14 tips to prevent nocturnal enuresis in children

Some practical tips to help your little ones avoid bedwetting during sleep.

Most children have wet the bed at some time. This, which is seen as something normal in most cases and which will eventually be solved, can be a real headache for parents when the problem becomes chronic.

Nocturnal enuresis is a real problem that requires treatment and understanding.It requires treatment and understanding on the part of adults towards the child. Neither the child is to blame nor does it on purpose, however, this does not mean that nothing can be done to avoid it.

Let's take a look at some tips to prevent children from wetting the bed during sleepWe also need to understand to what extent it is necessary for the child's family to have a good understanding of the problem.

What is nocturnal enuresis? Brief definition

Bedwetting is one of the most common problems in childhood.. According to the DSM-5, enuresis is the inappropriate emission of urine at least twice a week for at least three months in children over five years of age.

This problem can be a great interference in the child's life, since none of them wants to urinate on themselves, something that can cause problems in terms of socialization, autonomy and emotional state, generating high levels of anxiety.

Tips to avoid nocturnal enuresis

Follow these guidelines to avoid the recurrence of nocturnal enuresis.

1. Controlling what is eaten and drunk

The child should consume liquids, but their intake should be reduced after 7 p.m. and, above all, the child should drink less, avoid drinking them during the two hours before bedtime..

It is especially important to avoid consuming caffeine-containing beverages, such as tea, coffee or cola, since this methylxanthine has diuretic effects, i.e., it contributes to the formation of urine.

At dinner time, a light meal should be taken, without too much salt or sugar.without too much salt or sugar.

2. Going to the bathroom before going to bed

Although it may seem an obvious choice, you should make an effort and go to the bathroom before going to bed, to ensure that the bladder is as empty as possible and thus avoid nocturnal accidents.

3. Have easy access to a sink

Related to the previous point, sleeping in a room far away from the bathroom can make it difficult for the child to get up and urinate.

The best solution for this is to ensure that he sleeps at a point close enough to the bathroom so that he does not get lazy about having to get up and urinate.

Obstacles should also be avoided between his room and the bathroom and, if necessary, night lights should be placed to mark the way so that he is not afraid to go. If necessary, place a portable urinal in the room.

4. Use diapers

Regarding this point, the opinions of the experts are quite varied. There are those who consider that it is not at all advisable to use diapers in children and adolescents who have problems of nocturnal enuresis, while others recommend them on an ad hoc basis.

The reason why some professionals do not recommend the use of these diapers is that they interfere negatively in the child's motivation to learn to control his sphincters and to wake up dry the next day. They can make the child, when he/she feels the urge to urinate, instead of getting up and urinating, prefer to stay in bed, knowing that the diaper will take care of the bedwetting.

On the other hand, those who advocate the use of these diapers say that they help children feel more secure and self-confident..

Whichever option is more accurate, it is advisable to ask a pediatrician about whether or not the use of diapers is appropriate for the child in question.

5. Controlling the child's belly

It may be the case that the child has constipation problems, which can lead to less bladder control. This is due to the fact that the intestines, full of feces, pressure on the bladder, decreasing its capacity to hold urine..

A good way to get your child to urinate less is to introduce more fiber foods into the diet, such as fruits and vegetables. Once the constipation is overcome, he may see his urinary control increase.

6. Avoid blaming the child

The child has wet the bed, but it's not his fault and he didn't do it on purpose.. It should be understood that the child who suffers from nocturnal enuresis problems does this because he/she has no control over it, due to a problem in maturation.

Blaming the child and punishing him/her for bedwetting will only make the situation worse.

7. Be understanding

Parents or legal guardians should show that they are on the child's side, that they do not blame the child for the problem, and that they want the best for the child.

You should avoid making a drama every time the child wets the bed. If it so happens that a family member also suffered from bedwetting as a child, you can use him/her as an example that it is something that sometimes happens and that, with the passage of time and with a little effort, it can be overcome..

8. Do not bring up the subject when it is not the right time

When it happens, you should comment on what is happening, but you should not talk more than necessary on the subject, and much less when you are in front of family or acquaintances.

