Red Network Moment News, March 7 (Correspondent Wu Liang) Enuresis, on the one hand, will affect the psychological development and social behavior of children, making them more likely to have low self-esteem and rebellious behavior; On the other hand, it will also bring a lot of pressure and trouble to the parents of the child, how to avoid enuresis leading to "wetness"?
1. Adjust work and rest habits: establish a regular work and rest, encourage children to drink water normally during the day, and ensure daily water intake. Avoid foods or drinks containing theophylline or caffeine. Dinner should be early, and should be light, less salt and less oil. It is forbidden to drink water 2 hours before going to bed, including porridge soup, milk, fruits, juices and other foods with more water.
2. Reward mechanism: parents should not blame the child, but should give more encouragement, reduce the psychological burden of the child on the disease, and let him actively participate in the treatment process.
3. Develop good urination and defecation habits: develop a good habit of regular urination during the day and urination before going to bed. Eat more fiber-rich foods, defecate regularly every day, and actively treat constipation at the same time for children with constipation.
4. Record nocturnal urination: Continue to record a nocturnal urination diary during treatment, which can simply record whether it reaches a dry bed to help judge the condition of nocturnal enuresis and guide treatment.
5. Behavioral therapy
These include controlling fluid intake, adjusting the timing and structure of eating, training in normal urination and bowel habits, and establishing appropriate reward feedback mechanisms. Controlling fluid intake is not simply about limiting water, it is important for each child to ensure adequate daily water intake, and it varies depending on the amount of exercise, environment and diet of the child. If water intake is inadequate, it may mask underlying bladder disease and prevent normal bladder capacity from forming. The correct way is to ensure daytime fluid intake, control fluid intake before going to bed, that is, the recommended water intake should be guaranteed during the day, which should be: 4~8 years old children, both men and women are 1000~1400ml; Children 9~13 years old, male 1400~2300ml, female 1200~2100ml; Children aged 14~18 years old, male 2100~3200ml, female 1400~2500ml.
The above points are beneficial to improve the symptoms of nocturnal enuresis. Involve the child actively in behavioral training as much as possible. Parents should encourage children to urinate every 2~3h during the day and empty the bladder before going to bed. In addition, because constipation is closely related to enuresis, parents should treat their children in time if they find that their children have constipation, which is of great benefit to cure enuresis.
6. Wakefulness treatment: including alarm and alarm clock wake-up training.
Enuresis alarm: It is a device that can be placed on the bed or the child's underwear, and can issue a warning (sound or vibration, etc.) when enuresis occurs, so as to wake up the child to urinate.
Indications: For children whose education and guidance are ineffective and whose parents have a certain level of education can be considered. Continuous use for 2~3 months can generally obtain satisfactory efficacy, until at least 14 consecutive nights without enuresis can be considered.
Its mechanism of treatment of enuresis:
(1) Help children establish a normal mechanism of urinary awakening during sleep;
(2) Improve the urinary storage function of the bladder at night.
Alarm clock wakes up training
Alarm clock setting timing, sound selection, feedback methods, etc. require individualized solutions, and it is especially important to obtain the active cooperation of children and parents before treatment to assess whether the conditions are conducive to alarm clock treatment. The Enuresis Clinic of Beijing Children's Hospital has used alarm clock wake-up training to treat children with enuresis with different conditions, and has achieved good results in long-term follow-up guidance. Since children with monosymptomatic nocturnal enuresis generally do not have organic lesions, treatment should be given the correct education and guidance first. The disease can be self-limited, and some children can gradually disappear with age, so drugs or other special treatments are generally not taken for children before the age of 6. Most children with single-symptomatic nocturnal enuresis can achieve cure with behavioral therapy and arousal training therapy alone.
"My child wets the bed once in a while, is it enuresis?" This situation does not count. At present, the diagnostic criteria formulated by the International Pediatric Urinary Control Association are mainly used in mainland China: children aged 5~10 years old are at least 2 times a month; > at least once a month for 3 ≥months at least once a month for 3 months, normal urination occurs at inappropriate or socially unacceptable times, i.e., children with enuresis urinate in bed while sleeping; The amount of urine can soak the sheets and usually does not wake up from wet urine; There is a genetic predisposition. Therefore, the child occasionally wets the bed once and cannot make a diagnosis of enuresis.
"Why are they all children with enuresis, some getting better quickly, and some children seem to have no effect?" Like all diseases, enuresis is also severe, and the severity of enuresis can be judged from 4 aspects:
1. Age: It depends on the relationship with the secondary sex characteristics period, many children with enuresis suddenly heal themselves before and after the secondary sex characteristics period, if there is still enuresis during this period, then it means that its physiological development process is somewhat delayed.
2. Enuresis: Enuresis only once a night is only moderate enuresis, if the child is so many times a week, or occasionally enuretic, it means that the end of victory is near.
3. Criteria for enuresis time period: the earlier the time of the first enuresis at night, the more severe the condition.
4. Diaper range and difficulty criteria for awakening: the more difficult to wake up, the larger the wet range, the more serious the condition.
Criteria for determining the severity of enuresis:
Note: Mild 4-6 points; Moderate 7-9 points; Severe 10-12 points.
If there is no enuresis alarm, how can parents wake up correctly at night?
The Expert Consensus on the Management of Unisymptomatic Nocturnal Enuresis in Children in China, formulated by the Chinese Pediatric Enuresis Management Collaborative Group, proposes the correct nocturnal awakening method.
Timing of arousal: do not wake the child to urinate at will, but should wake up when the bladder is full and about to urinate. This method strengthens the nerve reflex of "nocturnal urination-arousal" and shortens the duration of enuresis.
The following methods can be used to determine that the bladder is full and awaken the child to urination:
(1) The child suddenly turns over or other agitated manifestations during quiet sleep;
(2) According to the time pattern of enuresis in the past, wake up urination before enuresis.
In order to make the time of enuresis more regular and convenient for parents to grasp the awakening time, children can be required to implement the "three certainty" principle in life: dinner time, sleep time, dinner to bedtime drinking quantitative. Under the principle of "three determinations", the amount of urine produced at the corresponding time at night is relatively stable, and the occurrence time of enuresis will be relatively fixed.