October 28, 2024 Nocturnal enuresis is the involuntary loss of urine during sleep in children over 5 years of age . It is a very common problem and can negatively impact children's self-esteem; In most cases it resolves on its own spontaneously; more rarely, it requires medical intervention. The actions of parents and caregivers should focus on two main areas: 1. Have as much information as possible about the problem. This way, they can be sure if there is something wrong and will have accurate information to make available to the pediatrician, if intervention is necessary. To do this, they must know how many times the child urinates in the 24 hours of the day, at what time and how much volume. This is achieved by keeping a daily record of the child's urination including: Date Time of urination Volume of urine during urination. No registration should be missed. If the time and volume are uncertain, especially if it was at night, the occurrence and what is known should be recorded. 2. Their attitude and relationship with the child in the context of the problem, which should be characterized by: Do not impose excessive rules, prefer talking about the subject with time and calmly; Praise what the child does well and do not reprimand when it goes wrong; Give rewards when the child shows motivation to solve or there is some progress. Routines and tips to help bedwetting During the day Distribute liquids throughout the day . Do not restrict the liquids offered, but do not offer them after the end of the afternoon. Always prefer water , avoid carbonated, sugary or caffeinated drinks. Encourage the child to go to the WC 5-6 times a day and whenever they feel like it, promoting a better knowledge about their bladder. When going to bed and at night Encourage your child to always urinate before going to bed . Children should not wear diapers at night , especially if they are over 8 years old, as this will be a demotivating factor. Use waterproof protectors over the mattress (and/or layer of sheets) to make changing clothes easier. Leave some dry sheets, underwear and pajamas next to the child's bed. Leave the hallway and bathroom lit , for example, with night lights, so the child can easily move around the house. When child wets the bed at night, they should not be reprimanded, as it is not their fault. The child should : Go to the bathroom first; Actively participate in changing bed linen and clothing; Go back to bed. The next morning The morning after the “accident”, talk to the family, avoiding bullying situations such as comments between siblings or other family members towards the child. Promote good hygiene in the morning : let the child do it alone and suggest small changes, if necessary. Try to get your child keep a diary of dry and wet nights ; there are age-appropriate diaries to paint and draw. Keep the pediatrician informed In most children who have nocturnal enuresis after the age of 5, the problem ends up resolving itself. The reason it happens is because the children are not yet prepared to initiate changes. It is very important that you always keep your child's pediatrician informed about your child's bedwetting and its characteristics. It is the pediatrician who can best advise on the monitoring and intervention needs in each case . When medical intervention is necessary, treatment can be long and with relapses. Author : Ana Fernandes Teixeira Meet the pediatrics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
