Nocturnal enuresis is an unreasonable urination, which is a fairly common problem in children 4-8 years old. Very often, preschool children urinate at night. Initially, many parents do not consider this a problem, but for the time being.
Definition
Pathology got its name from the Greek word enurio, which means "to urinate." The term "nocturnal enuresis" in official medicine refers to the pathology of the genitourinary system, which forms a disorder of the act of urination. According to experts, up to 5 years this is not a problem, therefore, up to this age is not recommended to raise a panic. Enuresis is much more common in boys than in girls, this is due to the structure and formation of the genitourinary system.
Kinds
There are three varieties of this ailment:
- Primary - the child urinates from night to night.
- Periodic - the baby has dry nights from time to time.
- Secondary - the little man does not have all the symptoms of nocturnal enuresis for several months, after which he continues to urinate again. First of all, this may indicate not a medical, but an emotional problem.
Symptoms
The main symptom of the disease, of course, is urinary incontinence, but the child may also have associated problems that parents must pay attention to:
- chronic depression and depression;
- frequent urination;
- decreased body temperature;
- marbling legs and arms;
- reduced number of contractions of the heart.
Parents should definitely inform the doctor about all the symptoms of childhood nighttime enuresis, as the correct behavior of the parents and the prescribed therapy are incredibly important in this case.
Causes
If we consider the problem only in children under 5 years old, then they have an organic pathology, which is hidden in the incomplete formation of the urethra. Rarely enough, but still the age threshold for natural incontinence can rise to 8 years, but this is only night abstinence. If the problem is present in older children or manifests itself at any other time of the day, then the reasons may be different:
- emotional upheaval;
- neuropsychiatric disorders and delay in the development of the nervous system;
- acquired nocturnal enuresis in a child of 7 years and older, the main cause of which are neurotic disorders;
- genetics - this problem with a probability of 77% can be transmitted from both parents;
- kidney disease;
- urological disorders of a traumatic nature;
- inflammatory and infectious processes that affect the bladder, most often it is cystitis;
- a malfunction in the production of the hormone vasopressin, which is just responsible for regulating the volume of urine.
Complications
If there is no correct and timely treatment, then serious problems can arise that affect the psyche of the baby:
- hysteria;
- neurosis;
- depression.
Only competent complex therapy and the sensitive attitude of parents can help prevent the formation of the disease.
Nocturnal enuresis in boys
Boys always want to be confident and strong, but not everyone succeeds. If one of them lacks strength and determination, he begins to feel not like everyone else, and flawed. As a result, complexes are formed, and he becomes nervous.
Such a malaise develops when a child is under great pressure from adults. If dad or mother, in a commanding tone, demand something to be done or quite often unreasonably forbid him to do what he loves, then the baby may openly express dissatisfaction. Night enuresis in such cases occurs as a reaction of the body to rudeness.
After the parents change their manner of communication, most often the psychological problem ends. A warm attitude and support of loved ones is very important for a little man.
Talking about enuresis as a painful condition is necessary if the boy often urinates in the daytime. The main concomitant symptoms are a slow heartbeat, pale arms and legs, inhibited mental state and low temperature. There are constantly extreme states in the behavior, then it is too hot-tempered and impulsive, then depressed and closed.
In such cases, the boys are insecure and have scattered attention. Such nocturnal enuresis can be treated quite successfully with complex therapy, diet and sedative drugs. Physiotherapy, hypnosis, acupuncture and reflexology are also often used.
Incontinence can often be the result of surgery. The most common operations are the removal of an umbilical or inguinal hernia, circumcision. It should be noted that the sooner you identify the cause of the disease and begin the correct treatment, the more effective it will be.
Every parent needs to know that raising boys is required to be literate. Both parents should follow the same line in different matters. Contradictions between adults most often lead to inappropriate behavior of their children. The kid begins to take the side of the one who allows more and does not scold him under any circumstances. Therefore, the demanding mothers and fathers, who learn to restrain themselves from urging and rather run to the toilet to stay clean, seem to be unfriendly and evil to the baby. Protesting against the rules, he writes in his pants. The kid enjoys the fact that he annoys and angers the “right” adults. To solve the problem, parents must establish a trusting relationship and contact, as the child must understand that they love him. Then he wants to be good and respond with understanding.
