What should parents know?
• Daily urinary incontinence is rare, and mostly in children up to 3-4 years of age.
• "Night" enuresis is a much more common problem, it affects not only children 5 years old (20% of children), but also 10-year-olds (10%), adolescents 12-14 (3%) and even adults over 18 years 1 %).
Enuresis happens:
• primary - is observed in the baby from the first years of life:
• secondary - when incontinence occurs after a significant "dry" period.
There are many causes of urinary incontinence: birth trauma of the central nervous system. disturbance of the production of certain hormones and nervous regulation of the urinary bladder, urinary tract infection, SARS, etc. Heredity is also very important. The most common cause are stresses, neuroses and other psychological factors that, against the background of a weakened state of the body, provoke bedwetting. Neurotic enuresis may be short-lived (as an acute stress reaction) and prolonged (if the psychological stress that has arisen has received some additional reinforcement). The older the baby, the more noticeable the effect of the state of his nervous system on the course of the disease. You can even make a general psychological portrait of children with similar disorders. In the daytime, as a rule, such a child is constantly overexcited, he actively plays, extremely reluctantly agrees to sit quietly, is inclined to hysterics. In the evening, the baby can hardly get into bed, he falls asleep for a long time, even if he is very tired, sleeps restlessly - he can talk in his sleep, constantly move. Parents who closely watch their child at night can notice that the first few hours of sleep are especially restless until the moment of involuntary urination (then the baby is noticeably calming down). To wake a child so that he deliberately sat down on a pot, almost never turns out. In addition, the interrupted sleep disinhibits the child's nervous system, and the next day the baby behaves more actively, which inevitably leads to a new incontinence episode. One of the diagnostic signs of neurotic enuresis is the child's sensitivity to changes in weather and air temperature. In cold weather, incontinence is more common than usual.
If the child woke up wet
The most common mistake is unwillingness to consult a child with incontinence. It is dangerous to think that over time the problem will disappear by itself. This position often leads to a worsening of the situation and the appearance of the child's serious psychological problems. If you notice that the child repeatedly wakes up in a wet bed, consult a district pediatrician. Probably, it is necessary to be surveyed to understand, whether the enuresis is connected with illnesses of kidneys and a bladder. Obligatory blood tests, urine biochemical examination, renal ultrasound of the kidneys and urinary tract, a study of the volume and frequency of urination during the day (the so-called diuresis daily), and in some cases, electroencephalography - to identify areas of the brain with impaired activity. But sometimes you can not immediately identify the cause of the disease. Sometimes the child is referred for consultation to other specialists (neurologist, psychologist, etc.). Clarification of the cause of enuresis is a long and complicated process, but only in this way can an effective treatment be selected. However, the most accurate diagnosis should not push you to self-treatment. Prescribe medication should only be a doctor, since any mistake (in dosage, drug choice, etc.) can lead to even more serious health problems. Drugs are prescribed in conjunction with physiotherapeutic methods (ultrasound, phonophoresis and other procedures) that regulate the functioning of the bladder and normalize the nervous system. To strengthen the muscles of the pelvic floor apply therapeutic gymnastics.
Recommendations for moms and dads
1. Like any other disease, enuresis has its own characteristics in each child, so do not try to drive the baby into any general framework. For each crumb, its own treatment regimen is being developed.
2. If the cause of the disease is stress, then the first thing to do is to eliminate it. A cozy, relaxing atmosphere in the family will make treatment more effective. It may be necessary to revise the family approach to education: in the case of a child with enuresis, any psychological pressure and conflict behavior is unacceptable. The kid needs not just the increased attention of mom and dad, but the unobtrusiveness and delicacy of this attention.
Z.Isli incontinence is provoked by the appearance in the family of a second child, parents will have to think about their relationship with the eldest. Paying maximum attention to the newborn, try to make your older child feel loved, do not feel unnecessary and unnecessary.
4. Of great importance is the observance of the correct mode of the day and especially the time of fluid intake. During the day, the baby should drink as much as he wants, but the last time this should happen no later than 2 hours before bedding.
5. Baby food should be as varied as possible. Do not abuse salt, spices and spices (they increase thirst), and also teach the child to the abundance of dishes with artificial flavors and flavor additives. If the baby is used to drinking a lot in the evenings, then try to gradually replace some of the liquid with pieces of juicy fruit (apples, oranges).
6. It is also strictly necessary to control and urinate: every 2.5-3 hours gently but firmly lead the child into the toilet or plant on a pot. This must be done immediately before bedtime.
7. Often, children with enuresis have problems with daytime sleep: they are reluctant to fall asleep, and the process of packing sometimes goes so nervously that even the subsequent sleep can not compensate for this. In this case, do not make the child fall asleep, you can come to a reasonable compromise: the baby will spend the afternoon in bed, but instead of sleeping will listen to quiet music or a fairy tale.
8. Reduce the amount of time that the child spends in front of the TV and at the computer, because these activities negatively affect the work of the nervous system of crumbs, lead to overexcitation and increase the risk of "night trouble".
9. Normalize the night's sleep and the process of falling asleep will help the so-called ritual activities - actions that are performed every night in the same sequence: cleaning toys, bathing, reading fairy tales, etc. It is desirable that the child's bed was sufficiently rigid (orthopedic fit well mattresses), and the air in the bedroom is warm. In the evening, try to limit the noisy and active games, replacing them with classes with a designer, plasticine, mosaic. The main thing is the "evening" rule: no strong feelings before going to bed. "The kid was disheartened in the evening?" Ask him to paint, but not with a brush, but with his hands. "Psychologists consider this method to be one of the best ways to calm a hyperactive child." Of course, that art classes take place with minimal damage to the environment you will have to prepare: to change the child into clothes, which it is not a pity to soil, to lay the floor with an oilcloth and give the young artist a large sheet of paper for self-expression. Rasna liberating children, it relaxes nerves and muscles, allowing splash out the accumulated emotions.
Exercises for the bladder
Simple and short-term auto-training relieve muscle and mental tension, create a more relaxed atmosphere and help overcome internal problems. Consult with the child psychologist, he will choose the best way to influence taking into account the personal characteristics of the baby. In addition, there are several special exercises that will help a child learn to feel the degree of fullness of his bladder and control the process of urination independently. Such methods are effective only for children over 3 years old who are already able not only to fulfill simple requests, but also to understand why they do it. Begin such "training" by asking the baby to hold back as long as possible and to urge to urinate.Exercise is performed daily 1-2 times a day, it helps to improve the functioning of the locking muscles of the bladder and slightly increase its capacity. If the regular training allowed to increase the time of "containment", then the exercise becomes more complicated. The child, as in the first case, is asked to suffer as long as possible, and then, after consciously starting urination, are asked to interrupt him, start again, and then stop again. Do not be discouraged if the baby can not immediately fulfill your requests. Continue gently and persistently to train the process of urination. Often, after the child learns how to manage it freely, incidents of night incontinence stop.
For those children who can not do these exercises, you can recommend the method of nightly awakenings. True, he will require one of the parents to be awake at night. The method is as follows: during the week the baby should be awakened every hour of sleep, starting at 12 o'clock in the morning. The next week the child is awakened 1 time per night (approximately in the middle between midnight and the time of usual awakening of the baby). In the third week the baby should be awakened 1 time per night - three hours after falling asleep, gradually cut the time to the training awakening to 2.5 hours, and then to 1 hour from the time of falling asleep. If incontinence episodes resume, the cycle is repeated.