Introduction
Nocturnal enuresis, or bedwetting, is a common problem in children. It is a source of stress for them, as well as for their families, who may also incur significant financial costs. The Avon Longitudinal Study of Parents and Children found that the prevalence of bedwetting <2 nights per week is 30% at 4.5 years and 8% at 9.5 years, and the prevalence of bedwetting <2 nights per week is 8% at 4.5 years and 1.5% at 9.5 years.1
Treatment has not usually been offered until children are 7 years old. The National Institute for Health and Clinical Excellence (NICE) has published a guideline on the assessment and treatment of children who have nocturnal enuresis;2 this makes recommendations for those aged under 7 years and also provides some advice for parents of children who are under 5 years old. Assessment, general advice, and advice on the use of rewards is similar for all children aged over 5 years. The guideline does not suggest that children aged 5–7 years should be given interventions such as alarms or drugs, but acknowledges that some of these children will benefit from them — as such, they should not be excluded from these interventions on the basis of age alone.
Guidance
Assessment of child and family
Table 1 gives some possible interpretations of a child's bedwetting history.
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Has the child been dry at night previously? If bedwetting is of recent onset, assess for signs and symptoms of ill health and for problems such as urinary tract infections (UTIs), diabetes, and constipation. Are there any medical or emotional triggers associated with bedwetting that require attention in their own right?
What are the details of bedwetting? How many nights a week does bedwetting occur? Does …