Already at 3-4 years old, children do not need diapers - they go to the potty on their own, can control the processes of urination and bowel movements. But these are general statistics. With specific babies, things can be completely different. Someone periodically wakes up in a wet bed, someone cannot endure the potty, someone even at an older age needs diapers. Moreover, such problems can be both single and pursuing the child constantly. It makes sense to talk about enuresis.
What is enuresis in children? This is a fairly serious disease that requires appropriate treatment. In the article we will also analyze its features, varieties and causes.
Disease forms
What is enuresis in children? This is urinary incontinence caused by problems with both the genitourinary and nervous systems. There are several forms of the disease:
- Primary and secondary.
- Night and day.
- Neurotic and neurosis-like enuresis.
Let's analyze these categories in more detail.
Primary and secondary form
We continue to consider what enuresis is in children. The primary type of the disease is given to those children who have not had "dry nights" since birth. who have not developed control over urination. The child cannot control this process day or night.
On average, the formation of such control begins in children at the age of 1-3 years. And ends at 4 years old. By this time, the conditioned reflex connection has already been fully formed: the urge to urinate makes the child perform certain actions - go to the toilet, go to the potty. And in the case of primary enuresis, there is a delay in the formation of this important connection.
With secondary enuresis, the situation is somewhat different. The baby has already formed the connection "the urge to urinate - to go to the potty." But for some reason it was destroyed. What could cause the reflex disorder? The causes of enuresis in children (nocturnal and daytime) can be both certain psychological factors and somatic chronic diseases. For example, diabetes mellitus, urinary tract infections.
The child still cannot tell what is happening with his body. Or shy to do so. Then the body begins to "speak" for him. Since at a young age there is still a close connection between somatic and emotional processes.
Night and day form
Daytime enuresis is not very common in children. The nocturnal form of the disease is more common. That is, it implies that a child over five years old has the fact of involuntary urination in a dream.
Often, this is also affected by the wrong water regime. Normally, the number of urination per day is 7-9, depending on the age and volume of fluid drunk. During a night's sleep in a he althy body, there is a break in urination. This does not occur in a child with nocturnal enuresis.
According to statistics, 10-15% of children aged 5-12 suffer from this form of the disease. As you get older, this percentage, of course, decreases. But according to the same statistics, in 1% of patients, enuresis persists into adulthood. At the same time, the disease occurs 1.5-2 times more often in boys than in girls.
Neurotic and neurosis-like form
Speaking about what enuresis is in children, it should be noted that it is customary to single out a neurotic and a neurosis-like form of the disease. As for the latter, its most common cause is an organic lesion of the child's nervous system. It could have happened during his fetal development or as a result of a neuroinfection.
The result is the same - a slow formation of control over the processes of urination. Or the complete destruction of this function, successfully formed earlier. This form of enuresis does not depend on the emotional, psychological upheavals that the child could experience. However, it can intensify with its hypothermia, overwork, excessive physical activity. Conspiracies from enuresis in children, of course, will not help here - this is only self-hypnosis. The help of a qualified medical professional is needed.
But with a neurotic form of the disease, the function of urination control is impaired underdue to various psychological reasons. This is a kind of response of the body to various stressful situations. Moreover, psychotrauma affects the child not only in reality, but also in a dream. It will be repeated in his drawings, dreams, games, conversations. If you believe the reviews, the treatment of enuresis in children in this case is based on psychological assistance. As soon as you manage to cope with the consequences of psychotrauma, enuresis will stop bothering the child.
Reason for condition
In the article we analyze the causes and treatment of enuresis in children. As for the first, it is difficult to identify unambiguous reasons here.
Doctors start diagnosing by asking how mom's pregnancy and childbirth went. Since the following causes of enuresis lie here:
- Intrauterine fetal hypoxia.
- Delayed intrauterine development of the child's nervous system.
- Transferred neuroinfection.
- Various birth injuries.
