How to help a child with urinary incontinence. Bedwetting - enuresis in children: causes, treatment, symptoms, signs Doctor Komarovsky nocturnal enuresis

Urinary incontinence is a pathological condition that is quite common in older children. The medical name of the disease is enuresis. Characterized by the inability to control one's urination during sleep, as well as in other situations. What is urinary incontinence in children, its causes and treatment should be considered in more detail. After all, this disease brings a lot of psychological problems to the child.

Related articles:

Causes of bedwetting in children

The appearance of enuresis is most often associated with an abnormal structure of the bladder. The disease also occurs in the following situations:

sudden urge to urinate; reduced bladder capacity; regular constipation contributes to decreased bladder function; frequent stressful situations; genetic predisposition to the disease.

Bedwetting in children is a fairly common ailment among school and preschool children. Timely contact with a specialist will help avoid chronic incontinence.

Causes of daytime incontinence

Daytime urinary incontinence is most often observed in girls. It is associated with the following factors:

a strong urge to urinate; uncontrolled urination when laughing; the entry of residual urine into the girl’s genital organ promotes spontaneous excretion of urine.

A single case of incontinence in a child is not dangerous.

Types of disease in children

Depending on the cause of spontaneous urination, the following types of this disease are distinguished:

Urgent incontinence. It occurs in children with an overactive bladder, which causes a strong urge to urinate. Stress urinary incontinence in children. It appears during the period of physical activity of the child, as well as during such reflex actions as sneezing or coughing. A baby with this form of the disease experiences weakness of the pelvic floor muscles and urinary and fecal incontinence. Reflex incontinence. It is a complication after injuries to the spinal cord and lower back. This type of disease is usually preceded by prolonged urinary retention. Bladder fullness. Occurs as a result of prolonged urinary retention. In this case, urine comes out in drops gradually. The child cannot control this process. Complete incontinence. Characterized by total uncontrolled urine output at any time of the day. It is a consequence of certain diseases of the renal and genitourinary systems.

Important to remember! Regardless of the form of the disease, immediate treatment of the baby is required! After all, this disease causes a lot of suffering, both physical and psychological.

Features of the disease

Child incontinence is not dangerous or alarming until the age of 4 due to the fact that the bladder is not yet fully formed. That is, a child at 4 years old already begins to have the physical ability to control urination even in his sleep.

Spontaneous urination is considered a pathology from the age of 6 years. At this age, the child should clearly respond to his urges even at night. If incontinence continues at this age, then this factor is the reason for visiting a doctor.

A child as young as 8 years old may suffer from this disease as a result of a disorder of the central nervous system. Due to such abnormalities in the body, children may experience incontinence.

As for the disease in children 10 years of age and above, it most often occurs due to psychological factors. Thus, incontinence in adolescence manifests itself in the following situations:

strong emotional stress, stressful situations; excessive care or lack of attention from parents, as a result of which the teenager, on a subconscious level, wants to feel like a small child; weakened pelvic muscles; sound sleep occurs due to the innate characteristics of the nervous system; infectious diseases of the genitourinary system;

Urinary incontinence in adolescence usually occurs at night during sleep.

Treatment of the disease

How to treat enuresis? In order to determine the correct and most effective method of treating a child, you need to consult a specialist. He will carefully examine the child and prescribe the most effective therapy. Most often, the doctor prescribes complex treatment, which includes:

Tablets for children. Drug therapy is aimed at relieving excessive activity and stress before bedtime. This will help ensure complete and quality rest. If spontaneous urination is associated with an infectious disease, then babies or older children are prescribed a course of antibiotics. In general, medications are aimed at normalizing the functioning of the nervous system, which will promptly signal the urge. The most common medications: Radedorm, Pantogam, Glycine, Melipramine, etc. Physiotherapy. For the normal functioning of the bladder, procedures such as electrophoresis, acupuncture, magnetic therapy, and massage are used. Psychotherapy. The essence of this method of influencing the disease is to communicate with a psychotherapist who will teach you how to cope with the disease using specific relaxation techniques and self-hypnosis. Maintaining a daily routine. It is necessary to allocate time for the child for physical and mental activity and ensure sufficient rest. You should also try to protect him from stressful situations and emotional experiences. Monitor your child's fluid intake throughout the day.

Exercises to combat enuresis

This treatment can be carried out at home. The essence of gymnastics is to strengthen the pelvic floor muscles and normal functioning of the bladder. The most effective exercises are:

In order to enlarge the bladder, you should delay the process of urination after the first urge. Repeat this procedure several times a day. Thus, gradually the baby’s body will learn to hold urination during sleep. To strengthen the muscle fibers of the bladder, you should stop this process several times at the time of urination. This helps the child learn to control the process of urine excretion. Before going to bed, gradually relax your body. Children can be asked to do this exercise in a playful way.

In this way, the baby will learn to control the urge to urinate.

Treatment with folk remedies

Since ancient times, enuresis has been treated with traditional medicine, which is still used in modern times. The main advantage of this effect on the disease is the absence of contraindications and side effects. There are many recipes that can help you relieve your child of urinary incontinence.

Dill

To prepare the medicine you will need the seeds of this plant in the amount of 1 tbsp. l. Pour 1 cup of boiling water and leave for 1 hour. After time, the broth should be filtered and taken 100 ml once a day, preferably in the afternoon.

St. John's wort

You should take 1 tbsp. l. St. John's wort leaves and 1 tsp. dried lingonberry fruits. Pour 1 liter of hot water over these medicinal plants and leave to infuse for 3 hours, covering tightly with a lid. After the time has passed, drink 1 glass of the resulting liquid 3 times a day.

Plantain

To prepare, you will need plantain seeds, which should be ground to a powder consistency. Use this powder in dry form, 1 tsp. Once a day, with plenty of water.

Sage

You will need 2 tbsp. l. of this medicinal plant in dried form. Pour 1.5 glasses of boiling water, wait until the broth cools down and give the child 50 ml 2 times a day. Older children can double the dosage.

A very important role in the treatment with alternative medicine is played by the child’s individual intolerance to certain ingredients. Therefore, when choosing a specific recipe, you need to consult a specialist.

Enuresis in children is periodic or constant involuntary urination during sleep or during strong concentration or passion, developing at the age when the connection between the cerebral cortex and the bladder should have been established - after 4 years. There are quite a large number of causes for this condition; they have some characteristics depending on gender and age.

Enuresis is called involuntary urination in children over 4 years old; at an earlier age this is still a variant of the norm

Enuresis is registered in every fifth to sixth child aged 5 years; this diagnosis is made in 12-14% of children of primary school age, and by the 12-14 year mark the number of patients is only 4%. Boys get sick 1.5-2 times more often.

The diagnosis of the causes of the disease is carried out by a pediatrician together with a pediatric urologist, neurologist, endocrinologist and psychologist; in some cases, the participation of a homeopath or psychiatrist is necessary.

Treatment is complex: behavioral therapy, diet, psychotherapy, and physiotherapeutic techniques are most often used; Occasionally, doctors resort to prescribing medications. Surgical treatment is used only if the cause of incontinence is operable diseases of the urinary tract or adjacent organs.

Classification of the disease

Warning! The diagnosis of enuresis is made if the child has signs of maturity of the bladder-cerebral cortex connections, which usually occurs after 4 years. The formation of this connection is evidenced by the fact that the baby can hold urine and first informs adults that he wants to go to the toilet.

Daytime enuresis indicates neurological diseases or abnormalities of the urinary tract

There are several classifications of the disease, taking into account different factors.

