Stress is certainly a contributing factor when it comes to nocturnal enuresis, and one of the main causes of stress in young children is illness or hospitalization. Reactions to stress vary with the child’s age, their ability to cope, the length of time the stressor continues, intensity of the stressor, and the degree of support they receive from their family and friends. The two most frequent indicators that children are stressed are changes in behaviours (such as thumb sucking or an increase in tantrums) and regression of behaviours (such as a return to bedwetting). Generally speaking, we find children’s bedwetting stops when the cause of their stress is resolved or disappears, which explains why he moves between periods of continence and incontinence. Clearly his hospital visits have sensitized him to stress making him more vulnerable to other potentially stressful situations. One way we can try to minimize his stress is by anticipating what events make him feel nervous, try to avoid these if you can or if this is not possible you can help him to prepare for these events by talking things through. It is important that he understands it is OK to feel angry, scared or worried and help him to find names for his feelings. Engaging in creative play is a great way to help children to prepare for events – if his hospital visits are ongoing you can help him work through this by acting out his visits before hand. Books are also a wonderful resource. The most important thing when it comes to helping children cope with stressful situations is to create a supportive and caring family environment, one where children are comfortable to talk about their fears. Continue to show him lots of love and encouragement particularly at those difficult times.

Regards,
Dr Cathrine

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