Also, doctors are interested in hereditary predisposition to the disease. And for good reason. After all, according to statistics, if one parent suffered from enuresis in childhood, then the probability that the problem will manifest itself in a child is 45%. And if both parents, then the indicator grows to 75%.
As for young children, for them enuresis is a consequence of the fact that the child was not instilled in time with self-care skills, the concept of hygiene. He needs to be taught in a timely manner (but not too early) how to use the potty. It is up to the parents to take care offor complete and timely emptying of his bladder, remind the child to go to the toilet.
Parents should try to wean their children from walking in diapers after two years. If the baby does not feel discomfort after urinating in panties, this will not teach him that it is important to go to the potty on time. But in no case should a child be left in wet clothes as a punishment.
As for older preschoolers and younger schoolchildren, their main cause of enuresis is the wrong drinking regimen. For example, at school, a section or a circle, a child does not have time to drink properly. But in the evening at home, he makes up for lost time. On the basis of an overflowing bladder, a nocturnal form of the disease occurs.
Now about the treatment of enuresis in children. Feedback on therapy is ambiguous: some parents note the success of the use of medications prescribed by the doctor. Someone talks about the benefits of physiotherapy and homeopathy. There are parents who again turned to diapers in the expectation that the problem would resolve itself - the tried and tested methods of treatment were ineffective. Of course, the reviews describe more than one case when, as the child grew older, enuresis passed without drug therapy.
But many also needed psychological help. In the same reviews, we will see that the emotional situation in the family also plays a significant role. Such an unpredictable reaction may arise in response to the constant scandals of parents, their addiction to thrillers and "horror films", physical punishment of a child, the birth of a younger brother or sister, frequent moves, and others.traumatic, unstable environments. A child psychologist will be able to work out a traumatic situation for a child, help to survive it. But often enuresis is a "side effect" of stress, depression, fear.
How does the baby feel?
What is enuresis in children? It is also a psychological trauma for the child himself. Caused not only by his problem, but also by the attitude of parents, peers and others towards her:
- A child can experience a complex internal conflict: he feels guilty, worried about what is happening, but at the same time feels that he is unable to cope with it on his own. He doesn't understand how to stop it.
- A child's self-esteem and self-confidence are severely damaged if they are punished because of enuresis by their parents, peers ridicule, others are negatively treated, even if they do not express their opinion directly.
- The child suffers from some of his limitations due to illness: it is difficult for him to be away from home for a long time, it is inconvenient to spend the night at a party. He is constantly afraid that new acquaintances will find out about his problem and take it negatively.
When is it necessary to see a doctor?
Many parents mistakenly consider enuresis to be a temporary childhood problem. Moreover, punish or scold the child for it. Yes, enuresis can go away with age by itself, but deep mental trauma will not go anywhere. It can develop into a neurosis or a more serious mental illness.
Howonly the parents noticed in the child the fact of a repeated lack of control over urination, the problem should be addressed to specialists: a pediatrician, a nephrologist, a neurologist, a urologist, an endocrinologist, a neuropathologist, a child psychologist. In fact, doctors prescribe additional tests and examinations.
Be sure to consult a doctor in the following cases:
- If the baby starts wetting the bed again for a long time after completely weaning from diapers.
- If day and night he can hardly control the urge to urinate.
- If a child continues to urinate in both bed and panties after he is 5 years old.
Also, pay attention to additional warning signs that require an immediate visit to the doctor:
- Baby feels the urge to urinate more than usual.
- Complains of burning when urinating.
- The child suffers from intense unreasonable thirst.
- The baby has swelling on the feet and ankles.
- Enuresis returned to the child after a long break.
Diagnosis
The diagnosis is determined by a specialist on the basis of a visual examination of the patient, his medical history, complaints about the symptoms of both the child and his parents. The doctor will definitely ask the following questions:
- Does the baby have problems holding urine during the day?
