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 In a new study, children who were punished for wetting the bed at
night were more likely to be depressed and had worse overall quality
of life overall compared to bed-wetters who were not punished.
Nighttime bedwetting, or “nocturnal enuresis,” affects about 15
percent of young children and is three times more common in boys
than girls, according to the authors. Up to a third of parents
punish their kids for bedwetting, they add.
While parents might think punishment will make bedwetting stop, they
should know that punishment can actually make the problem worse,
leading to more frequent bedwetting, more depression and a poorer
quality of life for the child, the researchers wrote in the journal
Child Abuse and Neglect.
Dr. Faten Nabeel Al-Zaben of the Faculty of Medicine at King
Abdulaziz University in Jeddah, Saudi Arabia, and a colleague
studied 65 children ages seven to 13 years old who wet their beds,
and 40 healthy children without a bedwetting problem as a comparison
group.
Next, the researchers divided the children with bedwetting problems
into two groups, those who were punished for bedwetting and those
who weren't.
On average, children who were punished for bedwetting at night wet
their beds more often than the children who weren’t punished.
The punished kids also showed symptoms of depression that were more
severe than the other two groups of kids.
The effect was worst when parents physically punished their kids,
and the more often they punished their children, the more likely the
children were to be depressed and have reduced quality of life
scores.
“Urinary incontinence affects both the child and the family on
several levels. It is often a source of shame and embarrassment for
the affected child, and children who have experienced treatment
failure have a lower self-esteem,” the authors write.
Dr. Max Maizels, a pediatric urologist at the Ann and Robert H.
Lurie Children’s Hospital of Chicago who was not involved in the
study, said that most healthcare workers would agree that punishment
causes problems for kids.
“Most instances of bedwetting, whether they run in the family or
not, have to do with heavy sleep and a sluggish coordination between
bladder signals that say ‘take me to the bathroom’ and a deep level
of sleep that prevents the signals from reaching awareness,” Maizels
told Reuters Health in an email.
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He said that if that coordination is sluggish then the bladder
empties without the child's permission, so anything that can be done
to accentuate the child's awareness will help reduce bedwetting.
“One common thing that can be done is called positive practice,
where children lay in bed before they go to sleep and practice
getting up and going to the bathroom,” Maizels said.
He added that reading children's books about bedwetting before bed
also helps raise awareness.
A change of scenery or temperature may help too.
Maizels said that when families go on a vacation or to Grandma’s
house, they’re startled when the bedwetting that happens with some
regularity at home is reduced while they're away.
“Cold seems to set up bedwetting. Some families have a child's bed
adjacent to an exposed wall and by moving the bed away from the cold
wall it seems to reduce wetting,” Maizels said.
Maizels also said that some dietary changes may help.
“Keep things that may irritate the bladder away from the diet while
the bedwetting is resolving like carbonated beverages, citrus,
melons, caffeinated foods,” he said.
Maizels also explained that constipation can be a big factor in
bedwetting when the over-full bowel puts pressure on the bladder.
“Try laxatives, milk of magnesia or any of the common laxatives,
prune juice, or apple juice works to help with evacuating,” Maizels
said.
SOURCE: http://bit.ly/1w2kaFR Child Abuse and Neglect, online
November 27, 2014.
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