By mode of occurrence: Night. It can appear every night after 4 years (constant form) or only periodically (intermittent form) - when the child has been either in a traumatic situation or has been subjected to intense physical or emotional stress. Daytime urinary incontinence in children. It most often develops in children with urinary tract diseases, in those who have an underdeveloped volitional sphere (when, during monotonous activities, he does not feel the urge). The daytime form of enuresis “starts” when the bladder is so full that, without waiting for a response from the cerebral cortex, it starts emptying itself. Mixed, when a child can urinate involuntarily both during the day and at night. According to the factor, involuntary urination was always observed (after 4 years) or developed after a “dry” period, enuresis in children is: primary (the most common type): always observed, there were no long “dry” periods; secondary: for six months or more the child got up to urinate, then stopped doing so. The share of secondary pathology accounts for only 20-25%. According to the symptoms accompanying urine leakage: monosymptomatic - if the child is not bothered by pain when urinating, there is no pronounced urge; polysymptomatic (it indicates complications) – when uncontrolled urination is accompanied by pain, frequent trips to the toilet, and urges that are difficult for the child to resist.

Warning! In adolescents, the main form is nocturnal enuresis, which is secondary.

Causes of the disease

The most common urinary incontinence observed in children is:

thin build; shy; shy; overly emotional; from large families; those exposed to excessive care from relatives; from low-income or disadvantaged families.

The etiological classification divides enuresis into the following forms:

simple: when examining a child, it is impossible to find the cause of this condition, but it is known that one or both parents suffered from enuresis in childhood. In this case, the risk of nighttime urination increases from 15% (in healthy children) to 44% (if only one parent was sick) and 77% (if pathology was observed in two parents); neurotic: develops in fearful and shy children who are very worried about the fact of their enuresis; neurosis-like: characteristic of children with a tendency to hysteria and neuroses; epileptic: the causes of enuresis in children are the pathological activity of the areas of the cerebral cortex responsible for the control of urination; endocrinopathic: enuresis develops as a result of diseases of the endocrine glands (diabetes mellitus, hyperthyroidism, diencephalic syndrome).

There are other causes of the disease:

Intrauterine and birth causes: damage to the brain or pathways from the cortex through the spinal cord to the bladder due to: gestosis; intrauterine infection; maternal hypertension; feto-placental insufficiency; umbilical cord entanglement; diabetes mellitus in a pregnant woman; brain or spinal cord injuries during childbirth. Diseases that develop after birth, leading to oxygen starvation of the brain: heart defects, pneumonia, bronchial asthma, tuberculosis. Infectious diseases of the central nervous system: meningitis, encephalitis, cerebral edema due to severe course of any viral or bacterial infection. Non-infectious diseases of the central nervous system: epilepsy, hydrocephalus, developmental anomalies of the lumbar spine. Psychiatric pathology: oligophrenia, chronic intoxication with drugs or alcohol. Urinary tract diseases: cystitis, adhesions in the urethra, neurogenic bladder, opening of the ureters in the wrong place in the bladder, which has a connection with the brain.

The causes of enuresis vary depending on the child's gender and age.

For girls

Bedwetting in girls develops due to:

For the prevention and treatment of diseases of the gastrointestinal tract, our readers advise

Monastic tea

This is a unique product that includes 9 medicinal herbs useful for digestion, which not only complement, but also enhance each other’s actions. Monastery tea will not only eliminate all symptoms of gastrointestinal and digestive diseases, but will also permanently eliminate the cause of its occurrence.

Readers' opinion... » psychological trauma: moving, divorce, birth of a baby, transfer to a new school; features of the nervous system that cause very sound sleep; drinking plenty of fluids; a decrease in vasopressin, a hormone that inhibits nighttime trips to the toilet; urinary system infections; injuries (including birth injuries) of the spine or spinal cord; developmental delays.

Girls suffer from enuresis one and a half times less often

In boys

Bedwetting in boys has the following causes:

the nerve pathways from the bladder to the cerebral cortex have not yet matured; the child is hyperactive; overprotection from relatives; stress; attention deficit; pathologies of the hypothalamus, leading to a lack of growth hormone and vasopressin; heredity; inflammation of the kidneys and bladder; allergic reactions; diseases leading to oxygen starvation of the brain; prematurity and trauma during childbirth.

In teenagers

Enuresis in adolescents develops due to:

spinal injuries; congenital pathologies of the urinary system, due to which their infection develops; stress; mental disorders; hormonal changes in the body; disturbance of awakening.

Does everyone have the same pathology?

Urinary incontinence in children is manifested by the involuntary release of a certain volume of urine during sleep or wakefulness. Such episodes can occur with varying frequency, paroxysmally, sometimes several times a night. Urination can occur either in the first half of the night or in the morning; At the same time, the wetted child does not wake up.

If enuresis manifests itself as a consequence of other diseases, these symptoms will also be noted. Thus, a neurosis-like form will manifest itself as stuttering, fears, tics, and hyperactivity. If the cause is hypoxia of the brain due to diseases of the bronchi and lungs, there will be a cough, periodic shortness of breath, wheezing, fatigue and others. With the endocrinopathic form of incontinence, symptoms such as obesity or, conversely, thinness with a good appetite, a tendency to infectious diseases, swelling, and bulging eyes will come to the fore.

If bedwetting in children is complicated, then in addition to involuntary urination, one or more of the following symptoms will be noted:

increased or decreased urination; pronounced urge to urinate or, conversely, lack thereof; painful urination; weak stream of urine.

How to find the reason

The following specialists diagnose enuresis in boys and girls:

pediatrician; pediatric urologist; neurologist; endocrinologist; psychiatrist.

Based on the examination and questioning of the child and parents, especially on the topic of deviations in the voluntary urination that they had in childhood, the pediatrician may suspect what form of enuresis occurs in the baby. To confirm his preliminary diagnosis, by referring the child to specialists for consultation, he can prescribe the following studies:

general urine and blood tests; bacteriological examination of urine; biochemical blood tests; Ultrasound of the urinary system; radiography of the spine and skull; electroencephalography; X-ray of the urinary tract with contrast (urography, cystography).

Treatment of the disease

Treatment of enuresis in children begins with treatment of the cause of this condition. For infectious diseases, antibacterial, antiviral or antifungal drugs are prescribed. If enuresis is caused by an endocrine disease, appropriate treatment with synthetic hormones or substances that suppress them is prescribed. For the epileptic form of incontinence, anticonvulsants are needed, for the neurosis-like form, sedatives are needed.

In addition, behavioral therapy is prescribed. It is that:

before bedtime, limit intake of salty, sweet and liquid foods; You can and should drink water, but it is advisable that at least 15 minutes pass between going to bed and drinking; before going to bed they ask you to go to the toilet; waking up a child (not a teenager) in the first half of the night in order to take him to the toilet; if a child sleeps in his room, he may be afraid to get up to urinate, so parents can turn on a night light in it; You can use special gaskets associated with the moisture detector. They stick to underpants and wake up the child when the first drops of urine appear.

Diet

The child's diet should be rich in vitamins, protein and microelements. To treat enuresis, the Krasnogorsky diet can be used: at night the child eats a small piece of herring, bread and salt, washed down with sweet water.

Psychotherapy

Psychotherapists and child psychologists work with children over 10 years of age; before this age, methods such as motivational psychotherapy and autogenic training are used.

Physiotherapy

The following methods are well suited for the treatment of urinary incontinence in children:

thermal procedures; laser therapy; electrophoresis; galvanization; acupuncture; magnetic therapy; electrical stimulation of the pelvic floor muscles; circular shower; massage.

Exercise therapy

Kegel exercises, aimed at improving the connection between the brain and the bladder, have a good effect. They are simple to perform - relax and tense the muscles of the perineum, but first the child must understand where these muscles are. To do this, ask him to stop urinating, and repeat this several times.

