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Dr Catherine
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4-7 years

Hi, my son turned 6 in May and he has NEVER had a dry night in the whole 6 years. We have tried minimising his fluid intake in the evening but have had no change. He wears a pull up or Dry Nights to bed every single night and some mornings its so heavy and soaked, and its not uncommon for his pull up to leak and wet the bed as well. I have read it could be due to a lack of the ADH hormone? if this is the case how does one go about increasing this? Im not keen on him taking medications for it either. Is there a specialist who can help with this? or am i better off waiting till his is at least 7yo before seeking help? Its just that he's never been dry in his life ! and he sometimes suffers from a thrush type itchy skin in his groin area due to that area being warm and moist for most of the night. Thank you

There are medications that children can take that help in the management and treatment of bedwetting. These are a man-made form of antidiuretic hormone (ADH) that works by substituting for the natural hormone. It helps the child's body to make less urine at night, and thus reduces the risk of the child's bladder overfilling during sleep. DDAVP is best used in the tablet form. Unfortunately medications do not always result in dry nights and are generally viewed as a form of management rather than treatment as children commonly return to wetting once they stop taking the medication. The best approach to treatment is the conditioning alarms. Medication is usually reserved for children who have failed treatment with a bedwetting alarm, and sometimes the two treatments are then given together. It is not unusual for the alarm not to work at first and may take up to 6 months of constant use. Children may experience one or two relapses, when this occurs you need to reintroduce and repeat the process. It may be helpful to get your son to practice setting the alarm off during the day (with a drop of water) so that way he will become familiar to the sound of the alarm. Some alarms have different settings that allow you to vary the sound – sometimes a louder alarm will raise a particularly deep sleeper. Others include a vibration option, which your son may respond to more easily. In the meantime, keep reminding him that the bedwetting is not his fault and even though it may not seem like it at the moment, it is something he will out grow. All the best,