After the "Bedwetting" that leaked from the domineering side, it was all over the Internet
"What's wrong with me wetting the bed" was brainwashed in a cycle
Parents seem to have had to wash this sheet
Then wetting the bed
It's really a "what's wrong"
Can it be skipped?
NO!
Your baby wets the bed frequently
May be enuresis
Parents pay attention
What is enuresis?
Enuresis in children, commonly known as bedwetting, refers to the average number of people aged 5 years and older who urinate at least twice a week in a state of nocturnal unconsciousness and persist for more than 3 months. Children who are tired or who occasionally wet their beds by drinking too much water before bedtime are not counted.
What are the classifications of enuresis?
Classification by etiology
Primary enuresis: bedwetting begins at an early age and there is no previous record of not wetting for more than 6 months.
Secondary enuresis: previously bed-free for up to 6 months or more, and now bedwetting is happening again.
Classified by concomitant symptoms
Non-monosymptomatic enuresis: accompanied by one or more lower urinary tract symptoms during the day. (Decreased frequency or frequency of urination, urgency, urinary incontinence, delayed urination, etc.)
Unsymptomatic enuresis: not accompanied by lower urinary tract symptoms during the day.
What are the causes of enuresis?
Enuresis is caused by a mismatch between nocturnal urination, nocturnal bladder storage capacity, and sleep-wake capacity.
◇ If the child's bladder storage capacity is normal, once the "vasopressin" is missing, the urine output increases at night, and the bladder cannot store excess urine;
◇ If the child's bladder storage capacity is small, it will not be possible to store the normal urine secreted throughout the night;
◇ If the child's bladder dysfunction, anatomical factors or urinary tract infection, can lead to a decrease in the body's reabsorption of water, resulting in an increase in urine output at night;
◇ If the full bladder does not transmit the information to the brain that needs to be urinated in time, or the brain center is delayed and cannot stimulate awakening in time, and the child cannot wake up from sleep to go to the toilet, the bladder will urinate on its own due to overfilling;
◇ If the child's daily defecation habits are not good, the feces will be backlogged for a long time, and it will compress the bladder, and the bladder will not urinate involuntarily because of stimulation;
◇ If the child's mental tension, anxiety and psychological pressure are too large before going to bed, it will cause the control of the sleep center to be disturbed, resulting in abnormal sleep, and often cannot wake up from sleep;
◇ If your child drinks too much of a specific beverage before going to bed, it will also cause bedwetting.
Children who frequently wet the bed often show that they are afraid to take friends home to play, dare not participate in group activities, dare not spend the night outside during the New Year's Festival, and are afraid of waking up to find "wet sheets". At the same time, children's bedwetting also seriously affects the quality of life and emotions of parents.
What is the effect of enuresis?
Bedwetting has a greater psychological and social impact on children. At present, bedwetting plagues 6%-10% of children aged 7 and above, making children extremely vulnerable in social interactions, and therefore feel self-blame, guilt, embarrassment, etc. These bad emotions accumulate to cause children with impaired self-esteem, anxiety and tension, social withdrawal, ADHD and other issues, if not paid attention in time, it may continue to affect adulthood.
Bedwetting can affect growth and development in children. Sleep is an important physiological process to promote children's growth and development, the human body secretion of growth hormone often reaches a peak within 1 hour after deep sleep, and bedwetting children are often accompanied by a long sleep incubation period, short sleep duration, sleep anxiety, night awakening, daytime sleepiness and other problems, if the deep sleep time is insufficient, the accumulation of time will be because of the relative lack of growth hormone and lead to short stature, developmental delay and so on.
In the face of the situation of children's enuresis, there are still many family members who think that "bedwetting is not a disease, it is naturally good to be big", but ignore the children's psychological appeals; there are also family members who "rush to the hospital", "holy water", "pig bladder" and other folk remedies that try everything, forcing children to swallow bitter water, and can not get timely and formal treatment; more parents think that "bedwetting" is the child's fault, regardless of the scolding and punishment of the child.
These may lead to the child's condition can not be effectively controlled, increasing the child's psychological burden. Bedwetting is not anyone's fault, this is a common symptom of the disease, it can and should be properly treated, family members should adjust their understanding of the disease, timely take the child to the doctor and clarify the cause.
What should I do in the face of enuresis in my child?