Drug therapy

Medicines for the treatment of enuresis are prescribed quite rarely - non-drug methods usually have an effect. But if the above methods do not give effect within 6-8 weeks, the following are prescribed:

vasopressin hormone analogues; a special type of antidepressant; anticholinergic drugs; nootropics (they should not be taken at night).

Operations

For the treatment of enuresis in children, operations can be used only in cases where involuntary urination is caused by abnormalities in the structure of the organs of the urinary system. Sling, let alone open, operations are not used in children.

But perhaps it would be more correct to treat not the effect, but the cause? We recommend reading the story of Olga Kirovtseva, how she cured her stomach... Read the article >>

One of the main medical and psychological problems of preschool children is a “wet bed.” Enuresis (that’s what this problem is called) is a fairly common problem in children over 4 years of age. Both the child and his parents are often confused, upset by this problem, embarrassed to contact doctors and, sometimes, miss precious time.

Enuresis- This is urinary incontinence - a common disease in children; it is most often observed in children aged 4-7 years, and in boys it is 2-4 times more common. Enuresis is considered a pathology in children over 3 years of age.

Dear parents! Many people believe that it is better not to focus the child’s attention on his problem, so as not to traumatize the psyche. This is the wrong position. Under no circumstances should you scold your child, but it is definitely worth explaining that it will be better for him this way, and that his parents are ready to solve his problem together. First of all, you need to calm the baby. He needs to know that you parents don't judge him. After all, if a child does not understand why he wakes up wet in the morning, first fear appears, then shame, and then it is not far from serious psychological trauma.

Urination is a complex physiological process. As the child grows, in parallel with movement skills, control over the mechanisms of urine excretion and bladder emptying is acquired. From the age of 1.5 years, most toddlers acquire the ability to feel the filling of the bladder. Control of the cerebral cortex over the nerve centers regulating urination is established between 3 and 5 years of life. In this regard, most cases of urinary dysfunction occur between the ages of 3 and 7 years.

When urinating, the bladder muscles contract. And the muscle that locks the entrance to the bladder and is responsible for holding urine relaxes, which leads to emptying of the bladder under relatively low pressure. In newborns and children in the first months of life, urination is involuntary, reflexive, and they cannot control the obturator muscle.

As the child grows during the formation of an adult urination pattern (by 2, 5 - 3 years), 3 factors are important:

An increase in bladder capacity (6 times) with a decrease in the frequency of urination;
- acquiring control over the muscles and mechanisms of urination;
- the appearance of inhibition of the urination reflex.

In the first months of life, a child urinates very frequently; this process is still almost not controlled by consciousness. By the end of the first - beginning of the second year of life, “small trips” become less frequent, the bladder gradually develops and reaches the desired size. By the age of three, the process of developing bladder functions ends. There is no reason to worry if during the day the baby asks to go to the potty 7-8 times, and at night his bladder “sleeps”.

Based on all this, we can talk about the presence of enuresis in a child only when he reaches four to five years old. Until this age, urinary incontinence can be considered normal.

Parents need to remember that the skill of independently controlling urination is developed in children at different ages. Just as at different times children begin to walk, talk and dress themselves. Most children, 70 percent, begin to control their bladder by three years, 75 percent by four, and by five years, 80 percent of children are able to hold urine overnight and wake up in a dry bed to get up and pee.

Usually there is daytime and nocturnal enuresis, and there is also a combination of daytime and nighttime incontinence. But this usually indicates serious problems in the health and development of the baby and, fortunately, is quite rare in pediatric practice. The main problem is still a wet bed at night. This is the main reason for visiting a pediatric nephrologist or urologist.

There is also a distinction between primary and secondary enuresis. Primary enuresis is manifested by urinary incontinence at night, during sleep, when the child does not wake up when the bladder is full, while secondary enuresis occurs as a result of various congenital and acquired diseases and can occur regardless of sleep, both during the day and at night.

Causes of enuresis

The causes of enuresis are varied: changes in the brain, disturbances in sleep and wakefulness, shortcomings in upbringing in the form of excessive freedom or excessive strictness, a neurotic environment at home - family conflicts, quarrels, etc. A patient with enuresis should sleep on a hard but warm bed. While sleeping, your legs and lower back should be wrapped warmly.

Experts identify a fairly large number of causes for the development of enuresis, and in most children several of them are combined at once. Recently, they have come to the conclusion that this disease may even be hereditary. If someone in the family has already suffered from enuresis, and there have also been cases of neuroses, psychopathy, alcoholism or epilepsy, then the risk of enuresis in a child increases 6 times.

The cause of enuresis can be a disease of the genitourinary system or anomalies in its structure. For example, a child may be diagnosed with inflammation of the urinary tract or bladder. Or it will be discovered that he has insufficient bladder capacity for his age. Anomalies in the structure of the genitourinary system can be either congenital or acquired - for example, as a result of injury or surgery. Sometimes in this case it is impossible to do without appropriate surgery and long-term treatment. Often in this case, the child experiences pain when urinating. If the baby complains of pain, you should immediately consult a doctor, and best of all, a pediatrician, who will tell you which specialist (urologist, nephrologist, neurologist, endocrinologist) the child should be taken to first.

Enuresis may also be caused by a slow pace of physical development. If a baby lags behind his peers in height and weight, it means that the development of his central nervous system is also delayed, and it controls urination in the body. This is possible if the mother had complications during pregnancy and childbirth, which led to early organic brain damage. In addition, such children, as a rule, are overly excitable, quickly become overtired and are characterized by increased tearfulness. For them, even a common ARVI or intestinal infection can become a provoking factor for urinary incontinence. Therefore, such a child must be protected in every possible way from situations that traumatize the psyche, and try to harden him from a very early age.

Another cause of urinary incontinence may be dysfunction of the lumbar segments of the spinal cord, which is responsible for the functioning of the bladder. This is the so-called “spinal enuresis”. It is associated with the autonomous regulation of the bladder, practically does not depend on any external factors and is monotonous in nature. This type of enuresis is treated by a nephrologist, urologist or neurosurgeon. To make a diagnosis, first of all, an image of the lumbar spine is taken, which helps doctors find out the essence of the disease and decide on treatment tactics - medications or surgery.

Experts believe that another cause of enuresis has been the recent widespread use of disposable diapers. The fact is that newborn babies urinate automatically, but already at six months the baby feels anxiety before wetting the diaper, and discomfort after the bladder has already been emptied. In addition, parents also draw the child’s attention to the fact that there is a potty to empty the bladder, which must be used if you want to stay dry. Therefore, some children begin to use potties from the age of one or a little later. Using a diaper, parents no longer worry so much about potty training their child. And the baby himself no longer feels discomfort from a wet diaper. Therefore, the formation of a conditioned reflex in a child is delayed. For the same reason, according to experts, the number of children suffering from enuresis has recently increased. Doctors recommend not to wear diapers all the time, but to wear them for a short time - for a walk, on a visit, to a clinic or store.

Very often, the causes of enuresis can be purely psychological. This is the so-called neurosis-like enuresis. It can occur in a completely healthy child after some kind of emotional shock or protracted traumatic situation. This can be a strong fright, getting used to a fundamentally new environment, if, for example, the child went to kindergarten, school or the family moved to a new apartment. Here's a typical example. In a family that already has a child, another baby was born. By this time, the eldest was already accustomed to the potty. Parents' attention to the older child wanes even before birth. Everyone is focused on the mother’s well-being, and after childbirth, on the numerous worries associated with caring for the newborn. In addition, a mother who has just given birth needs some time to restore the energy expended. The child feels abandoned and defenseless, so he returns to behavioral stereotypes characteristic of a younger age, including urinary incontinence, and thus unconsciously strives to attract the attention of his parents and return their love and care. There are many options here, it all depends on the specific situation.