Teens
In children over the age of 12, urination should be established. According to statistics, this problem occurs only in 2% of adolescents, and after 16-18 every hundredth child suffers from it. The causes of nocturnal enuresis in older children include:
- problems with the endocrine system;
- adverse reactions to thioridazine and valproate;
- consequences after obstruction of the upper respiratory tract.
Diagnostics
This problem is not uncommon, therefore, to make an accurate diagnosis, the pediatrician collects an anamnesis. Since it is possible to associate this disease with a hereditary factor, in cases of urinary incontinence, doctors interview both parents of the baby. For an accurate diagnosis, the doctor needs to know the duration and frequency of incontinence episodes, as well as the nature of urination (jet power and whether discomfort is present). If there is a suspicion of a urological disease, as well as pathology of the urinary tract, the doctor will definitely send an ultrasound scan (ultrasound) of the bladder and kidneys.
As additional procedures, the patient is recorded:
- on an x-ray of the spine in two projections;
- laboratory examination of primary urine;
- defectological comprehensive examination (for neurological diseases).
Treatment
There are many different methods for treating nocturnal enuresis in children. In order to figure out which ones will help a particular child, you need to consult a doctor, and then make a decision.
It happens that wait-and-see tactics simply do not suit parents, moreover, the doctor insists on the use of drugs. As practice shows, the percentage of children who have been helped by medications is very small. If the magic pill did not work after 2 weeks, then it is recommended to cancel the therapy. Often, the following drugs are prescribed:
- "Driptan";
- "Desmopressin";
- Spazmeks.
These funds, as stated by the manufacturers, inhibit and reduce the involuntary urge to urinate, as well as increase the volume of the bladder.
Even with increased anxiety, a doctor may prescribe antidepressants:
- "Dosulepine";
- Imipramine
- Dotiyepin;
- Amitriptyline.
Motivational therapy is a highly effective way to treat nocturnal enuresis in a child 5 years old and older. It should be noted that in this case the baby is the best psychotherapist. There is an opinion that until he himself wants to free himself from the problem, it will not disappear. This method is designed for older children, since for this you need to establish personal motivation. The essence of the method is to reward the child for dry nights. You can make this a kind of holiday.
Each little man has his own motivation. One is incredibly important praise, but someone will need a dog, a bicycle, a trip to the sea, a new toy or going to the movies. The reward may be tangible or not. It is recommended to hang a calendar in the baby’s room and mark dry nights in it. A mandatory task for parents is to focus on success, and not on wet matters.
Psychotherapy sessions are a method that is effective only when the child himself wants to get rid of the problem. Typically, the technique works on older children from 8 years. In this case, nocturnal enuresis is a serious problem, since it manifests itself due to psychoemotional disorders. The main components of therapy are:
- full confidence in the specialist;
- it is also required to take into account that work on a child will affect the deeper layers of the psyche, therefore emotional negative outbursts often arise;
- time is needed to restore the cause of incontinence;
- often this aggravation occurs in vulnerable, anxious and touchy children who hide their emotions throughout the day and relax at night.
- there is an opinion that enuresis reflects the relationship of the child and the parent, mainly mother and son.
- if adults have strong control over the child and a significant desire to make him better, as well as excessive custody, then all these bursts can contribute to the appearance of nocturnal enuresis in children.
- important in therapy is that without the participation of parents it is impossible.
A controlled amount of fluid is a method whose distinguishing feature is that after 17 hours the baby should drink no more than 20% of the fluid from the daily norm. And a couple of hours before bedtime, parents should give generally a minimum amount of drink. It is important that the air in the room is cool and humid, and the child is wrapped in a warm blanket. Under such conditions, the feeling of thirst will be inevitable and natural. It is also not recommended to allow physical activity and active games before bedtime, so that the child does not sweat and does not ask to drink.
