Pediatricians & Bed Wetting

Your pediatrician will be an important part of dealing with bedwetting. However, since medical health professionals are so busy today, you will want to make sure that you approach your child’s physician in a way that ensures maximum cooperation. Here are some tips that can help you communicate with your child’s pediatrician in a way that will ensure better treatment options for your child:

Keep a diary

One of the best ways you can help your doctor treat your child is to keep a diary of your child’s bedwetting. Starting from the time your child seems to be bedwetting more frequently, keep notes in a small notebook. In this notebook note:

•When your child wets the bed (dates and times, if possible)
•Any family history of bedwetting
•Any results of bedwetting (crying, problems at school, teasing)
•Any medications your child is on or any medical problems your child has had or is having
•Any questions you have about bedwetting
•Any questions or comments your child makes about bedwetting
•Any comments that your child makes before bedtime that may indicate a problem (aches before bed, emotional upsets during the day)
•Any bedwetting products (disposable liners, moisture detectors) your child is using and how effective they seem to be
•Any other symptoms your child seems to be experiencing
•Notes on any resources or information about bedwetting that you encounter that seems helpful

Health care professionals are busier than ever today and keeping such a diary can be a big help to a busy physician. Go over the notebook with your doctor and together look for patters, and possible causes. Get answers to the questions you have written down.

Keeping a diary can also be useful for you and for your child. If your child shows improvement (wetting every few days rather than once a night) you can show your child this improvement. If you yourself have any questions, you can easily refer to the resources and information you have collected in your notebook for more information.

Explain any underlying problems

Sometimes, doctors will not pay attention to bedwetting once they have ruled out an underlying condition, because they assume that it is not a very threatening situation.

If your child’s self-esteem, grades, or social development is affected by bedwetting, you need to let your doctor know because at that point bedwetting has moved from a non-threatening problem to a problem that is affecting your child’s development. Discuss with your doctor the steps that must be taken to stop bedwetting or at least cope with the problems your child has developed as a result of it.

Did your child’s bedwetting develop at the same time as other symptoms?

If your child has developed bedwetting and snoring or extreme fatigue at the same time, you should mention this to your pediatrician.

In rare cases, something called Obstructive Sleep Apnea (OSA) may contribute to bedwetting. OSA means that some blockage – such as enlarged lymph glands called adenoids – block flow of air to the lungs.

In some cases, this problem causes snoring while for some children OSA causes brief periods where breathing is entirely interrupted. OSA is thought to cause enough to seriously interfere with breathing. The most common cause of OSA is restless sleep, early morning headaches, and fatigue.

Some researchers have also linked this condition to bedwetting. Bedwetting caused by OSA is very rare, but can be treated, usually by removing the tonsils or adenoids. Your doctor can run a special test to determine whether your child’s bedwetting is related to OSA.

Get a Second opinion

If you are not happy about your doctor’s response regarding your child’s bedwetting, don’t be afraid to seek more help, possibly from a specialist. Get the care for your child that makes you feel comfortable. Every doctor has a different approach to child bedwetting. If your doctor is satisfied that your child will overcome the problem while you want some form of treatment, you may seek a physician who will help you.

However, you are the parent and you should take responsibility for your child’s health. If your instinct tells you that something is wrong, seek a second opinion. Consider the following problems that can easily be mis-diagnosed or overlooked:

•bladder reflux – This illness can contribute to bedwetting and can require surgery to correct
•constipation – If your child does not empty his or her bowels regularly or completely, remaining waste can press down on the bladder and cause bedwetting.
•Malfunctioning of the urinary sphincter – The sphincter muscle is responsible for controlling urine flow. In those people who do not have a functioning sphincter, bedwetting is chronic and will not go away by itself.
•Kidney diseases – Some kidney diseases cause bedwetting as well as other symptoms. Without resolving the kidney problem, there is not much chance in successfully beating the bedwetting problem.
•Undiagnosed underlying problems – Some children may wet the bed due some serious problem such as abuse, diabetes, epilepsy, OSA, or other problems. If medical avenues are not carefully explored, these conditions will remain undetected and untreated, putting the child at risk.

