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Opinion Does your child have bed-wetting issues? Positive reinforcement is essential

Disrupted nights can damage children’s self-esteem and exhaust them before a day at school.

TODAY MARKED THE launch of the ‘Dry Nights for Smarter Days’ campaign from Bedwetting.ie. The campaign launched a new app, the Bedwetting Tracker and also released research which looked at the impact of bed-wetting on behaviour and ability to learn at school. Bed-wetting is not considered a medical condition in those aged under five.

In my work as a sleep coach, I was asked to be a part of this campaign as the research showed the serious effects of disrupted nights for children facing a day at school. Tiredness and, I would go so far as to say, sleep deprivation can have a significant impact on children. However, it is important to remember that your child is not wetting the bed for attention or out of some behavioural issue. It is very much an involuntary action at night.

Primary Nocturnal Enuresis (bed-wetting) describes an issue where the child (over 5-6 years of age) has never been dry at night. This is likely to be a medical issue and you should, first and foremost speak to your GP.

Secondary Nocturnal Enuresis describes a child who had previously been dry at night but who, for some reason, has regressed. This launch is perfectly timed for this back to school week, as a sensitive child starting school – or simply entering a new stage at school – may experience a slight regression.

There are a number of reasons why this may happen:

  • It is often hereditary. If one or both parents wet the bed, there is a good chance your child will also wet. Children are likely to stop wetting around the same time that their parents did.
  • Hormone levels (Vasopressin) normally increase at night to signal to the kidneys to slow down. In some children, these levels don’t rise and more urine is produced overnight. A deep sleeper will not be able to recognise the feeling of a full bladder and will wet overnight.
  • Children may simply have a small bladder capacity or indeed children who already have constipation issues, may be more likely to wet the bed as increased pressure on the bladder will cause involuntary urination.

The research of 457 parents of children who are frequently wet at night, revealed some interesting statistics:

  • 1 in 10 children find it hard to concentrate in school.
  • 1 in 3 parents feel that their child would achieve better results if their child did not wet the bed.

Making other carers aware 

These parents worry about their child’s learning abilities and feel that they may be falling behind. Still, only 1 in 4 parents felt that they should be telling the teachers about what is going on at home. I found this very interesting, as my advice would be that support and encouragement should be a huge part of dealing with this issue. Perhaps it is a fear of “labelling their child”?

Still, this issue needs to be addressed and not just swept to the side. They may struggle to do their schoolwork or homework simply because they are tired or were unable to retain the information learnt in school that day. They may be overly emotional, which doesn’t make for a happy home life for anyone.

Inadequate sleep or, more importantly, not enough sleep can impact greatly on all of our productivity during the day. This goes not only for children, but for parents too. Tiredness and exhaustion, particularly when accumulated over an extended period of time affects learning, concentration levels and can have repercussions on many levels. There can even be damage to a family’s quality of life when members of the family are consistently being disrupted at night.

Broken sleep is in fact more detrimental to our physical and emotional well-being than only getting a short amount of sleep at night.

Positive reinforcement

Some of the traditional methods of dealing with bed-wetting such as, wearing night-time nappies, lifting your child or bed-wetting alarms, whilst widely used, are often just short-term solutions and do not really address the issue. Positive reinforcement, on the other hand, can help; rather than addressing the nights that a child wets the bed by getting cross with them, let the dry nights be the focus of your attention. Give the child a sense of responsibility and encourage them to help in the clean-up process.
Bedwetting.ie and the new Bedwetting Tracker app are a step in the right direction and I would strongly recommend that parents use this resource. And, as with any issue, please speak to your GP or public health nurse about it. If there is an underlying medical condition, they will be able to point you in the right direction.

But, remember, at the heart of this is a child who cannot control what is going on. It is genuinely as frustrating for them as it is for their parents. They need to be supported and encouraged and not reprimanded, as this is certainly not a discipline issue but one which often needs a number of deep breaths, time and patience… and a high functioning washing machine!

Niamh O’Reilly is a sleep consultant with thenursery.ie. To learn more about bed-wetting please visit bedwetting.ie or download the Bedwetting Tracker

Just one in ten parents seek GP help about child’s bedwetting

Survey shows 47 per cent of GPs think bedwetting is hereditary

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Niamh O’Reilly
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