It is not that you should treat the matter as if it were a taboo subject, but you should not shout out loud that the child wets the bed. If you do, the child may feel humiliated and this may not only cause a trauma, but also a worsening of the bedwetting..

9. Make the child responsible for its improvement

As we have already mentioned, the child is not to blame for wetting the bed, nor does he do it voluntarily. This does not mean that the child should not be made to share certain responsibilities related to the problem.

If he has wet the bed, instead of changing the sheets for him, he should assist in the process.. He should also change his own pajamas.

10. Frequent urination

To prevent the child from relieving himself during the night in bed, he can be taught to go to the bathroom with a certain frequency, such as two or three hours. This will prevent the retention of too much urine in the bladder and avoid unwanted accidents during the night.

11. Waking the child

If necessary, the child can be awakened once during the night to make sure that he/she does not have to urinate and, if so, to go to the bathroom and relieve him/herself.

This should be done gently and only once a night.. Doing it too much or too often can have a very negative effect on the child's necessary rest.

The purpose of this is to prevent the child from wetting himself at night and to solve this problem, not to cause insomnia that will then turn into drowsiness the next morning when he is at school, clearly affecting his academic performance in a very negative way.

12. Write a dry night diary

This tool can be very can be very useful to have a long-term perspective of the successes achieved by the child.. In this diary you can write down the nights when you have managed to keep the bed dry and also those when unfortunately it has been wet.

With this you can have a more objective measure of the success of the treatment, in case the child is undergoing one of them, and also the application of the tips described above.

13. Bladder training

Bladder training exercises are actions that a child with bedwetting problems can do that allow him or her to have better control over his or her sphincters.

For example, he/she can practice holding the urge to urinate for a short period of time during one hour of the day or go to a bathroom, start urinating and stop the stream for a few moments and then start urinating again..

14. Make the child understand that he/she must get out of bed to urinate.

Instead of crossing your fingers so that your child does not urinate on himself tonight, it is better to convince him how important it is to go to the bathroom before going to bed and, if he already feels the urge to go to bed, to make an effort and go to the toilet.

The alarm method or Pipi-Stop

Although the tips explained here are useful to help overcome the enuresis that the child may suffer from, seeing a psychologist and pediatrician to initiate appropriate treatment is imperative, especially if the situation is serious.especially if the situation is serious. In cases where the child finds it very difficult to wake up to urinate or where enuresic episodes occur between 5 and 7 times a week, one of the most popular and effective treatments is the alarm, also called Pipi-Stop.

This technique, developed by Mowrer and Mowrer, consists of a device that is placed in the pants of the patient. a device that is placed in the child's pants, which is activated when the first drops of urination occur.. Once this happens, the device makes a noise, waking the child and stopping the urine emission. Thus, once the child is awakened, he/she goes to the bathroom to relieve him/herself. In this way, through classical conditioning, the child associates the urge to urinate with waking up.

This method will help the child to be more aware of how much he/she wants to urinate while sleeping, preventing bedwetting and, over time, having better sphincter control, combined with an increase in self-esteem and a reduction of emotional problems that may be associated with bedwetting episodes.

Bibliographical references:

• Bragado, C. (2009). Nocturnal enuresis. Effective treatments. Madrid: Ediciones Pirámide.
• Glazener, C. M., and Evans, J. H. (2004). Simple behavioural and physical interventions for nocturnal enuresis in children. Cochrane Database Syst Rev, (2),
• Naitoh, Y., Kawauchi, A., Yamao, Y., Seki, H., Soh, J., Yoneda, K., Mizutani, Y., and Miki, T. (2005). Combination therapy with alarm and drugs for monosymptomatic nocturnal enuresis not superior to alarm monotherapy. Urology, 66(3), 632-635.
• Rodríguez, L., and Gracia, S. (2008). Diagnosis and treatment of nocturnal enuresis. Diagnostic and Therapeutic Protocols of the AEP. Nefrología Pediátrica Asociación Española de Pediatría, 116-126.