I it is unintentional!
the Relation of experts to night “surprises“ which kids sometimes arrange very much changed lately. It is from now on considered to be that enuresis at children is younger than 5 years - a temporary phenomenon, and it turns into a medical problem only for those who outgrew this boundary.For the first time months of life the bladder of the kid is exempted by
from the contents without volition of the little owner, to 1,5 years the baby this process sometimes manages to subordinate to the will, and only by 3 - 4 years the child becomes a full master of the situation. At the same time from 1,5 to 5 years children study cleanliness, and achievements in this area can quite alternate with failures. So night surprises in 3 - 4 - and even 5 - summer age speak only about uncoordinated work of nervous system, to be exact - immaturity of some reflexes which regulate “a small toilet“. From there is conclusion: enuresis as an illness develops at children only after 5 years.
Some role in development of this problem is played by heredity: if one of parents of the kid had enuresis, probability that the child will follow his measure, is equal to 40 - 50% if both were ill - 70 - 80%.Everything is good in its season
Mechanisms of a day and night urination differ in
from each other and are formed usually at different times. At first the kid learns to control himself when does not sleep. First of all the child should master management of sphincters (so call muscles which close an exhaust outlet of a bladder) - they - that and give to the kid a signal that it is time to visit a toilet. Over time the dream of the child becomes less deep, and it gives it the chance to wake up both in the afternoon, and at night, only the bladder will give to the owner a signal that it is full.
Approximately at the same stage the organism of the kid begins to produce special hormone (it is called antidiuretichesky), which constrains production of urine at night. First its quantity is not enough yet to prevent “leaks“, and they happen often, especially if to consider that bladder capacity at children is absolutely small. While operation of all these mechanisms is adjusted, it is better for parents to have patience and not to force an event. You should not put small to bed without diaper (both in the afternoon, and at night) and especially - to abuse, knowing that it is not ready to restrain yet.
of the Direction of search
Having heard the diagnosis “enuresis“, parents usually wait that the expert will look for at the kid some deviations in development of bodies of uric system. Fortunately, such finds - a big rarity. Most often either the modest sizes of a bladder of the kid, or insufficient development in his organism of antidiuretichesky hormone are the main reasons of night disorders. Doctors call these phenomena so:“ neurogenetic bladder “or“ neurogenetic dysfunction of a bladder“. Both concepts mean that violations in work of a bladder appear from - for problems in work of nervous system.
the Action program
If to your kid already was 5 years old, and it gives night surprises to you at least 2 times a month, better, without tightening, to show it to the doctor. Examination of kids is conducted by means of two tests:
- Measurement of capacity of a bladder.
At first collect the child`s urine for one “approach“. The received result is compared to the so-called functional capacity of a bladder which is counted on a formula: to age of the child add 2 and multiply the received result on 32. For 5 - the summer kid these calculations you look so: (5+2) x 32 = 224 ml. Test results are considered normal if for once it is possible to collect 70% of this quantity, that is in our case - about 160 ml of urine. Collected less - clearly that spaciousness of a bladder is small.
- Scoping of a night urination.
At other children enuresis usually is explained by the hormonal reasons, from - for whom more urine is produced at night, than it is necessary. To check whether so it, is possible as follows: weigh in the evening a dry diaper, and in the morning - wet. Then subtract a difference between two measurements and add to it the weight of first morning “toilet“ (1 ml of urine = 1 g). If the result exceeds an indicator in 160 ml (for the child of 5 years), it will mean that there is not enough antidiuretichesky hormone.
some more “checks“ which are appointed to children of any age at problems with a toilet Are.
- needs to exclude an inflammation in uric ways. Unfortunately, it is found in 30 - 40% of kids. > it is important to li to be convinced by
- that the child has no congenital or acquired defects of an uric path. For this purpose to the kid carry out ultrasonography of kidneys, a bladder and a X-ray of both bodies.
- At last, the doctor has to make sure that the kid sick with enuresis, has no epilepsy or mental disorders.
- By 1,5 years to people around that it is wet. - m and 30 - m month it does not pisat
- Between 20 in panties in the afternoon any more. the problem of wet sheets is usually solved by
- In 3,5 years. every second child suits to
- Between 3 and 4 years surprises from time to time at night, and it is normal.
- By 4 - 5 years the kid wakes up and asks on a pot. Casual troubles are possible, but in it there is nothing terrible.
Alarm clock or medicine?
What, depends on results of inspection and the carried-out tests.
- If becomes clear that the kid has a small capacity of a bladder, it is worth trying the program under the name “Alarm clock“. You do not give to drink to the child for the night on a mnoga and more often land on a pot, including at night. In a month the child gets used to such mode, and for three usually recovers. the doctor will appoint by
- In a case when small lacks antidiuretichesky hormone, to it the preparation “Desmopressin“ (Ferring). At the heart of this medicine - analog of scarce hormone.
- to Those children in whom the uric infection or other illness accompanying enuresis it was found it will be necessary to cure first of all. be not surprised to
- if the doctor advises to show the kid to the psychologist. Usually its help is necessary to hyperactive children, it is difficult for them to concentrate. Such kids really have psychological problems which are shown in the form of enuresis. Quiet, balanced children can react thus to different shocks too: divorce of parents, moving, conflicts in a garden. Anyway searches of the reason should be begun with visit to the pediatrician, and he will solve where exactly to direct small.