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June 9th, 2010
Bed Wetting: Possible Causes Part 1
When looking at possible causes of bed wetting is is essential to identify the type of bed wetting a child struggles with. If a child is able to stay dry during the day but not at night and this has been the case since potty training started, it is called primary nocturnal enuresis. In this case the causes could possibly be the following.
- HORMONES
The development of a hormone - the Antidiuretic Hormone (ADH)- that reduces the production of urine. At about sunset there is a burst of this hormone in the human body. It gives a message to the kidneys to reduce urine output during the night. This hormone is not present at birth but normally develops between the ages of 2 to 6 years of old. In some children it only develops after the age of 6. If this is the case, time could be the healer.
- NEURAL PATHWAYS
From ages 2 to 6 a child become familiar with what a full bladder feels like. This development is separate from ADH development and has to do with neural pathways to and from the brain. In some children the development of these pathways may take longer than in others. - SMALL BLADDER
Between ages 2 and 6 a child’s bladder becomes bigger; making it easier to sleep for longer periods. In some cases a child’s bladder can be small till he is much older. Should this be the case a child would probably need to use the toilet frequently during the day too. - OVERACTIVE BLADDER SYNDROME
In short it means the bladder tends to experience spasms that causes it to empty frequently. There are various causes for this. The main symptom is that a child needs to go to the loo very frequently during the day too. - GENES.
Bed wetting can be genetic. Research found that chromosomes 13q and 12q can be linked to bed wetting. Often a close family member like a parent, grandparent, aunt or uncle had the same problem as a child - DEEP SLEEPERS
Some children are very difficult to wake up and they sleep so deep that they are not aware of their full bladders - CONSTIPATION
When the bowels are full it can put pressure on the muscles of the bladder. - SLEEP APNEA
Intervals where a child stops breathing while asleep. This is normally due to enlarged adenoids or tonsils. Severe obesity can also lead to sleep apnea. - SLEEPWALKING
Children who sleepwalk can sometimes be found urinating on carpets or floors . This is because they are under the impression that they are in the bathroom while they are actually in a cupboard or sitting room. - ADHD
Children with Attention deficit hyperactivity disorder are 2,7 times more likely to wet their beds. - STRUCTURAL ABNORMALITIES
In some cases a structural abnormality in the urinary system could be to blame. This will have to be identified via ultra-sound. Normally if this is the case, the child will probably have daytime incontinence too. - FLUIDS
Drinking too many fluids before going to bed.
ALLERGIES
Allergies to colorants or preservatives found in food and drinks. These allergens could irritate the bladder muscles, leading to uncontrollable spasms and bed wetting.
CAFFEINE
Caffeine is a diuretic – causing the body to produce more urine. It can also irritate the bladder muscles, leading to bladder spasms and subsequent bed wetting. That glass of chocolate milk that Katie’s having before going to bed could very well be the culprit.
For a discussion of the possible causes of secondary nocturnal enuresis click on this link.