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Bed Wetting

Summary

Enuresis, or bedwetting, is the involuntary passing of urine during sleep in children over the age of five. It is a common condition that often improves with time but can be distressing for both children and parents.

While bedwetting is usually not a sign of a serious medical issue, certain conditions such as diabetes, urinary tract infections, neurological disorders, or emotional stress may contribute to it. A healthcare provider may evaluate these possibilities if bedwetting is persistent or associated with other symptoms.

Diagnosis and When to Seek Help

It is important to seek medical advice if bedwetting:

  • Persists beyond the age of five without improvement
  • Is accompanied by pain, excessive thirst, or unusual daytime urination
  • Begins suddenly after a long period of dryness
  • Occurs alongside other symptoms such as constipation or behavioral changes

A doctor will assess the child’s medical history, perform a physical exam, and may conduct urine tests if needed to rule out underlying conditions.

Management

Most cases of bedwetting improve with time, but several approaches can help:

  • Behavioral strategies:
    • Encouraging regular toilet trips before bed
    • Reducing fluid intake in the evening
    • Using waterproof mattress covers to reduce stress and inconvenience
  • Alarm therapy: Bedwetting alarms can help train the child to wake up when their bladder is full.

Medication: Desmopressin, a medication that reduces urine production at night, may be used in some cases, especially for short-term control (e.g., sleepovers).

Follow-Up and Monitoring

Providing emotional support is key, as bedwetting can affect a child’s confidence. Avoiding blame and using positive reinforcement can help reduce stress and improve outcomes.

With patience, reassurance, and appropriate management, most children outgrow bedwetting successfully.

History and Exam

Key diagnostic factors

  • Presence of risk factors
  • Increased fluid intake at night
  • Urinary frequency
  • Constipation

Other diagnostic factors

  • Abnormal voiding habits
  • Abnormal breathing pattern at night

Risk factors

  • Genetic predisposition
  • Constipation
  • Upper airway obstruction/sleep-disordered breathing
  • Attention deficit hyperactivity disorder (ADHD)

Diagnostic Investigations

1st investigations to order

  • urinalysis

Investigations to consider

  • urinary tract ultrasound

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    Other Related Conditions

    ASTHMA

    CONCERNS REGARDING GROWTH

    FEEDING PROBLEMS

    CONSTIPATION

    BED WETTING

    SEIZURES

    SLEEP DIFFICULTIES

    CHALLENGING BEHAVIOURS

    AUTISM SPECTRUM DISORDER

    LEARNING DIFFICULTIES

    ADHD & Oppositional behaviours

    LANGUAGE DISORDERS

    TICS & TOURETTES DISORDER

    ANXIETY

    DEPRESSION

    INFECTIONS

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com