Monday, August 24, 2009

53) Problem Situations (continued)

In ten posts(16 to 25), we covered some problem situations that parents face. We took a break to touch on other topics. Now, we shall revert to five more situations, as promised in post 26.

BED WETTING

Parents with children who bed wet are a flustered lot, not knowing how to rid their children of the vexing problem. The more they panic, the more the child is distressed, and the more serious the problem becomes. So, lesson number one is NOT TO PANIC, although it must be acknowledged that the problem cannot be wished away.

Here are some facts on bed wetting:
01) It is more common among boys than girls, in the approximate ratio of 3:1.
02) It is estimated that about 20% of children in the 5 and above age group, bed wet.
Usually, the problem could start when the child is about 5, though cases are know when children are embarrassed at a younger age.
03) It is not because of poor toilet training.
04) It happens mostly because the child has not achieved bladder control.
05) It is not a disease.
06) The reasons why it happens in some children and not others, is not clearly established. Only assumptions are made.
07) In such children, the level of Antidiurectic Hormone(ADH), which suppresses urine formation at night, could be low.
08) Deep sleepers find it difficult to wake and empty their bladders.
09) Stress at school, among siblings and in the home, could worsen the problem.
10) Even after the problem is solved, there can be a relapse triggered by death in the family, divorce of the parents, arrival of a new sibling and child abuse.

Children with a bed wetting problem develope low self esteem because of being teased by siblings and peers. It is traumatic for them to be excluded from school camps and over night picnics with classmates. Worried parents scold these children, mistaking their behaviour for defiance or an attention-getting gimmick. Scolding and threatening do not help. Impatient and impulsive parental response distress children,
at a time they most need understanding and support. Parents should know that children will not stoop to lower their own self image, just to frustrate them. Confident of their own children, supportive parents try some of the precautions listed below:

01) Provide a night lamp in the child's bedroom so that he does not have to go the toilet in the dark. To some children darkness is terrifying.
02) Cover his mattress with a plastic sheet, to prevent soiling it.
03) Check if the child is stressed in any way and gently reassure him that his anxiety can be addressed.
04) Work on a reward system for the nights he does not bed wet.
05) Persuade him to delay urinating during the day, so that he gains better bladder control.
06) Limit his liquid intake before bed time.
07) Despite these steps, when he wets his bed and his night clothes, get him involved in the cleaning. He should wash himself and deposit the soiled clothes and sheets in a bucket with water, to soak the soiled items. In the morning, he should join his mother in rinsing the clothes.
08) Huang Huifen, in an informative article on bed wetting in the Straits Times, of July 02, 2009, recommends the use of an Enuresis Alarm. The alarm is set, say for 3AM, when the little fellow responds to the buzz and goes to the toilet. The gadget has a sensor which is attached to the child's undergarments. When the senor detects moisture in the underwear, the alarm goes off, waking the child before he bed wets.

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