New Poll Shows Few Understand Bed-Wetting; Common Childhood Condition Often Untreated

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NEW YORK, Dec. 12, 1996-- Five to seven million children wake up every morning in a wet bed. A new survey of 9,000 families found that despite the prevalence of the condition, only some parents understand that bed-wetting, medically known as primary nocturnal enuresis (PNE), may be a medical --not behavioral-- condition that can be treated.

Nearly half the people surveyed (47 percent)^A mistakenly believe bed-wetting, or primary nocturnal enuresis (PNE), is a condition associated solely with drinking too many liquids before going to bed. "Although limiting liquids with caffeine before bedtime should be encouraged, parents should understand that bed-wetting may be a common medical problem, and their child's physician is the best source of information about treatment for a bed-wetting child," confirms Marc Cendron, M.D., Pediatric Urologist at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

"Last year at my son's school physical, we were pleased to discover that there are treatments available for bed-wetting," said Mrs. Dillehay, a Tennessee resident and mother of two. "Treating my son's bed-wetting problem has changed his whole outlook on life; he can now attend sleepovers and the entire family doesn't worry about his condition anymore."

Other Findings, According To The Poll:

• MYTH: Child wets the bed on purpose.
  FACT: Bed-wetting is not the child's fault, and is known to run in families. In fact, researchers have identified the first direct genetic link to PNE on a single region of chromosome 13. "We now have scientific evidence that many cases of bed-wetting are caused by genetic factors beyond a child's and parent's control," said Hans Eiberg, associate professor at the Danish Centre for Genome Research, who discovered the specific genetic marker. Research suggests that if both parents have a history of bed-wetting, their child has a 77 percent chance of wetting the bed. If only one parent was a bed-wetter, a child has a 44 percent chance of wetting the bed. There is only a 15 percent chance of a child bed-wetting if neither parent has a history of the problem.
  
  
• MYTH: Child is lazy.
  FACT: While the exact cause of PNE has not been identified, research indicates that bed-wetting is usually a physiological and not a behavioral problem. Recent studies have found that some children who wet the bed lack a normal increase in antidiuretic hormone (ADH), which controls urine production at night. "In non bed-wetters, ADH levels increase at night, leading to a decrease in urine production. In some bed-wetters, there is no increase, or it's insufficient, resulting in an overproduction of urine and, thus, bed-wetting," said Lane Robson, M.D., Pediatric Nephrologist at The Children's Hospital in Greenville, South Carolina.
  
  
• MYTH: Bed-wetting is a result of deep sleeping patterns; fully waking a child is helpful.
  FACT: Although 44 percent^A of the parents surveyed believe bed-wetting is caused by a child's deep sleeping patterns, studies have shown that fully waking a child throughout the night to urinate is not a useful intervention. "Parents who wake bed-wetting children interrupt the child's sleeping patterns, as well as their own. Waking the child to full consciousness repeatedly is a disruption, and may lead to sleep deprivation for the entire family," said Dr. Robson.
  
  

Two-thirds (70 percent)^A of parents surveyed indicated they do not worry about their child's bed-wetting and assume their child will outgrow the problem. Yet, only 15 percent of bed-wetting children will spontaneously outgrow the condition each year, and some continue to be affected until adulthood.

"It is important that parents have compassion and care when dealing with a bed-wetting child so as to avoid feelings of shame, which is the number one emotion associated with enuresis," said Brian F. Greer, M.D., a child psychiatrist in private practice in Boca Raton, Florida. "Of all the negative emotions, shame is the most devastating for the child, as it often leads to the greatest number of disruptions in personality development. Such disruptions may reveal themselves in poor school performance, antisocial behavior, isolation, and depression." Twenty-one percent^A of parents surveyed say they punish their child when he or she wets the bed. "There is absolutely no role for punishment in the treatment of bed-wetting," said Dr. Greer.

Treatment begins with a thorough history, a physical exam, and a urinalysis. The physician will then decide how the child should be treated and provide the parents and child with information and counseling. Treatments for PNE may include behavioral modification and drug therapy. The main behavioral modification technique used is a signal alarm device or moisture alarm, where a child gradually learns to associate bladder fullness with a conditioned response. Many medications have been recommended for treating the bed-wetting child. The most commonly used medications may include nasal sprays and tricyclic antidepressants. Contact your physician for more information.

^(A) Respondents could choose more than one option, and thus, percentages exceed one hundred.

The National Kidney Foundation has an informational hotline where the public can obtain free literature on enuresis. The toll-free number is 800-622-9010.

Bed-Wetting: Do's And Don'ts

William J. Cromie, M.D., Chief, Section of Pediatric and Reconstructive Urology and Vice Chairman, Department of Surgery at the University of Chicago, offers the following practical tips to help the parents of bed-wetters:

• Do talk to your doctor about bed-wetting. Even if your physician doesn't mention the condition, don't be afraid to ask questions about this common problem. A urine test is important to rule out medical conditions, such as urinary tract infection and diabetes.
  
  
• Do give your child an explanation of what is happening to him/her. You could be the positive role model your child needs. Learning about the problem helps both the child and family cope with their natural concerns.
  
  
• If you were a former bed-wetter, share your experience with your child. Making sure that your child understands that bed-wetting may be hereditary can ease your child's anxiety and better help him/her cope with this condition.
  
  
• Do change your child's habits. Encourage the child to urinate before going to bed. Have him/her avoid foods and drinks containing caffeine, which can increase the output of urine.
  
  
• Most importantly, don't punish or belittle your child as it only adds to the child's embarrassment. Support your child by seeking the professional advice of a pediatric urologist or an expert in the field.
  
  

CONTACT: Ellie Schlam of the National Kidney Foundation, 212-889-2210, or Kathryn Metcalfe of Noonan-Russo Communications, 212-696-4445, ext. 206