Often, neurosis-like enuresis leads to children becoming timid, suspicious, fearful, unsure of themselves, or, conversely, irritable and hot-tempered. Neurosis can also manifest itself as a stutter or tic. Specialists have a considerable number of ways to help a child with neurosis-like enuresis. These include combinations of medications that strengthen and calm the nervous system, and a special diet, as well as hypnosis, physiotherapy, reflexology, and acupuncture. However, for the success of treatment, a calm atmosphere in the family and the most active participation of both parents in it are first of all necessary.

Often, children with enuresis may experience sleep disturbances, which are considered by some experts to be the main cause of this disease. In some cases, these are difficulties falling asleep, with restless superficial sleep, and in others, excessively deep sleep with disturbances in awakening.

Enuresis can also be a consequence of insufficient or incorrect education in children of neatness skills or accidental reinforcement of the reaction of emptying the bladder in unacceptable conditions. Proper teaching of children neatness skills may be impossible if parents adhere to completely opposite educational approaches: one of them treats this without due attention, with indifference, and the other, on the contrary, shows excessive harshness and even punishes the child for “wrongdoing.” And if the first the situation is quite understandable, then the second requires clarification. If, for example, the mother is too strict with the child and pays excessive attention to his cleanliness, then his enuresis is not due to the fact that he was not taught to restrain himself, but becomes a form of a kind of protest against the mother, whose attitude seems unfriendly and angry to him. Growing up, such a child may even take pleasure in such behavior, because it upsets and irritates the mother. The lack of a full-fledged upbringing can apparently explain the fact that children who are in children's institutions for a long time are more often wet the bed than children living at home.

To reassure parents, it must be said that the most common cause of enuresis is a certain immaturity of the nervous system and bladder. It’s as if the system for transmitting information to the brain that the bladder is full and needs to wake up is not working.

However, the problem remains, and parents need to develop a line of behavior in relation to a child suffering from enuresis. And first of all, consult a doctor as soon as possible, because the effect of treatment directly depends on the duration of the disease: the less time the child is sick, the more effective the treatment will be. First of all, this is a psychological problem, since enuresis necessarily forms an inferiority complex and social inferiority in the child. And the longer he suffers from enuresis, the more insecure, withdrawn, shy and vulnerable he becomes. This means that the more difficult it is for him to believe in himself and take the path of recovery.

Enuresis and character.

For many children, regardless of age, enuresis, like any long-term illness, causes a feeling of inferiority. Even the little ones have a hard time with this problem. Shy than their healthy peers, they often strive for privacy and withdraw into themselves in order to avoid the ridicule and disgust of others. Feelings of insecurity often appear or worsen in kindergarten or school age and can lead to the development of low self-esteem, self-rejection, up to a complete inability to learn and be realized in various areas of life. Children who have urinary incontinence for a long time, under the influence of experiences, in some cases change in character. Some become more aggressive, others become more timid, indecisive, withdrawn, and withdrawn. There are also those who, at first glance, do not worry about their illness in any way, but they may experience various changes in adolescence.

How can parents help?

First of all, monitor the child’s daily routine and follow all the doctor’s recommendations.

It is important to develop a stereotype of behavior before going to bed. You need to go to bed and wake up at a certain time. A few hours before bedtime, it is recommended to exclude games and TV. A short walk before bed is advisable. A soft bed is undesirable. It is recommended to slightly raise the foot end of the bed.

Never scold or punish your child for a wet bed. He is already punished by his illness and worries no less than you. In addition, fear of punishment suppresses the child and only worsens the situation. It should be remembered that the very fact of involuntary urination depresses the child’s psyche and cannot be aggravated. It is necessary to instill in the child that his illness is a temporary phenomenon and in every possible way to stimulate his active desire for recovery.

Try to make your child's life no different from the lives of other children, despite his problem. For example, you should not refuse some trips to nature, to visit, or on vacation with the whole family. Firstly, a change of environment often means that the child wakes up wet less often than at home. Secondly, parents are quite capable of solving such a problem on a trip, but the child will not feel defective and guilty.

As a rule, doctors advise first of all to limit fluid intake in the afternoon, the last of which can be no later than 3-4 hours before bedtime. In the evening you need to give up kefir, milk and fruit. Firstly, they contain a lot of liquid. Secondly, they have a diuretic effect. It is better to offer your child a piece of cheese, herring, pickled cucumber, a few spoons of honey or some salted nuts. This will help retain fluid in the body and prevent it from overfilling the bladder. At the same time, food should not contain spicy substances or artificial flavors.

This measure can sometimes help, but in some cases it becomes the cause of daily torment for both children and parents, only exacerbating tension, the reaction to which can become the main manifestation of the problem. If the child is encouraged to follow such a diet, this technique can be successful; if not, then it is better not to prohibit the child from taking liquids.

Before going to bed, be sure to remind your child to go to the toilet, and it is advisable to do this several times in the last hour. You can place a potty next to his bed if he suddenly wakes up. Many children are afraid of the dark, and fear can prevent them from getting out of bed at night. Therefore, do not forget to turn on the night light in the children's room at night (very low power, less than 25 W, and curtained).

You can wake up the child at night so that he goes to the toilet and stays dry, and you need to try to determine at what time the child becomes incontinent and wake him up just in time. If you decide to wake your child at night, you need to wake him up, bringing him fully conscious, otherwise you will only strengthen the mechanism of enuresis.

There are so-called enuresis alarm clocks - this is a small device that is attached to the child’s underwear and, when wet, from the first seconds of urination, gives a signal with sound or vibration, forcing him to wake up. This reinforces the conditioned reflex to urinate. But keep in mind that it is necessary to periodically change the type of signal so that the wake-up reflex is developed specifically for urination, and not for a certain sound or vibration.

A child should never be punished. Of course, he doesn’t do this on purpose and suffers no less than his parents. You should also avoid wearing diapers at night.

If the child is so big that he can take care of himself, you can offer him to take a shower in the morning and make the bed himself. But this must be done calmly, without irritation or hostility. This attitude will help the child calm down, feel the support and love of his parents, and show him that he is not alone in his misfortune. Practice shows that in some cases it is enough to change the model of the relationship between the baby and the parents to get rid of the problem.

A reward system for waking up dry has a good effect. Start a calendar with your child, where he himself will mark “dry” and “wet” nights. You can do this as follows. With the help of parents, the child keeps a special diary, which he fills out daily. “Dry” and “wet” nights are marked with special icons (for example, a child draws a sun or a cloud). The child is explained that if he achieves that within a certain period of time there are more “dry” nights than “wet” ones, or there are five or ten of them in a row, then he will receive a prize. Of course, it is better for parents to approach this procedure creatively and take into account the child’s individuality. And information about the frequency of enuresis collected in such a diary will be extremely useful for the doctor.

From the very beginning of treatment of enuresis, special exercises for training the act of urination are useful, aimed at developing a conscious feeling of fullness of the bladder and strengthening the mechanisms that provide confidence in independent control of urination.

There are several similar exercises. For example, the child is asked to hold back the urge to urinate for as long as possible, after which the volume of urine released must be measured (it will correspond to the volume of the bladder, which is important for the doctor to know). The exercise is carried out daily. It is especially effective if enuresis is associated with low bladder capacity. However, if a child experiences pain while performing the exercise, then it should not be performed, but should be reported to the doctor immediately.

