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Enuresis or bed-wetting refers to
involuntary passage of urine while asleep. It is a common
problem in infants and young children. It is regarded as
a period of adjustment. By the time a child reaches the
age of two years, he can usually learn to control the
passage of urine during the day. However, it may be
another year or so before he can achieve control all
through the night.
Enuresis may be primary, in which case normal control was
never achieved at any stage, or enuresis may be
secondary, where the child starts wetting the bed after
an initial period of normal bladder control. Bed-wetting
in certain cases may go on until the fourth or fifth
year, without the child being abnormal. Even then the
best trained child may fail to live up to expectations on
certain occassions, when he is highly excited. Some
children are chronic bed-wetters all the way into their
teens. This situation becomes one of irritation and
concern for the parents.Causes
Most cases of
bed-wetting are caused by psychological or emotional
disturbances, generally resulting from lack of security,
resentment or anger towards parents, fear and anxiety.
This may account for as many as 90 per cent of cases. The
remaining 10 per cent cases may be due to worm
infestations or urinary tract infections, diseases like
childhood diabetes, paralysis of spine and epilepsy.
Enuresis may also appear during serious illnesses.
Treatment
Punishment plays
no part in the successful treatment of this condition.
The child should not be made to feel guilty. This may
cause him to lose confidence in himself and rob him of
his self- respect.
The parent should ensure that the child who faces this
problem has plenty of sleep and rest and a pleasant home
environment. The following suggestions may help the child
overcome the problem of bed-wetting.
- Reduce the amount of
fluid just before child goes to bed. Do not be
unreasonable, especially on a hot night, for the
more concentrated urine may be irritating the
child and causing him to lose control of his
bladder during sleep.
- Do not be overanxious
about this problem. Making an issue of it may
only prolong the problem. Try to keep the child
relaxed, even if he is a little slow in
overcoming this habit.
- Make the child void
his bladder before going to sleep, especially if
this is a frequent problem.
- Be sure to reward him
in an appropriate manner when he succeeds in
keeping dry at night. Do not punish him when he
fails.
- Give your child a
happy home of which he can be truly proud. Try to
remove all friction within the family. This may
help to solve not only the bed-wetting but all
other nervous problems as well.
In regard to physical
treatment, the child should be placed on an all-fruit
diet for few days. If possible, he should be given warm
water enema daily during this period to cleanse the
bowels. He should also be given cold sitz bath daily. The
procedure is to fill an ordinary bath tub with cold water
to a depth of four inches or so. The child should sit in
it in such a way so that his feet and sexual organs are
immersed for the most part in water. Only the seat and
feet should touch the bottom of the tub, while the knees
are always above the water.
The knees should be kept apart and the water should be
vigirously dashed over the abdomen with the hollow of the
hand. The throwing of the water is then followed by a
brisk rubbing of the abdomen with both hands. After this
process has been carried on for a while, all the parts
immersed in the water except the sexual organs
themselves, should be rubbed vigorously with open hand
and then dried with a rough towel. When the child becomes
stronger, the rubbing -dry process should be carried out
with the hands. This is in itself a good exercise and
improves the condition of the skin.
This will help tone up the bladder. Bed-wetting in
children of fairly advanced stage is usually due to
mental strain, induced by over-stimulation of the brain
through excessive school work, and incitement by parents
to learn too much. In these cases, the child should be
given plenty of rest and quiet and freedom from all undue
mental activity and nervous excitement.
An excellent home remedy for bed-wetting is the use of
mixture of sesame seeds (til) and bishop’s weed
(ajwain). About 24 gms. of sesame seeds should be mixed
with 12 gms of ajwain and 36 gms. of jaggery. About 6
gms. of this confection should be given to the child in
the morning and evening. This will bring good results.
Fresh air and outdoor games are also helpful in the
treatment of bed-wetting in children. The child should be
encouraged to spend as much time outdoors as possible and
play outdoor games in preference to indoor ones.
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