Text by Xanet van Vuuren, Photographs by Gallo Images/Getty Images.
Source: This article was taken from the February 2011 issue of Living & Loving.
There are many reasons your child may be wetting his bed or soiling himself. We shed some light on the condition.
Unfortunately, your child isn’t born into the world knowing how to use a potty. He may be fabulous at throwing tantrums and hold a world record for unpacking cupboards, but knowing when and how to use the little boys’ room usually takes some time and quite a bit of effort to get acquainted with.
Many children master these skills quite easily, but some kids have a few hurdles they have to overcome before they become “accident free”. These children may have various medical, emotional or behavioural problems, which you may be unaware of, that cause them to wet their beds or soil themselves. Children don’t do this on purpose or to irritate you – they could have a problem, which can be treated successfully.
BED-WETTING
HOW COMMON IS BED-WETTING?
Enuresis is the medical term used to describe an inability to control urination. Pretoria based counselling psychologist, Sigi Graham, from the Child Behaviour Centre, says boys are more likely to have enuresis than girls, but a diagnosis of enuresis won’t be made before a child’s fifth birthday. “It’s estimated that 10% of five-year-olds wet their beds. These figures reduce steadily each year and only about 5% of children still wet their beds at the age of 10 years old.”
DIFFERENT TYPES OF BED-WETTING:
Sigi explains that enuresis refers to the repeated intentional or accidental voiding of urine into bed or clothing. “A child will have to wet his bed at least twice a week for a period of three consecutive months before a diagnosis of enuresis can be made.” There are five different types of bed-wetting known as enuresis, explains Sigi:
1. Nocturnal enuresis – this happens at night while a child is asleep.
2. Diurnal enuresis – this happens while a child is awake.
3. Nocturnal and diurnal enuresis – this happens both during the day and night.
4. Primary enuresis – the condition of a child who’s never developed bladder control.
5. Secondary enuresis – the condition of a child that develops enuresis at least six months after he learnt to control his bladder. This type of bed-wetting is normally caused by a psychological factor.
CAUSES OF BED-WETTING
Sigi says there may be various causes of enuresis. “Bed-wetting may be a result of a medical condition, genetics, sleep problems, hormonal problems or emotional problems.” If your child has a problem with bladder control, it’s best to take him to a medical professional to find out what the problem is.
WHEN TO SEEK PROFESSIONAL HELP?
“If you’re worried about your child’s health or bladder control you should voice these concerns to your paediatrician when you take him for his routine check-ups,” advises Sigi. If there’s anything to be concerned about, the doctor will advise you as to what to do next and how to handle the situation.
TREATMENT FOR BED-WETTING
Sigi says exercise, habit changes and medication may be used to treat enuresis. “Before treatment for bed-wetting can be prescribed, your child will have to undergo a medical examination to determine the possible cause of his problem. Treatment may sometimes include medication, psychological evaluation or therapy. The doctor may also advise adjustments to your child’s diet.”
“Parents should restrict their child’s fluid intake before bedtime and make sure he visits the toilet just before he goes to bed. The child should pay another visit to the toilet before the parents go to bed as well,” recommends Sigi. She adds that bed-wetting alarms are also a great way of treating enuresis.
Children shouldn’t be shamed for wetting their beds. “A positive and motivational attitude is necessary to work towards success,” says Sigi.
SOILING
HOW COMMON IS SOILING?
Sigi says a diagnosis for soiling can only be made once a child has reached his fourth birthday or if he is at the same developmental stage as a four-year-old. “Soiling is an equal occurrence between boys and girls, but it’s more common in school-aged boys than girls.” Gigi explains that soiling, or encopresis, is the repeated involuntary or intentional soiling in children who are already toilet trained.
According to Dr Miriam Stoppard in her book, Complete Baby and Child Care, there are three types of soiling: “Soiling that has been present from babyhood; regressive soiling, in which a toilet trained child reverts to an earlier stage of development; and aggressive soiling, which is an emotional response to over-strict parenting or severe or out-of-date toilet training.”
DOs AND DONTs
Follow these helpful tips from counselling psychologist, Sigi Graham, on what to do and what to avoid when your child has enuresis:
- Try to maintain a positive attitude and motivate your child to succeed.
- Invest in a mattress protector to minimise damage to your child’s bed.
- If your child does wet his bed, help him clean up and put him back to bed.
- Protect your child’s dignity. Don’t make fun of the situation.
- Don’t exclude any medical conditions that may be the cause of his bed-wetting.
- Avoid punishing your child and placing any unnecessary pressure on him, as this may add to the problem and not resolve it.
CAUSES OF SOILING
“There can be various causes of soiling, including medical, behavioural and emotional problems,” says Sigi. As with bed-wetting, you’ll have to take your child for a full medical examination, and possibly psychological evaluation, to find out why he’s doing it.
TREATMENT FOR SOILING
Before it can be decided which treatment will be best for your child, he’ll have to go for a medical examination. “Psychological evaluation and therapy may be necessary if it’s an emotional or behavioural problem. Dietary and behavioural changes (encourage your child to sit on the toilet after meals for five to 10 minutes, two to three times daily) are also recommended,” explains Sigi. She adds that, if a child manages not to soil, a star chart is a useful way of encouraging him to keep on trying.
SIGI EXPLAINS WHAT PARENTS SHOULD AND SHOULDN’T DO WHEN IT COMES TO SOILING:
- Try to maintain a positive attitude and motivate your child to succeed.
- Take your child for a medical examination so that any medical conditions for his problem, such as constipation, can be excluded.
- Make sure that your child always has a clean set of clothes with him whenever he leaves the house.
- Remind your child to go to the toilet regularly in order to avoid accidents.
- Avoid punishing your child, or placing any unnecessary pressure on him. This won’t solve the problem, it will only add to it.
PARENTS, PLEASE TAKE NOTE!
“Encopresis and enuresis are simply medical terms used to describe age-inappropriate toileting accidents,” explains Sigi. She adds that the above factors are not sufficient to make a diagnosis, but merely some of the factors that are considered when making such a diagnosis. “If parents have concerns they should discuss them with their doctor to get a medical diagnosis and a treatment plan. Remember, avoid shaming your child, and keep a positive and reassuring attitude.”
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