After sufficient training of the conscious desire to urinate, they move on to complicating this exercise: after holding back urination for a long time, the child is asked to start urinating and stop it, start again and stop again. In some cases, after these simple exercises, it is possible to stop enuresis.

If there is no improvement or the child is for some reason unable to perform these exercises (this may also be due to mental retardation), then the method of waking up at night on a schedule can be used. During the first week, the baby is woken every hour of sleep, starting at midnight. In the future, he is woken up only once a night, after a certain time after falling asleep, which is selected in such a way that the child does not wet himself during the rest of the night. This period of time is gradually reduced from three hours to two and a half, two, one and a half and finally to one hour after falling asleep. If episodes of enuresis are repeated twice in a week, then the cycle of single night awakenings is repeated again from a time equal to three hours after falling asleep.

Such techniques can also be very effective. Every evening, before falling asleep, the child tries for several minutes to mentally imagine the feeling of fullness of the bladder and the further sequence of his own actions. He goes to the toilet and urinates.

You can also, just before bedtime, for the purpose of self-hypnosis, slowly repeat several times to the child, for example, the following words: “I want to always wake up on a dry bed. While I sleep, urine is tightly locked in my body. When I want to pee, I will quickly get up on my own.” "

Strive to save the child from mentally traumatic situations, create a calm environment in the family. Clarification of family relationships and resolution of conflicts should only occur in the absence of the child. Spare him your adult problems.

Dress your child according to the season, excluding hypothermia and wet feet. A common cold can often make the situation worse.

In the evening and before bed, avoid noisy, stimulating games, or sitting for long periods in front of the computer or TV. It is better to offer your child some quiet games, reading books, drawing or coloring pictures.

It is also useful to drink special tea, using equal parts of St. John's wort and yarrow as tea leaves. It should be taken with breakfast and lunch. However, remember that these are still medicinal herbs - you should prepare a weak tea, and once a month take a break for ten days.

For enuresis, in addition to medications, psychotherapy should not be neglected. In the fight against urinary incontinence, a variety of methods are used, including the so-called “dolphin therapy,” when healing comes from communicating with dolphins. Dolphins, unfortunately, are not sold in pharmacies, which makes them difficult to obtain. In any pediatric center there is a psychologist who will be able to balance the psychological background of the child and prepare him to fight the disease.

Drawing has a beneficial effect on the child's psyche. The younger the child, the more interesting it is for him to paint with gouache paint with thick brushes on large sheets of paper of different shapes, white and colored. Many children like to create pictures with their fingertips or their entire palm. Parents do not always welcome such creativity, dooming children from an early age to cliches and templates. But when it comes to treating enuresis, it is necessary to liberate the child’s thinking and relax his body as much as possible. And in painting with their fingers and the whole palm, children most fully reflect their emotional state.

It is quite accessible for parents to conduct autogenic training aimed at relieving the child’s muscle and nervous tension, creating an atmosphere of calm and relaxation and allowing him to tune in to relieving the problem of enuresis. Here is one of the options for conducting such training for preschool children - in a poetic and soft play form. This game is not difficult for either parents or children.

Classes should be done every evening before bed. The duration of the workout varies from 15 to 30 minutes. The words of auto-training should be read to the baby in a calm, slow and quiet voice. Over time, when the child learns them by heart, he can conduct the lesson every evening independently, without the participation of an adult. Before starting training, you need to learn with your child the names of all parts of the body. When conducting an evening lesson, an adult needs to take care of his internal mental balance. If mom or dad are overstressed or upset, then the activity should be entrusted to someone close to you, since in a relaxed state induction (transfer of an emotional state) from one person to another is very strong, and in the end the opposite result may occur: the baby will not only not calm down , but on the contrary, will become overexcited. All words should be pronounced in a soft, calm voice, slowly, with long pauses, and when naming parts of the child’s body, gently touch them with your palm (to the head, knees, feet, and so on). Individual formulas of suggestion are repeated 2-3 times with a change in logical stress. With proper autogenic training, the baby relaxes and may even fall asleep.

Game "Magic Dream" (autogenic training for preschool children in poetic form).
Now I will read poetry, and you close your eyes. A new game "Magic Dream" begins. You won’t really fall asleep, you’ll hear everything, but you won’t move, you’ll just relax and rest. Listen carefully to the words and repeat them to yourself, with inner speech. No need to whisper. Relax quietly with your eyes closed. Attention, the “Magic Dream” is coming...
Eyelashes droop...
Eyes are closing...
We rest peacefully (2 times)…
We fall asleep in a magical sleep...
Breathe easily... evenly... deeply...
Our hands are resting...
The legs also rest...
Relax...fall asleep...(2 times)...
The neck is not tense and relaxed...
Lips part slightly...
Everything is wonderfully relaxing...(2 times)...
Breathe easily... evenly... deeply...
(A long pause is made and words are spoken aimed at correcting the problem):
I sleep dry today...
Tomorrow I'll wake up dry
The day after tomorrow I'm dry
Because I'm dry...
As soon as I feel it, I’ll wake up,
I'll definitely wake up!
- Your body is relaxed, but you know that you sleep dry... Tomorrow you will wake up dry...
- If you want to go to the toilet at night, you will feel it and wake up, you will definitely wake up...
- In the morning you will wake up dry. You are the master of your body and it obeys you.
- You're doing great, you sleep dry. If you want to go to the toilet, you will wake up, you will definitely wake up and go to the toilet. Your bed is dry. You’re great, you’ll succeed.”
I would like to draw special attention to parents: you should not try to independently correct the child’s mental state with some kind of psychological games. The problem of enuresis in children is quite complex and complex, even if it is not noticeable at first glance. Therefore, it is better to contact specialists. Inept actions of parents can lead to a complication of the situation - the disease will worsen and require more time to heal.

Drug treatment of enuresis

The question of treating enuresis with medications is decided by the doctor. Depending on the main cause of this disorder, which the doctor determines during the examination, various drugs can be selected for treatment, which belong to the groups of nootropics, adaptogens, and antidepressants. Recently, a completely new effective remedy for eliminating enuresis has appeared in our pharmacies - Adiuretin-SD (desmopressin, MINIRIN), used in the form of nasal drops. As a result of the action of this drug, nighttime urine production is reduced to such a volume that can be retained in the bladder until waking up in the morning. This drug best helps children whose daily rhythm of urine production is disrupted and too much urine accumulates at night.

It must be borne in mind that the use of any medicine, as a rule, is regulated for a certain period (usually from one to two to three months) and after the end of the course of treatment, enuresis may resume. Therefore, over the course of a year, the doctor usually prescribes several courses of treatment. In consultation with the doctor, it is recommended that children be given medicine during travel, trips to camp, and during periods of living together with friends or strangers. It is unacceptable to use vasopressin analogs on your own, since nocturnal enuresis in a child may be associated with a completely different pathology, for example, an infection of the urinary system. And this requires the appointment of antibacterial therapy, after which the phenomena of nocturnal enuresis disappear.

If the cause of enuresis is a violation of the nervous regulation of the bladder, with a predominance of increased tone of its smooth muscles, leading to a decrease in bladder volume, DRIPTAN is used. It increases bladder capacity and reduces spasm, making spontaneous muscle contractions less frequent and eliminating urinary incontinence. In some cases, treatment with MINIRIN in combination with DRIPTAN is indicated.

If the tone of the bladder is reduced, it is recommended to adhere to a regime of forced urination every 2.5 - 3 hours during the day. It is important that the child empties his bladder before bedtime. MINIRIN AND PRAZERIN are prescribed as therapy, increasing the tone of smooth muscles.

