About Bladder Control in Children

Human beings are not born with the ability to control their bladders. As children age, they slowly gain continence, but 5 million to 7 million children over the age of 6 experience nocturnal enurensis, or bedwetting. Some as old as 18 still wet the bed. Bedwetting creates an immense amount of pressure in children. If your child is still wetting the bed at night, here are some explanations why and some strategies to help your child get better bladder control.

Child Bladder Function

• The bladder stores and contains the urine created by the kidneys. In children, bladder size corresponds to the child's age. A child can hold 1 to 1-1/2 ounces of urine for each year of age. A 6-year-old can hold six to nine ounces of urine. Control of the bladder is established over time. Most children achieve daytime bladder control by age 3; nighttime bladder control is established by about age 4. Only 1 to 3 percent of teenagers over 16 continue to wet the bed.

Causes of Incontinence

• Bedwetting affects 10 percent of children 4 or older. More boys are affected than girls. Bedwetting rates decrease in children by about 15 percent per year. Physical abnormalities account for 5 to 10 percent of bedwetting cases. Other health conditions in children, such as spinal bifida or tethered cord syndrome, can produce bladder problems and incontinence. Family history is also a major factor in bladder control.

Side Effects

• Bedwetting can be very damaging to a child's confidence and self-esteem. It creates social limitations, as many children with bedwetting problems don't stay away from home overnight. Parental frustration over cleaning up bedwetting situations can be interpreted as a sign of failure by children, further affecting their confidence.

Treatment

• Bladder control programs, supervised by a doctor, can help the child naturally learn to control his urine flow. Bedwetting alarms, which go off when the alarm senses urine, can train children to wake up at night to empty their bladder. Encouraging your child with praise or treats for successful bladder management can help motivate your child to want to try harder for control. Another successful strategy is to make your child take some responsibility for cleaning up after themselves. In no way should a child be punished for bedwetting; it will teach them nothing. Caffeinated drinks, like soda, should be avoided, as it works as a diuretic to stimulate urine production. A healthy diet full of fruits, vegetables and dietary fiber can reduce constipation, easing the pressure on your child's bladder.

Medicine and Surgery

• Because bladder control is an acquired instinct, treatments and surgery are often unnecessarily risky and dangerous. If your child is experiencing nocturnal enurensis after age 6, a trip to a pediatric urologist can inform you if your child has severe bladder or sphincter dysfunction. Otherwise, medical help isn't needed unless bedwetting starts in a child who previously had no problem, or if the condition starts adversely affecting the child's social life or mental health.