Babies need to be in nappies as they cannot control their bladder. As they get older and turn into little people their nervous system is moving along nicely and the frequency of bedwetting goes down and eventually stops.
Bedwetting is one of the most common disorders among children. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. Approximately 5% to 10% of all seven-year-olds have enuresis.
The reasons for bedwetting involve the inability to awaken from sleep in response to a full bladder, coupled with excessive nighttime urine production or a decreased functional capacity of the bladder.
Children who wet the bed may do so for emotional reasons. They may feel insecure due to the arrival of a new baby, a change of school or because of the parents' marital problems. In these cases, the child needs love and reassurance.
Why do some children have a problem?
There are numerous possible reasons why children - and their families - suffer from bedwetting:
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- Slower central nervous system development
- Food allergies or intolerances
- Infections (kidney or bladder)
- Diabetes
- Excess water consumption prior to bed
- Being scared of the dark
- Laziness
- Side effects of medication
- Caffeine (some give this to their kids – and I highly suggest not doing it), e.g in tea, coffee and many fizzy drinks
Vitamin B12, folate and iron levels
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A study from 2012 found significantly lower mean vitamin B(12) and folate levels in patients who suffered from bed wetting. These findings were confirmed in a study in 2015 which also identified that average blood iron was significantly higher.
A February 2018 study in the Journal of Pediatric Urology may offer hope for those pursuing non-drug options.
Based on these results, the authors concluded that supplementation with vitamin D and omega-3 fish oil could help prevent nighttime bedwetting episodes among children seven to 15 year of age:
Vitamin D – 1,000 IU minimum but children frequently take up to 2,000 IU daily under the guidance of their physician.
Omega 3 – 1,000 mg daily, can be taken as a capsule, gummy or liquid.
Traditional Approach
Parents and children are often given the following advice by doctors to curb bedwetting:
Bed alarms – alarms have sensors that detect moisture, which wake the child up as they begin having an accident.
Education and reassurance – diet changes, avoidance of caffeinated drinks and also avoidance of fluid before going to bed. Make sure the child urinates before going to sleep.
Positive reinforcement – encouraging the child after dry nights.
Medications Commonly used include:
Desmopressin – Taken at night with a small sip of water, this medication can be used for children age 6 or older. Common reactions listed by Epocrates Drug Database include headaches, nausea, abdominal pain, high blood pressure and rarely seizures, respiratory arrest and anaphylactic allergic reactions.
Imipramine – This medication can also be used for those 6 or older. Epocrates lists a “black box warning” for this medication, stating that it may increase suicide risk in children, adolescents, and young adults with major depression. Additional common reactions listed include drowsiness, dizziness, and blurred vision to name a few.
Due to the possible side effects of medications, more natural alternatives are desired as first line by most.
Common strategies to help with bedwetting
- Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day.
- Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
- Be encouraging. Make your child feel good about progress by consistently rewarding successes.
- Eliminate bladder irritants. At night, start by eliminating caffeine (such as chocolate milk and cocoa) and if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate a child’s bladder.
- Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
- Consider if constipation is a factor. Because the rectum is right behind the bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one third of children who wet the bed, though children are unlikely to identify or share information about constipation.
- Don’t wake children up to urinate. Randomly waking up a child at night and asking him or her to urinate on demand isn’t the answer, either – and will only lead to more sleeplessness and frustration.
- Don’t resort to punishment. Getting angry at your child doesn’t help him learn. The process doesn’t need to involve conflict.
What can you do to identify the cause of bedwetting in your child?
- Identify food allergies and remove (gluten and dairy are big)
- Avoid caffeine and fizzy drinks
- Limit intake of water and fluids prior to bed
- Always have them go for a whee right before bed
- Use a night light
- Star board (get a star for each night they don’t wet their bed and a prize at X stars)
- Taking off their bedsheets self and taking them to the laundry
- Supplement with Fish oil
- Give a Multivitamin
- Give a Probiotic
- Give a methylated B-complex
A known cause of bedwetting is slower development of the central nervous system + low b12 and low folate contribute to a slowed central nervous system = increased susceptibility to nocturnal enuresis (ie. bedwetting).
If one has low folate and low B12, then their methylation system is going to be less functional.
As their methylation is not up to speed, then the development of the CNS is hindered.
As the CNS development is hindered, so is the nervous system of the bladder which leads to nocturnal enuresis.
Restoring nutrients for CNS development is critical to reducing bedwetting.
The younger the child, the more development they are experiencing. The more development they are experiencing, the more methylation they are utilizing. The more methylation they are utilizing, the more nutrients they require to support methylation.
If the child’s methylation is not supported with nutrients, then bedwetting may show up.
Before you start blindly supplementing your child we would highly recommend to arrange some of the following tests which are all available from CountryHealth:
Which Lab Tests can be useful?
- Genetic testing for MTHFR variants - a simple buccal swab test
- Full blood count and biochemistry panel
- serum folate
- serum ferritin
- serum cobalamin
- urinary organic acids
- plasma amino acids
- urinary methylmalonic acid
- Comprehensive Digestive Stool Analysis (if your kid has digestive complaints)
- Homocysteine
- Food intolerance testing
References:
- Journal of Pediatric Urology. 2018 Feb 5. pii: S1477-5131(18)30034-2. doi:10.1016/j.jpurol.2018.01.007. [Epub ahead of print]
Do you want your child to be tested?
We are keen to help you finding the root causes of bedwetting in your child
Why do some kids get dry and others struggle with bedwetting?