To improve metabolic processes in the brain, as well as in neurosis-like conditions, drugs such as NOOTROPIL, PICAMILON, PERSEN, NOVOPASSIT are recommended. In addition, courses of vitamin therapy (B6, B12, B1, B2, A, E) are indicated.

The treatment of enuresis includes physiotherapy, in the form of effects on the bladder with various currents, ultrasound and thermal procedures (paraffin or ozokerite), which regulate the functioning of the nervous system. General strengthening massage and therapeutic exercises aimed at strengthening the pelvic floor muscles are also used.

Other methods can be successfully used in the treatment of enuresis in children, in particular herbal medicine, physiotherapy, reflexology, and psychotherapy. A necessary condition for the success of their use is the high qualifications of the specialists conducting the treatment.

Treatment of nocturnal enuresis is a long process, it takes months and sometimes years, so parents need to be patient.

Contact your doctor if:

The child continues to wet the bed after 5 years;
started wetting the bed again after a long period of not doing so;
has difficulty controlling bladder functions during the day and at night.

And, of course, you need to strictly follow all the doctor’s recommendations, because you can only get rid of this disease with the help of a specialist. In any case, it is necessary to ensure that the child lives a normal life, does not shun his peers, plays sports and everything that interests him. With the right approach, nocturnal enuresis poses virtually no restrictions for the child. In addition, it is known that with adequate and correct medical care, enuresis can be cured or goes away on its own as the child matures.

Treatment of enuresis with folk remedies

Spray a mixture of essential oils of sage, lavender, coriander in the room in a ratio of 3:2:1. For each procedure, use 2-5 drops of a mixture of oils in 30 ml of one of the listed mixtures. Inhale 5-15 minutes every day or every other day. The first session lasts 1-2 minutes. The course of treatment is 15-20 sessions.

For childhood convulsions, take 2 drops of Eleutherococcus extract for each year of the child’s life to be taken in the morning and afternoon in a small amount of water.

Take 4 parts of hawthorn flowers, 1 part of horsetail herb, 2 parts of mint leaves, 2 parts of St. John's wort herb. Mix the herbs, pour 1 dessert spoon of the mixture into 1 cup of boiling water, leave for 15 minutes, cool, strain (squeeze out the raw materials), take 1/2 cup 5 times a day, but no later than 17:00 as a folk remedy for nocturnal enuresis.

1. Mix 1 part mint leaves, 1 part sage leaves, 2 parts motherwort herb, 1 part valerian root, 2 parts St. John's wort herb, 1 part calamus root. Prepare and use as in the previous recipe. But it is advisable to take this collection for enuresis 1 hour before bedtime.

   Mix equal parts of birch leaves, knotweed herb, St. John's wort herb, mint herb, chamomile flowers, centaury herb.

   Mix equal parts of St. John's wort herb, chamomile flowers, yarrow herb, dill fruits, thyme herb, lingonberry leaves, arnica flowers, shepherd's purse herb.

   Mix equal parts of knotweed herb, St. John's wort herb, agrimony herb, centaury herb, mantle leaves, lungwort herb - equally

   Mix equal parts of elecampane root, fireweed leaves, mint herb, motherwort herb, wormwood herb, damask herb, meadowsweet flowers, horsetail herb.

1-5 Herbal collections for enuresis are prepared as follows: before preparing the collection, grind the herbs in a meat grinder or coffee grinder. 1-2 tbsp. spoons of the crushed mixture pour 1 liter of boiling water, pour into a thermos along with the grass, leave overnight. Take 100-200 ml half an hour before meals during the day. You can add honey, sugar, jam to taste. The course of treatment is 3-4 months, then a break for 10-14 days, change the collection and continue treatment.

Vanga's recipes for bedwetting in children

Boil about 2 kg of watercress (Nasturtium Officinalis R. Br. L.) in 10 liters of water. You need to know that this herb is most healing in May, when it is getting ready to bloom. Strain the broth, wait until it cools, and do sitz baths up to the waist seven nights in a row before bed. Mix the grass taken out of the water with pork fat, make compresses on the stomach on the first day, and on the lower back the next day. The compress should be kept overnight. Vanga advised this recipe to be used only by those who have a healthy spine. If the vertebrae are too distant from each other, then before starting baths, in the summer you should do a course of sunbathing, and before each bath, the child’s lower back should be lubricated with gun oil.

Pour 1 tablespoon of dill seeds with a glass of boiling water, close the lid and leave for 4-6 hours, filter. Give the child a drink at once. The course of treatment is 7 – 10 days.

Pour boiling water over 1 tablespoon of birch buds and leave for 1 hour, then strain. Give the child a drink at once. The course of treatment is two weeks.

Pour 50 g of sage leaves or meadow sage herb into an enamel pan, add 1 liter of cold boiled water, boil for 15 minutes. Leave for 30 minutes, filter. Give the child to drink the decoction warm, 1/2 cup 3 times a day. The course of treatment is 10 days.

Pass fresh shepherd's purse grass through a meat grinder and squeeze out the juice. Mix 50 drops with 1 teaspoon of water and drink. And so - 3 times a day. Or prepare a water infusion: pour 2 - 3 tablespoons of the raw material into a glass of boiling water, leave for 4 hours and let the child drink 1/3 glass 3 times a day half an hour before meals. The course of treatment is 7 – 10 days.

In the morning and afternoon, give children 30-40 drops of pantocrine in 1 teaspoon of water. The course of treatment is 10 days.

If you have kidney disease in children, you must follow a strict diet, eat only corn bread and drink a decoction of corn hair.

You need to put your child to bed after eating only light food. There is no need to give him something to drink before bed.

Take dry coriander and red rose with cut off edges of the petals - 15 g each, lettuce seeds and purslane seeds - 45 g, Armenian clay - 15 g, pomegranate flower - 3 g, camphor - 1.5 g. Give at a time child 4 g of powder from this mixture.

Nocturnal enuresis in children 8 years old - treatment.
Treatment of nocturnal enuresis in children 8 years old does not pose a serious problem if you find out the source of the disease and carefully study the symptoms of its course.

Urinary incontinence in an 8-year-old child.
Full control over urination in a child is formed between the ages of 1 and 3 years and is usually completed by the age of 4. Depending on the age and volume of fluid consumed, the number of urination episodes reaches 7-9 (no more and no less!). At the same time, during sleep at night there is a break in urination, that is, most of the episodes occur during the daytime. However, not all children learn to fully control urination and sleep dry by the age of five. In these children, such a night break, as mentioned above, does not occur; the body continues to secrete fluid, and the child pees in the bed. According to statistics, this happens in 10-15% of children aged 5 to 12 years. These children suffer from enuresis. Thus, enuresis is a pathology of the urinary system, characteristic of children over five years of age and consisting of involuntary urination during night sleep.
Daytime urinary incontinence occurs less frequently in children and is not related to enuresis. There is also a permanent form of incontinence, but this is a different disease that occurs as a result of damage to the central nervous system due to injury or an infectious disease.
The older the age in question, the fewer cases of enuresis there are, but in 1% of children the disease persists into adulthood. It is customary to distinguish two forms of enuresis. If a child of 8 years old has been peeing at night since early childhood, regularly and without any breaks, then they speak of primary enuresis. In a case where urinary incontinence in an 8-year-old child stopped for some time (from six months or more), and then resumed again, we are talking about secondary enuresis.
It is clear that if in the first case the child simply cannot “outgrow” it, then in the second situation he has already learned to control his bladder, but then, under the influence of some provoking factor, urinary incontinence developed again.