- Are there periods of time when he does not suffer from enuresis?
- What is the familythe history of this disease - did parents, close relatives suffer from it?
- How often does a child suffer from enuresis?
- Does he snore at night?
- How does this problem affect the child, his communication with family, peers, others?
- What treatments did you use yourself?
To clarify the diagnosis, the doctor may prescribe a urine test for analysis, offer to keep a 24-hour urination diary, where parents should enter the amount of fluid the child drinks and urine excreted by his body.
Drug therapy
Are there bedwetting pills for children? Yes, but such funds cannot be prescribed independently. They must be prescribed by the attending physician if necessary.
In particular, "Minirin" is prescribed for children with enuresis. This is a hormonal drug. It contains synthetic hormones - the very ones that are lacking in patients with enuresis. Accordingly, it will be effective only in relation to those children whose lack of control over urination is caused by problems with the nervous system. If the cause of enuresis is, for example, urology, Minirin will be powerless.
As for "Driptan" in children with enuresis, reviews about the drug are also ambiguous. Far from all patients, the drug helped. One of the parents notes its complete uselessness, someone - temporary help. We can say that its effectiveness is individual. Such tablets for enuresis in children haveside effects - in particular, rashes on the skin. They are prescribed only in case of serious problems with enuresis. The indication for use is urinary incontinence caused by both neurogenic disorders and motor incontinence. In particular, the medicine is prescribed for children's enuresis.
Among the alternative means are "Atarax", "Pantocalcin". But again, the benefits of treatment vary from person to person. Drugs are not equally effective for all patients.
Among non-drug methods, a bedwetting alarm collects a lot of feedback. There are many patients to whom this method helped to cope with enuresis. But there are those who noted its uselessness in their case. The authors of the reviews highlight the high cost of such treatment.
Home Treatment
We analyze the causes and treatment of enuresis in children. As for the latter, psychotherapy also plays a significant role. Moreover, not only in the office of a specialist, but also at home. Often there are symptoms of enuresis in children in response to the emotional state of the parents. As soon as the situation at home returns to normal, the disease recedes.
Experts advise parents to:
- Never scold, punish or humiliate the child for this problem. Such behavior will only aggravate the situation, cause the child to feel guilty, ruin his self-esteem. And perhaps leave a mental trauma for life.
- If enuresis occurred abruptly, it was most likely caused by a traumatic situation. Talk softly to your child aboutworries him. Remove the cause. The disease may go away with it.
- When talking to your child about enuresis, always be gentle and tactful. Be sincere, attentive to the problems of the baby. He must be sure that you accept him as he is, do not judge and always protect.
- Never discuss a delicate problem with strangers in front of a child. This can forever deprive you of his trust, aggravate the baby's guilt for the disease.
- Educate your child to be responsible for their condition. Give him the idea that treatment will definitely help him.
- Create a daily routine, a drinking regimen for the child and try not to deviate from it.
- Restrict, as far as possible, the child from irritating, exciting influences during the day and especially before bedtime. Here he should not experience strong emotions and worries.
- In the evening, reduce the amount of liquid your child drinks. Limit your intake of vegetables, fruits, and other "watery" or diuretic foods during this time.
- Make sure your child emptys their bladder before bed.
- The bed in children suffering from enuresis should be hard. If the child sleeps soundly, then it is better for adults to turn him lightly several times at night.
- Wet clothes, wet underwear should be changed immediately. It is great if the child will actively participate in this process (of course, voluntarily).
- Protect your child from hypothermia, long walks and situations where the urge to urinate failsgo to the toilet immediately.
- Give your child as much time as possible: walk with him longer in the fresh air, read together, be creative, play educational games. After all, when a child's hands are involved, it helps to get rid of emotional overstrain.
Enuresis is a more serious disease in terms of psychology. If control over the urges of the bladder in most children with age still appears on its own, then the psychological trauma from improper treatment or its absence can remain for life.
