Enuresis in Children
Why do they wet the bed?
Primary enuresis is children who have never stopped wetting the bed, are over six seven years old, and are still wetting the bed.
Secondary enuresis is children who have stopped urinating for at least a period of more than six months and then begin to wet the bed again.
Obviously, most of the cases we have in children with primary enuresis, children who have never stopped urinating, these children need a specialized evaluation, these children need to take some type of treatment, the most important thing we have to know is if it is a Anchored enuresis, simply if you urinate at night if it is an isolated enuresis know if you have a family history if the mother urinated in the bed if the father urinated in the bed, know that if you have a family history you have a 50% probability that your child urinates In bed this, it is described that each year 15% of these children with primary enuresis will stop urinating on their own, how we can help them, we must take certain measures before thinking about medicating simply changing habits.
What changes in habits?
Limiting liquids at night, not that my child falls asleep and to fall asleep he has to have a glass of milk at 9 o'clock at night, do not eliminate it. Many of the children still have immature bladders or are very reactive to liquids.
The urinary system, urination is a complex neural system that ends up developing until the age of 20, so we can still have teenagers who wet the bed so we can accelerate this maturation process bladder one of the measures is to limit fluids at night, limit substances that are irritating to the bladder such as citrus juices, dyes, irritating substances for the bladder such as acids, all kinds of junk food that children eat like chitos caprichitos nachos etc., which have that orange coloring that stays on the hands, that orange coloring is irritating to the bladder, chocolate, tea, coffee, Coca-Cola all these substances have caffeine and will cause an increase in nighttime urination.
Attention to Claims
Well, the above mentioned must be limited to another important factor is the reinforcements in children do not work; Negative reinforcements actually make them self-conscious about scolding them, displaying them in front of other people for wetting the bed, hitting them for wetting the bed does not solve the problem but makes them more introverted children.
Atención a los Reclamos
Bien, lo anterior nombrado hay que limitarlas a otro factor importante es los refuerzos en los niños no funcionan; los refuerzos negativos de hecho hacen que se acomplejen en regañarlos, exhibirlos delante de otras personas por orinar la cama, pegarles por orinar la cama no solucionan el problema si no que los convierte en niños más introvertidos.
Positive reinforcement is important
What should be done is positive reinforcement that if it is shown by studies that if they work, positive reinforcement means rewarding when you do not urinate, encourage you not to urinate with objectives with goals, for example if you do not urinate three days in a row you have this small prize, if you do not urinate a week you have a bigger prize, this will encourage the child to get involved in limiting liquids in that he gets involved in the food that he does not have to eat to get involved in having to get up in some period of the night to urinate.
These things will make the connection between the urinary sphincter and the bladder muscle faster. Remember that I mentioned that voiding function is a complex neuronal function and that it can take up to 20 years for it to be solved, that if we talk about pharmacological treatments, there are pharmacological treatments that are not made exclusively for children who urinate if they are not effects collaterals of other medications because we know that we can use them to control urination at night but they have collateral effects it is important that you ask your doctor before taking any medication to control urination what other effects it may have, always try first with changes habit before trying drug treatments