How to treat enuresis in an 8 year old child?
Eight years is the age at which urinary incontinence can lead to serious psychological harm. This situation causes the child to feel embarrassed, ashamed, and guilty before his parents for the wet bed the next morning. He is afraid that his peers will tease him after learning about a sensitive problem, so he begins to withdraw into himself, becomes insecure, and irritable.
For this reason, it is so important not to delay the treatment of enuresis and not to self-medicate - all this has a detrimental effect on the patient’s socialization.
It is better to immediately take the child to a specialized treatment center, where experienced doctors will carry out all the necessary diagnostic measures and prescribe comprehensive treatment.
As a rule, a specialist takes urine and blood tests, collects anamnesis, is interested in the child’s daily routine and diet, performs an ultrasound and, based on all the data obtained, finds out the cause of bedwetting.
Subsequent treatment depends on this cause:
If the problem is a lack of the hormone vasopressin, which reduces the amount of urine excreted at night, the child is prescribed tablets containing a synthetic analogue of this hormone - desmopressin. For example, Minirin sublingual tablets are popular: they are small in size and dissolve quickly, which is important if the patient is only 8 years old.

If the cause of a wet bed is an internal urinary tract infection, antibiotics are prescribed, in addition to Minirin.

When it is discovered that the walls and muscles of the bladder are very weak, physiotherapeutic procedures and therapeutic exercises may be prescribed.

Often the development of secondary enuresis is associated with severe fright, fear and other types of stress that the child has experienced. Then a neurologist and a child psychologist or psychotherapist can come to the rescue. They can also prescribe medications - herbal sedatives for children, etc.
As a rule, specialists prescribe a comprehensive treatment course so that the effect is achieved faster.

The term enuresis (from the Greek enureo - “to urinate”) is commonly used to describe bedwetting in children over 5 years of age. Therefore, the definition of “nocturnal enuresis” is essentially a tautology, although it has taken root in speech. In addition to enuresis, there is another urinary pathology - daytime urinary incontinence. If a 7-year-old child pees during the day, then this most likely has nothing to do with enuresis. This disease has its own mechanisms, developmental features and causes. For involuntary urination at night, the reasons are completely different.

Causes of nocturnal enuresis in children 7 years old.
One of the most common reasons is heredity. If at least one of the parents had the same disease in childhood, the probability that it will be passed on to the child is about 45%. If both mom and dad suffered from enuresis, then this figure rises to 75%!

Often the source of enuresis is birth trauma or trauma the mother received during pregnancy. This leads to disturbances in the child’s nervous system, which, in turn, inhibits his development of skills to restrain the urge to urinate.

Sometimes pathologies of the internal organs of the urinary system, an injured, underdeveloped or weakened bladder or ureters prevent urine retention.

Urinary tract infections can also cause urinary incontinence and excessive urination.

Not so long ago, doctors identified another reason - hormonal. Enuresis can be caused, as it turned out, by insufficient production of the hormone vasopressin by the pituitary gland. It is this hormone that helps the body sleep peacefully, despite the urine produced by the kidneys. Vasopressin makes its concentration higher and its quantity lower. With a lack of vasopressin, the same non-concentrated fluid accumulates in the bladder as during the day, in the same volume that a child’s bladder cannot cope with.

Treatment of enuresis in a 7-year-old child.
If a 7-year-old child regularly pees in bed at night, this causes him severe discomfort. Due to age characteristics, 7-year-old children are very susceptible and vulnerable, so the situation with urinary incontinence negatively affects the child’s psychological balance, self-esteem and communication with peers.
Considering that 7 years is the age when a child has just entered school life, such a blow to the psyche can affect all further development and the process of socialization. That is why you should not delay the treatment of enuresis. Of course, a doctor should treat urinary incontinence in a 7-year-old child, since self-medication may not only not be beneficial, but also harm the child’s health. Therefore, you should not expect that the child will “outgrow” everything, especially if the enuresis is secondary (that is, it appeared after a long “dry” period).
The main thing in treatment is to correctly identify the cause. To determine the source of the disease, the specialist carefully examines the patient. The child's urine and blood are tested, the bladder and kidneys are examined using ultrasound, and the rhythm of urination episodes and the volume of urine excreted are monitored. You may also need to consult a neurologist and psychologist if the doctor sees the need for this.
After diagnosis, the specialist prescribes treatment. Drug treatment most often consists of influencing the hormonal system and psychological state of the child. The lack of the hormone vasopressin is compensated by the drug Minirin, which is desmopressin - a synthetic analogue of the “native” vasopressin. An herbal sedative may also be prescribed to reduce stress levels.
Specific medications are prescribed in each case - for example, antibiotics for urinary tract infections, etc.
The outcome of treatment largely depends on the parents’ attitude towards the child’s illness. An atmosphere of support and participation will help the patient quickly cope with psychological discomfort and have a positive impact on his well-being.
Mothers can also help the doctor during the examination by keeping a diary with a schedule of the child’s “dry” and “wet” nights. By the way, today a specially developed application for smartphones “Dry nights - happy days” is already available, which allows you not only to note “unsuccessful” nights, the number of episodes of urination per day, but also the amount of liquid the child drinks. So with this new product it is also convenient to control your drinking regime.

Enuresis - night urination, is a common disease in children 4-7 years old. Preschool children often pee at night. At first, parents do not consider this a problem. But we must not delay and waste the time to treat this not only physiological, but also emotional illness.

Both children and parents are ashamed to admit the disease and see a doctor. If your child wakes up in a wet bed, this is not normal and should be concerned.

A sensitive problem should be carefully discussed with the child. He is already suffering, and should not feel shame or fear of his parents, and should not hush up or hide traces of the night’s incident from adults. Your child must trust you completely and agree to be examined and treated by a doctor. Often the wrong position of adults leads to psychological trauma, sleep disturbance and the formation of an inferiority complex.

The ability to control the process of urination matures in the head. This happens at different times for different children. But by the age of five, 80% of children can sleep peacefully through the night and go to the toilet when they wake up in the morning. Daytime incontinence in preschool children is rare. We won't talk about him. Nocturnal enuresis is often a disease that requires contacting a urologist. Enuresis is several times more common in boys.

• Primary enuresis– when the child does not wake up to pee at night.
• Secondary enuresis– a consequence of severe mental or physiological trauma. In this case, involuntary urination can occur both at night and during the day.

The child learns to control the process of urination along with other skills and life processes. At the age of one and a half years, babies feel the filling of the bladder and express anxiety when the moment approaches to empty it.

The relationship between the brain and the center for regulating urination is formed by 4-5 years. When the bladder muscles in children contract, they push out the accumulated fluid, and the inlet muscles relax. Small children cannot control the relaxation of this muscle; the process occurs involuntarily.

By the age of three, the size of the bladder increases, the brain gives a command to keep the muscles in a tense state, as a result of which the process is inhibited. A 2-3 year old child is already asking for something “small”. During the day, the excretory system turns on 7-8 times, and at night the bladder is not disturbed by urges. The “adult” urination pattern is fully developed by the age of four. Before this, night “swimming” in children is not a pathology.

Prerequisites for the occurrence of enuresis

The causes of enuresis in girls and boys are not the same. The development of the body and behavioral patterns of each child are individual. Conditions of upbringing, habits, and hereditary traits can affect the formation of health.

How factors can cause enuresis in children?

State of brain development. Slow development of the central nervous system entails insufficient ability to control the process of urination. The reason for slow development may be an unsuccessful pregnancy or difficult childbirth. Children with this feature are easily excitable, nervous, and have difficulty concentrating. A calm environment and hardening of the baby’s body will help to avoid enuresis.

Daily routine with periods of sleep and wakefulness. – one of the common causes of night urination. This is restless superficial sleep or deep sleep (when the child does not remember when he is woken up at night).