The causes of nocturnal enuresis are different, so you need to figure out what can cause incontinence problems in everyday life. It is important to follow the lifestyle:
- how much time the baby is on the street;
- time of falling asleep;
- what he does throughout the day;
- whether he leads an active lifestyle and observes the daily routine;
- how often a child sits at a computer;
- what films, television series and programs he prefers;
- with whom he talks in the yard.
Everything that children are fed emotionally for the whole day spills out during sleep. Any incontinence can be the result of emotional overloads in the evening. It is important that the house has a calm atmosphere before going to bed.
Many parents who are faced with a similar problem need to know how to treat nocturnal enuresis. To do this, you can use bladder training, but only if there are no problems with urology. The method does not have any bad effects on the genitourinary system. Children can be accustomed to aging from 3 years old. This does not mean that you need to withstand for 30 minutes or 1 hour. Literally 5 minutes is enough for the baby to gradually develop a sense of control.
A urinary alarm is a method that not many people use in Russia and the CIS countries. Although when using this technique for the treatment of nocturnal enuresis in children, everything goes positively almost 100%.
How does he work:
- a sensor is attached to the panties, which is aimed at regulating moisture;
- the other part is attached to the alarm;
- as soon as the child begins to fulfill his need, the bell rings;
- then the child wakes up and can fix the beginning of urination, he turns off the device and sits down on the pot. The essence of the method is to consolidate the control of night urination. There are also modern wireless models of the device, making it easier to use.
This unit can also be replaced. For this:
- Mom must set an alarm for a specific time;
- then for two weeks it is required to wake the child at the same time until midnight and plant it on the pot;
- after that the alarm is set at 1 am, in a few weeks - at 1:30, and this continues until it reaches morning.
In this way, you can develop control over urination. It is important that the child must necessarily wake up and the process of urination should take place in a conscious rather than half-asleep state.
Folk therapy
There are different treatments and causes of nocturnal enuresis, but many parents prefer to use grandmother's recipes, which have concentrated centuries of experience in treating the disease. Effective means are the following decoctions:
- One tablespoon of dill seeds needs to be poured with boiling water and insisted for one hour. Drink a drink is necessary for half a glass for children under 10 years of age and 1 glass for those older. The course is designed for 10 days, after which you need to take the same break, and then repeat the procedure again.
- As you know, honey has an anti-inflammatory and sedative effect. Before bedtime, the baby is required to give a tablespoon of the product for 1 month.
- Brew 15 grams of dried plantain leaves with a glass of boiling water and insist for 20 minutes. Drink 4 times a day for 1 tablespoon.
- 1 tbsp aspen bark is poured with a glass of boiling water and boiled for 10 minutes. Drink half a cup 3 times a day for 3 weeks.
- 3 bay leaves are steamed with a glass of boiling water and boiled for 10 minutes. The broth is drunk half a cup 3 times a day. The course of therapy is designed for 7 days.
Other medicinal plants are also used to treat nocturnal enuresis, namely:
- onion;
- parsley;
- lingonberry;
- sage;
- St. John's wort
The only thing is that these herbs are not always applicable to young children. Since not every child is able to drink half a glass of liquid, which is unpleasant for him to taste, and violent treatment instead of benefit can bring significant harm.
Prevention
Of course, it’s better to prevent any disease than to treat it later. In order for the baby not to undergo emotional experiences due to incontinence, measures should be taken to prevent this ailment:
- to teach a child to a pot from an early age;
- control fluid intake;
- timely treatment of diseases and overall monitoring of health;
- protection of the baby from stressful situations;
- high-quality atmosphere in the family;
- in difficult moments, parental support must be present for the child.
When parents notice a depressed or anxious state, as well as tearfulness, it is necessary to identify the cause of this and help the child adapt. If the family has a friendly relationship and there is attention from the parents, then all difficulties can be defeated with ease.