frequency of night escapes: The authors fail to agree on this dati, but most speak of episodes that take place at least four times a month. In any case, it should be the pediatrician who assesses it, because cases of bedwetting are also diagnosed with a lower frequency of urination.
Refering to age at which these escapes take place, we talk about the period between four and six years; that is, a stage in which the child should have already achieved bladder control during the night.
To talk about nocturnal enuresis, we must discard congenital or acquired urinary tract defects. Enuresis is also disconnected from other diseases such as diabetes mellitus or neurological diseases.
The episodes of night escapes have had to happen for at least three or six months.
Likewise also it is important to consider family history, because it has been shown that the risk of enuresis increases 2.4 times if a brother has also suffered it, 5.2 times if the mother suffered it in his childhood and 7.1 percent if it was the father who suffered from nocturnal enuresis.
In Babies and moreThe great invention of a father: absorbent pajamas, for children who wet the bed In most cases, the diagnosis is made with the patient's detailed medical history, a complete physical examination and a calendar or diary of the escapes that have occurred in recent weeks.
Guidelines to follow if our child wets the bed
Many experts bet first on follow a behavioral treatment before starting the pharmacological, because the enuresis is due to a maturational delay that will be solved sooner or later.
In Babies and more Diapers, urinals and torn pants: different ways of learning to go to the bathroom in the world can help parents relax These are some of the behavioral guidelines recommended by SEPEAP:
Explain to the child in a simple way how the kidneys and bladder work, so that you understand the basic mechanisms by which nocturnal enuresis occurs.
Do not blame the child for the situation Or embarrass him. On the contrary, it is necessary to reinforce the idea that it is a delay in the maturation of that area, as well as reward the achievements.
It is not recommended to wake the child at night to urinate, nor prevent him from drinking liquids. Experts consider it more advisable to involve the child in its healing, and for him to take the initiative by setting the alarm to get up at night, or teaching him that it is better not to drink excessive fluids after seven in the afternoon.
It is appropriate to establish an observation period of at least two weeks of self-records, that is, write a diary or table of urination and involve the child when filling it out.
In any case, it must be the specialist who assesses whether or not to follow a treatment, as well as when to start it, as there are experts who prefer to start around five years of age, and others who choose to wait until eight or nine years.
Therefore, our advice if your child still wet the bed or have any questions about it, is that check with the pediatrician as soon as possible, because if there is a problem of enuresis it is better to solve it as soon as possible. He will tell you how to proceed and the best treatment to follow according to your specific case.
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