After talking two days ago about the ten tips that parents can follow to help children leave the diaper, and after talking a little about the night diaper yesterday, because of what is more difficult for them to control the sphincters at night than during the day , today we continue with the issue focusing on the night, when we see the days, weeks and months pass and our son or daughter does not control and continues to have "night leaks."
I mean those children who they reach five years old and they still need the diaper at night. There is no way, we have removed the diaper because someone has suggested that we have to remove it, we have spent days and days washing sheets, we have told him to change them himself and there is no progress. It is called nocturnal enuresis and then we will answer the question: What if after five years there is no way to remove the diaper at night?
What to do if a five-year-old child keeps wetting the diaper at night
As I said yesterday, the first thing we should be clear about is that it is normal. It may be because The child's bladder is not yet large enough as to retain the urine generated at night, because still not able to wake up When your bladder is full or because it does not secrete enough antidiuretic hormone (ADH), the hormone responsible for determining how much urine should seep into the kidneys (the more hormone, the less it filters and the less urine reaches the bladder).
We must be clear, very clear, that he does not do it to annoy him, he does not do it to attract attention, nor does he do it as a revenge for anything, since the first one who would not want to live something like this is the child, who feels wet and upset. If the child has never been able to control at night, it is not something that is linked to emotional problems. If instead it has been a season without a diaper, but then again wet the bed every night, or several nights, you could be restless or stressed by something and as parents we would have to try to find the cause, to help you with it.
It may happen that nocturnal enuresis is due to a Physical problem, that is, to some type of malformation in the bladder or renal level. The pediatrician can ask some questions about it to try to find out if the enuresis could respond to it, and if he believes he will request an ultrasound with which you can see the shape of the organs and decide whether to refer to the urologist or if everything is normal and it is due to something else. In case it is not a physical issue, you can choose to try to do something about it or wait.
Possible treatments to bedwetting
I personally am not very much in favor of using treatments for bedwetting, basically because many times they don't work and because some of them are annoying for the child. But if the fact that a child has leaks at night is a problem for the family and / or for the child, some of the solutions could be attempted, since the most important thing is the child's well-being and self-esteem.
Before entering with them, to say that if it is a problem for the child, it could be because someone laughs at him or the children to whom it happens, and this would have to work, because it's not the child's fault, he does not choose to do so and, as he has no control over it, nobody should laugh at it, being also something normal.
- Explain that It is normal: Obviously, to make it clear to the child that it is something normal, that we know that it is not their fault, but that it is something that simply happens, and tell them that we are going to try to put a solution, if it were possible, but that if it is not solved it does not happen either any.
- Decrease fluid intake In the late hours of the evening: It is not a panacea, it is not a solution that actually works great wonders, but it can be useful for the night to generate less urine and take longer to fill the bladder.
- To do pee before bedtime: Just before going to sleep, empty your bladder, of course.
- Wake him up at night to make a pee: it is not something that children get too excited about, but it can serve as night training so that you can feel the full bladder and eventually getting up to urinate if you feel like it.
- Do not reward and do not punish: it is usually recommended to give prizes on dry waking days, to reinforce, but since it is not something that the child does voluntarily, I am not very supportive or rewarding, much less punish if he escapes . The more natural we do it, the more normal he will see it and the easier it is for him not to be ashamed of it. A monthly calendar is usually used in which a sun is drawn if the child dawns dry, or a cloud raining if there has been an escape that night. If at the end of the month there are more suns than clouds (a percentage, or all suns and no clouds ... this must be agreed with the child), receive a prize. Again, I say the same thing, the idea is that you don't feel bad about it, If you are not able to achieve it and you run out of prize, what do we do?
- ¿Change the child's sheets?: I put it in question because it is advice that many parents receive. As he pees and stains everything, he sees what it costs us parents at night to get up to change the bed, doing it. If the child wants to do it, nothing happens, that he does it, but that we be the ones to do it can be taken by the child as a punishment, as a "you have pissed, because now you clean it", and this It shouldn't happen. If it has got wet, we help you. Help us make the bed and that's how we ended up before, or change the pajamas while we make the bed. But not play with the feeling of punishment. Also, if the leaks are every night, Why don't you wear a diaper? There is no reason to remove it if you are unable to control.
This is done for about three months, after which there may be some improvement or none. If this happens, if there is no change, you can try the following:
- Use an alarm, a belt, which the child is put on before bedtime and he notifies him when he starts to get wet. The child wakes up by the alarm and can go to the sink to finish peeing there. It is a method we talked about a while ago in Babies and more with which it is estimated that almost half of the cases are solved. If the child gets along, if it doesn't bother him, it doesn't seem bad. If instead the child is disturbed by the belt or the fact of waking up at night by an alarm then affects him during the day (which is more tired, irritable, etc.), then he would not use it.
- Use a medical treatment: Desmopressin is given to the child, which acts as the ADH hormone, the hormone that regulates the amount of urine that is filtered from what we have already talked about. If a child secretes little ADH or does not have receptors for that hormone, he will have many problems withstanding urine. In case you secrete little, the treatment can be useful. The problem is that it increases blood pressure a little and some children have nausea and headache. In principle, according to the American Academy of Pediatrics, should be the last resort, but when it is reached it can be useful in a high percentage of children.
If there is no treatment that works
There are children for whom no treatment is useful, although in adolescence, because they already secrete enough ADH or because they are already able to notice when the bladder is filled at night, most already control the urine. It is usually hereditary, and when you ask if it happened to one of the parents it does not usually fail: it happened to one or the other until I don't know how old.
If ours is one of these, of which there is no possible remedy, we will only have keep working on the subject, continue to give our support and advise that during the day try to endure the urge to urinate when you have them, so that the bladder capacity increases, in addition to continuing to tell you not to abuse liquids and caffeine, which will make you feel more like Pee at night.
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In Babies and more | What is nocturnal enuresis, Children with nocturnal enuresis can suffer it in adult life, Some facts about nocturnal enuresis, Mojarlacama.es, a place to know everything about enuresis
