Bedwetting in children is often considered a normal part of growing up, and celebrated as a milestone when it stops. When it doesn't stop, it could be a sign of overactive bladder or urinary incontinence.
An overactive bladder is one of the common causes of urinary incontinence. The bladder itself tries to void frequently, often without sending the signal to the brain to warn the child that they need to urinate. This results in wetting during both daytime and nighttime hours.
Urinary incontinence is defined as a loss of bladder control. In children, this often results in soiled clothing or bedwetting at night. While this behavior is common in children still being potty trained, most outgrow it by the age of 3.
The signs and symptoms of an overactive bladder in children might be hard to spot. In general, caregivers should look out for the following symptoms:
- frequent daytime wetting after age 3, or nighttime wetting after age 4
- using the bathroom more frequently, or rushing to the bathroom
- interrupted sleep
The causes of overactive bladder in children can vary greatly from child to child. Some of the most common causes include:
- Caffeine. Found in energy drinks, caffeine is a diuretic that forces fluids out of the body and can lead to more frequent urination. It can also cause muscle spasms in the bladder in high amounts.
- Allergies. Eating or drinking something that the child is allergic to can also cause overactive bladder.
- Anxiety. Situations that case fear or anxiety for a child can also trigger wetting.
- Bladder structure. If the bladder itself is abnormally small or there are some abnormalities in the bladder or connected systems.
- Bladder wall irritation. The bladder may respond to an infection or irritation by voiding frequently, causing the symptoms of overactive bladder.
Overactive bladder can also occur if the body does not produce enough of a hormone called ADH. This chemical slows down the production of urine, and the body tends to produce more ADH at night.
If the body does not produce enough ADH, urine production may not slow down at nighttime. This can lead to the bladder becoming too full and the child needing to urinate.
There are also a number of causes of wetting that relate to the behavior of the child. These include laughter or being too distracted to go to the bathroom in time.
If wetting continues after caffeine has been cut out of a child's diet and allergies and anxiety have been ruled out, caregivers may want to consider a visit to a doctor.
Is it age-related?
Overactive bladder isn't related to age, although many children can outgrow the condition. Overactive bladder can affect both children and adults. While it can occur at any age, it is more common in adults over the age of 40.
Most children outgrow the condition by around the age of 7. Wetting or frequent voiding in small children under the age of 3 is normal and should not be considered a problem.
When to see a doctor
As mentioned above, many children outgrow the condition. If a child is still showing signs of overactive bladder by the time they reach age 7, it should be brought to a doctor's attention. The doctor will be able to offer advice for the best treatment options.
The child's doctor will likely run a series of tests to check for the underlying cause of the symptoms. These tests may include urine samples to check for infection and an ultrasound to look for any abnormalities in the bladder or connected systems.
The most common treatment options usually include bladder retraining and pelvic floor exercises.
Bladder retraining involves putting the child on a "voiding schedule" where they go to the restroom to urinate on a schedule. This helps to slowly train the bladder to hold more and more urine, as it is designed to.
Pelvic floor exercises provide a way to strengthen the muscles that are used to slow and stop the flow of urine and prevent wetting.
If these techniques do not work or seem to have no effect on the overactive bladder, there are some medications that can be used to calm the overactive bladder. However, this line of treatment often results in a return to the wetting behavior after the medications are stopped.
If an ultrasound scan shows that abnormalities in the bladder are causing the wetting, the child's doctor may suggest surgical options for repairing the problem.
Surgery is usually the last option for treatment, however, as most children outgrow their wetting problems and never require surgical intervention.
Home remedies and lifestyle changes
There are a few lifestyle changes that caregivers can consider when trying to help a child with an overactive bladder. These changes include:
- Cutting out caffeine. As mentioned before, caffeine can contribute to or cause an overactive bladder, especially in children. Caffeine can also have a negative effect on sleeping patterns in children, so it may be a good idea to cut it out of their diet altogether.
- Avoiding drinking before bed. This only works for nighttime wetting, but by stopping drinking fluids a couple of hours before bedtime; the risk of nighttime wetting is reduced.
As far as home or natural remedies go, there are a number of herbal remedies that show some benefit for the treatment of overactive bladder. However, these remedies are not regulated by the United States Food and Drug Administration (FDA).
The use of any natural remedies in children should definitely be discussed with a doctor before considering them.
Talking to a child's doctor about their overactive bladder can be an awkward topic. However, it is an important conversation to have, especially if the child has not outgrown their bedwetting or other symptoms.
Caregivers should take the time to learn all they can about overactive bladder and take that information to their child's doctor. The doctor will be best equipped to help caregivers make the best decisions about their child's health.