Build a team.

There are many people in your child’s life that can help ensure that bedwetting is a solvable and un-stressful problem:

•Teachers: You do not need to tell your teachers about your child’s bedwetting, but you should be in contact with your child’s instructors to make sure that your child’s grades or social development is not suffering. An alert teacher can also often be your first alert of bullying or teasing that is taking place.

•Pediatrician: Your child’s doctor should be one of your first stops when bedwetting becomes a problem, as your child’s pediatrician can run tests to determine whether there are any physical or underlying causes behind the bedwetting.

•Therapists/Child Psychologists: If your child’s grades, self-esteem, or social skills are affected by bedwetting, you may need to help your child develop a team of emotional support. Therapists and others can discuss your child’s feelings with him or her and can help your child develop coping strategies for teasing and other problems.

•Pediatric nephrologist or urologist (kidney or urinary system specialist): In some children, a medical problem such as a badly working urinary sphincter can cause bedwetting. Kidney specialists and urologists can tell you whether your child’s urinary system is fine or whether there is some underlying medical problem or physical problem behind the bedwetting.

If bedwetting persists very late (such as into adolescence) or is a nightly problem even by age eight or so, medical or physical reasons should be explored very carefully as they are a likely culprit.

Work with your team

You should choose the specialists who work with your child carefully, choosing those who seem to see the problem in the same light as you, and choosing those whose treatment options agree with you. When looking for health care professionals to treat your child’s bedwetting, you will also want professionals who listen to you and your concerns.

Once you have found a team you trust, however, it is just as important that you work effectively with them. This means following instructions to the letter (asking for clarification when needed) and being very frank about other treatments you are using and about which treatments seem to be working and which do not.

Do Your Own Research

While a doctor can be very useful in helping you deal with your child’s bedwetting, health care workers today are busier than ever and no one doctor can keep up with all the research and new information coming out each day. You may want to contact organizations such as the National Kidney Foundation or the American Academy of Pediatrics for more resources and then raise the information you find with your doctor.

You can contact some key resources about bedwetting yourself:

•The American Academy of Pediatrics (AAP) provides lots of useful information, and pamphlets about a variety of conditions, including bedwetting…

American Academy of Pediatrics (AAP)
141 Northwest Point Boulevard
Elk Grove Village, IL 60007_1098
Phone: (847) 434_4000
Fax: (847) 434_8000

Alternative address:

The American Academy of Pediatrics
Department of Federal Affairs
601 13th Street, NW
Suite 400 North
Washington, DC 20005 USA
Phone: (202) 347_8600
Fax: (202) 393_6137
Email: kidsdocs@aap.org
Web Address: http://www.aap.org

•The PottyMD is a great resource about toilet training and bedwetting. Since this groups focuses only on this problem, you are sure to get information that is pertinent to the topic. Many parents swear by this resource.

PottyMD
2216 White Avenue
Knoxville, TN 37916
Phone: 1_877_POTTYMD (768_8963)
Web Address: www.pottymd.com

•The National Kidney Foundation has recently launched a number of resources about bedwetting. Their website has lots of information and even video clips about the subject. Plus, if your child’s bedwetting is caused by a kidney problem, this group can help you get information on that issue, as well.

National Kidney Foundation
30 East 33rd St., Suite 1100
New York, NY 10016
Phone: 1_800_622_9010
Web Address: www.kidney.org

•The National Kidney and Urologic Disease Information Clearinghouse provides all sorts of information about conditions that affect the kidneys and urinary system. Not surprisingly, they have several resources just about bedwetting.

National Kidney and Urologic Disease Information Clearinghouse
3 Information Way
Bethesda, MD 20892_3580
Phone: 1_800_891_5390
Web Address: www.kidney.niddk.nih.gov

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