Physicians and parents should not "ignore" children with nocturnal enuresis after they have reached 6 years of age(27). DO NOT accept "He'll grow out of it" as an acceptable solution. There can be significant psychosocial consequences when physicians and parents do not treat older children with enuresis. Parents do have treatment solutions that can eliminate years of wetting for the majority of children with nocturnal enuresis.

Do Not Punish Your Child. Unfortunately, findings suggest that 20-36% of parents have punished their children for bedwetting. (28,29) Punishment can take the form of withdrawal of privileges, increased expectation of household chores (cleaning and laundry) and can even escalate to verbal and physical abuse. Since these children have no control over their wetting, punishment is inappropriate.

The way in which parents approach the child with enuresis can be a source of conflict between parents — especially since there is no one cause and treatment. The parent who was enuretic themselves may share some experiences but may choose not to relive the humiliation they felt. Often this wasn't previously discussed with their spouse. The extra workload of changing bedding and getting the child up during the night may cause even the best parents to become frustrated with their child.

Children with Enuresis Often Have Lower Self-esteem (30) and a Less Positive Self-concept (31,32). Children with enuresis often go to great lengths to hide their wetting from other family members and their friends. Parents report finding wet sheets and clothing while their child denies that they wet. Avoiding sleepovers or making excuses to be picked up early are common. As the child reaches middle and high school, overnight school trips and camps are avoided. Since developing independence is a normal developmental task at this age, enuresis can impact this. Shame, inferiority, and feelings of isolation are common. Often the child feels they are the only one with this problem.

Treatment is Beneficial. Research does indicate that these feelings dissipate once the enuresis in cured. Children who have received treatment for nocturnal enuresis have improved scores in social behavior and self-concept(31,33). Frequent follow-up with emotional support and encouragement are important components of successful treatment for children with enuresis. (34)



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