Helping children and young people who wet the bed
Around one in five children aged 4½ - and almost one in ten of those aged 9½, occasionally wet the bed. It can also happen to older children and young people.
Bedwetting (or ‘nocturnal enuresis') is a complex condition which can be very distressing for children and their parents or carers. In particular, it can affect children and young people's emotional wellbeing and their social life.
Although most of them will eventually grow out of the condition, it can take a number of years - and some may need additional help and treatment.
New NICE guidance ‘Nocturnal enuresis: the management of bedwetting in children and young people', aims to ensure all those up to the age of 19 receive the support and treatment they need. It also aims to ensure parents and carers are given comprehensive advice.
NICE stresses that bedwetting is not the child or young person's fault and they should not be punished. In fact, it recommends using a system of rewards for not wetting the bed, either on their own, or alongside one or more treatment options.
Bedwetting may be caused by a number of factors, such as problems with the bladder or not waking up during the night when the bladder is full, and it can take time and effort to get the treatment right. The child, parents or carers and healthcare professionals need to work together to find a solution that meets their needs, says NICE.
Sometimes, for example, a quick or short-term measure might be required to help with social occasions like holidays or sleepovers. On the other hand, a longer-term solution may be preferable.
In the first instance, NICE recommends using a special alarm which wakes the child up when they begin to wet the bed - as this has been found to be the most effective, long-term option for most children and young people.
If an alarm is not suitable or doesn't work, or a faster-acting or short-term measure is more appropriate, NICE advises using drug treatments such as desmopressin - or a combination of approaches.
A ‘lay' member of the NICE committee that developed the recommendations has two children who both suffered with bedwetting for “a considerable length of time”. She explained why the guidance is important.
“It makes it clear that GPs should not just send you away until your child is 7, for them then to be put on a waiting list to see a nocturnal enuresis specialist.
”It clearly highlights how important alarms are. Families will hopefully no longer be told you can't try an alarm until your child is at least 7 years old, or that an alarm might work but there's an 18-month waiting list.”
She also welcomes the emphasis on using a combination of approaches: “If I was more aware of the benefits of using an alarm alongside desmopressin in the case of our son, I think we'd have put a more concerted effort into trying this combination therapy," she said.
27 October 2010