Extremes in the system of raising children. If the baby is allowed everything and is not taught cleanliness and personal hygiene, then he does not pay attention to wet panties or bed. Or, conversely, if a child is too harshly reprimanded for every little thing, he is afraid to remind himself once again and ask to go to the toilet.

Causes of the disease:

• psychological situation at home;
• heredity. If there are cases of neuropathic diseases, enuresis in the family, this may be the cause of the disease;
• abnormalities in the formation of the genitourinary system. Insufficient bladder capacity;
• inflammatory processes, consequences of injuries and operations;
• improper organization of the child’s sleeping place. The bed should be hard and warm. You should always wrap your lower back and legs tightly, wear warm pajamas at night and socks.

Another reason is the abuse of diapers, which can be convenient for mom. The child is warm and there is no need to constantly put him on the potty. But this leads to the fact that three-year-old children do not know the potty and urinate in their pants. A child should be potty trained as early as one year of age.

He must understand that discomfort from wet onesies or diapers occurs after urination. At the level of conditioned reflexes, the need to stay dry is formed. The child begins to worry at the right time, indicating that it is time to go to the potty. By the time the child arrives at the nursery, he or she must be able to cope without diapers during the waking period. Even up to one year old, you should not keep your baby in a diaper all the time. Only during a walk, visit or clinic.

Nocturnal enuresis in boys

Boys always strive to establish themselves, they want to appear strong and independent. Not everyone can do this. If such a child lacks confidence and determination, he begins to feel defective. He develops complexes and becomes nervous.

This character most often develops when a child is under strong pressure from adults. If a mother orders something to be done, often unreasonably prohibiting the child from doing things that are pleasant for the child, the baby cannot openly express dissatisfaction. Enuresis in such cases occurs as a reaction to rudeness or a protest against prohibitions.

By changing the way you communicate with your child, you can eliminate the psychological cause of the disease. The child needs a warm attitude, protection from loved ones, and their support.

We should talk about enuresis as a painful condition if the boy often urinates during the daytime. Associated symptoms are a slow pulse, a depressed mental state, pale legs and arms, and low temperature. The child's behavior is characterized by extreme states. Either he is quick-tempered and impulsive, or he is withdrawn and depressed.

The boy behaves timidly, insecurely, his attention is scattered. Neurosis-like enuresis is successfully treated with complex therapy - sedatives, diet. Hypnosis, physiotherapy, reflexology, and acupuncture are also used.

Enuresis can be a consequence of surgery. The most common operations in boys are groin or groin removal, circumcision and others. In any case, the sooner the disease is identified and treatment begins, the more effective it will be.

Raising a boy should be harmonious. Both parents should stick to the same line on this issue. Disagreements and contradictions between them lead to inappropriate behavior of the child. He takes the side of the parent who allows everything and does not scold under any circumstances. Therefore, a demanding mother or father, who teaches to restrain the urge and run to the toilet in order to stay clean, seems angry and unfriendly to the baby.

Protesting their demands, he pees his pants. He begins to enjoy angering and irritating the “right” adults. Full-fledged upbringing consists of attentive attitude towards the child, his needs and requirements. You need to establish contact and trust with him. The baby should feel that he is loved. Then he will want to respond in kind, to be good.

Enuresis in girls can also be associated with psychological problems.

Character changes in a child with enuresis

To start treatment, you need to persuade the child, who is ashamed, to admit his trouble even to his mother, and to go to the doctor. Children suffer greatly mentally from enuresis; the delicacy and patience of loving parents is of great importance. If a child feels ridicule or irritation, he will withdraw, avoid peers, and consider himself inferior.

Treatment. How to help a child cope with illness?

• Follow the doctor's instructions, monitor your sleep and diet.
• The child should fall asleep and wake up at the same time. Before going to bed, it is advisable to take a walk in the fresh air.
• It is better to exclude active games, TV and computer in the evening hours. They can be replaced with calm board games and reading.
• The foot of the bed should be raised slightly.
• Don't scold your baby if the bed is wet again the next morning. Support him with a joke, cheer him up. Tell him that the illness will soon pass.
• Limit drinking in the evening. Kefir, milk, fruits have a diuretic effect. They can be replaced with salted nuts and a piece of cheese. Salt promotes water retention in the body.
• Do not deny your child trips, trips, and visits. Sometimes in another environment the child remains dry at night.

Some practical tips:

• if it is difficult for a child to go without drinking for 3-4 hours before bedtime, do not focus on this, do not prohibit drinking, just reduce the portions;
• Sometimes children don't get up at night because they are afraid of the dark. Place a potty next to the crib and leave the night light on in the nursery at night;
• If you wake your child up at night to go to the toilet, bring him fully conscious. Otherwise, the enuresis reflex will only become stronger;
• do not wear diapers at night;
• If the child is old enough, treat him like an adult. Let him himself, preferably without witnesses, make his wet bed, take a shower himself;
• Keep a diary with your child in which you will note dry and wet nights (draw the sun or a cloud there, if there are more and more “sunny” nights, praise him). The diary will be very useful for the doctor when choosing treatment methods.

Treatment of enuresis with medications

The question of prescribing medications can only be decided by a pediatrician. He will determine the cause of the disease and select drugs for treatment - adaptogens, antidepressants, nootropics .

Children do not like injections and pills. The medicine Adiuretin-SD is available in the form of nasal drops. It reduces the amount of urine and allows you to retain it until the morning. It is indicated for children whose rhythm of urine accumulation is disrupted. There is less of it during the day than at night.

Medicines are prescribed in courses. After finishing the treatment, the problem may return. The doctor recommends the duration and frequency of courses. This remedy must be taken by a child when he finds himself among strangers, at a children's camp or on a trip. He will feel more confident.

You cannot choose your own medicine to treat enuresis. The cause may be an inflammatory process, a cold, or an infection, which should be treated not with nootropics, but with antibiotics. Self-medication of enuresis is prohibited!

If the nervous regulation of the bladder is impaired and it is in good shape, then Driptan is used. It relaxes the walls of the bladder, thereby increasing its volume. This drug is combined with Minirin.

To activate the tone of the bladder muscles, the doctor prescribes Minirin + Praserin.

To activate processes in the brain, it is recommended to take Nootropil, Picamilon, Persen, Novopassit and a complex of vitamins.

Other treatments

Physiotherapeutic procedures include exposure to the bladder with ultrasound, currents, and heat treatment (paraffin or ozokerite).

Traditional methods of treating enuresis

Herbal infusions:

• mix hawthorn, horsetail, mint, St. John's wort in a ratio of 4:1:2:2. 3 tbsp. l. collection pour 0.5 l. boiling water and leave. Take 100 g 5 times a day;
• Mix knotweed, St. John's wort, chamomile, mint, and yarrow equally. Brew as described above;
• Lingonberry leaves, dill, and thyme are useful for preparing infusions.

A set of special exercises

The exercises are aimed at developing control over the urination process. The child must learn to restrain himself when necessary. To find out the volume of the bladder, the child is asked to hold the process when he urges. Then measure the amount of urine. This will be the volume of the bubble. In the evening, ask your child to imagine that his bladder is full and he wants to go to the toilet. After that, send him to urinate.

It is better to accompany all procedures with jokes and perform them, if possible, in a playful manner. If something doesn’t work out or the child refuses to do the exercise, don’t insist. Return to it when the patient is in the mood.

Treating nocturnal enuresis in a child requires a lot of love and patience. Help your child cope with a serious illness. A positive attitude will speed up healing. And eliminate the obvious causes of the disease.

Useful video about the treatment of nocturnal enuresis in children

Replies