Balance all aspects of everyday life
Diet: less oil, less salt, light diet, less spicy or calcium-rich foods, dinner at least 2-3 hours apart from bedtime;
Drinking water: drink water normally during the day, avoid eating foods or drinks containing theophylline and caffeine, do not ignore the amount of water taken on weekdays, drink water for dinner and after meals should not be excessive, start 1 hour before going to bed to 8 hours after bedtime to limit water intake;
Defecation: constipation and enuresis have a certain correlation, train to develop the habit of daily regular defecation, ensure appropriate drinking water and postprandial activities, balance dietary structure, ensure a certain plant fiber intake, and use less drainage drugs as much as possible;
Urination: empty the bladder before going to bed, urinate at least once after dinner to bedtime, cultivate good urination habits, and do not hold urine;
Sleep: Observe the child's sleep, improve the sleeping environment, take warmth and comfort as appropriate, avoid strong light stimulation, encourage children to sleep alone, develop fixed work and rest habits, and should not overactivate activities or watch TV, play mobile phones, etc. before going to bed.
Timely consultation, regular diagnosis and treatment and follow-up
At the age of 6, it should be actively sought to see a doctor, with the help of a doctor, it should be determined as soon as possible whether enuresis is caused by psychological, social or physical causes, and at the same time, to assess whether growth and development are affected as a result, and actively cooperate with drug therapy if necessary;
Carry out urine control training before and urine before urination, select alarms, alarm clocks or dry bed measures according to the situation, implement reward mechanisms, and actively encourage children to get up and urinate on their own;
Insist on writing a "urination diary", pay attention to the reactivity of drugs or interventions, regularly follow up to evaluate the effect of drugs, and pay attention to children's emotional and psychological changes.
bibliography:
Chinese Collaborative Group on The Management of Enuresis Disorders in Children. Expert consensus on the management of monosymptomatic nocturnal enuresis disease in Children in China[J]. Journal of Clinical Pediatrics, 2014, 32:970–975.
Wang Guanghai, Jiang Fan. Sleep Health and Common Sleep Disorders in Adolescents[J]. Chin J Pediatrics, 2019, 57:733–736.
Ma Yanli, Shen Ying, Liu Xiaomei. Advances in the diagnosis and treatment of nocturnal enuresis in children[J]. Chinese Journal of Practical Pediatrics Clinical Journal, 2018, 33:1348–1350.
Geng Xinling,Wu Jianyong,Gao He. Brain structures associated with sleep. World Journal of Sleep Medicine[J]. 2015,42:105-109.
[5] Maternik M. Understanding of and misconceptions around monosymptomatic nocturnal enuresis: fifindings from patient and physician surveys. J Pediatr Urol 2018;15(1):e1e37.
[6] Von Gontard A.Equit M. Comorbidity of ADHD and incontinence in children. Eur J Child Adolesc Psychiatr 2015;24(2): 127e40.
[7] Tryggve Neve us. Management and treatment of nocturnal enuresisdan updated standardization document from the International Children’s Continence Society.Journal of Pediatric Urology 2020;16,10e19.
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Expert introduction
Chen Zhiheng
Chief Physician, M.D., Master Supervisor
Deputy Director of the Department of Pediatrics, Third Clinical College, Central South University, Deputy Director of the Department of Pediatrics, Third Xiangya Hospital
He is currently a member of the Children's Health Care Youth Committee of the Science Branch of the Chinese Medical Association
He is a member of the Scientific Society of Hunan Medical Association
Member of the Genetic Diagnosis and Standardization Branch of the Asia-Pacific Society of Biomedical Bioimmunology
Deputy Leader of the Developmental Behavior Group of Hunan Medical Association
He graduated from the Institute of Endocrinology of the Second Xiangya Hospital with a master's degree in 2005 and a doctorate in 2014
In 2014, he was sent by the hospital to study at Rainbow Children's Hospital in Cleveland, USA, and from December 2016 to December 2017, he was sent by the National Scholarship Council to ohio State University in the United States as a visiting scholar for one year
He has been engaged in pediatric clinical, teaching and scientific research work for more than 20 years, presided over one project of the National Natural Science Foundation of China, 2 natural science foundations of Hunan Province, and participated in a number of national and provincial scientific research projects
Main research directions: pediatric endocrinology, growth and development, short stature, precocious puberty, child health, genetic metabolic diseases
Liu Lin
Deputy Chief Physician, Ph.D
Member of the Disease and Immunization Group of pediatricians branch of Hunan Medical Doctor Association
Member of Pediatric Nephrology of Hunan Medical Association
He has presided over one National Natural Science Foundation of China and one Provincial Natural Science Foundation, participated in a number of national projects, and published many SCI papers.
Main directions: blood diseases and critical illness, growth and development, enuresis, children's kidney disease.
Consultation hours: Every Thursday afternoon
Author / Chen Zhiheng Liu Lin
Editor / Zhang Jingming
Audit / Kai Jiang
Editor-in-Charge / Shan Li
Provenance / Pediatrics Second Party General Branch
Produced / New Xiangya WeChat Creative Circle
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