BED WETTING EXPLAINED

(Nocturnal Enuresis) and Chiropractic's Approach to the Problem

Many times parents actually blame their child for urinating in bed. They believe this is a behavior intended to get back at them for something. Nothing could be farther from the truth. No, children do not willfully wet their beds.

Oh, the anguish of the young child who wets the bed at night! He cannot go to camp, stay over night at his friend's house, or go on trips without the constant fear of the wet bed in the morning. Psychologically the bed wetting child bears a burden, but so does the mother. The constant changing of bed linens is certainly a chore she would like to put behind her.

Just what causes Nocturnal Enuresis (bed wetting) and is there any help for this problem? Yes, there is and to explain why children wet the bed we must understand a spinal reflex called the phrenic reflex. You see, when a baby sleeps, its respiration (breathing) gets slower and slower until a mother might bend over the crib and exclaim, “My child's not breathing!” Then suddenly the infant shudders, takes a deep breath, and the normal breathing cycle resumes. With a sigh of relief, the mother returns to her activities.

This pattern of breathing goes on throughout the night. As the infant sleeps respiration continues to slow down until the carbon dioxide in the body gets high enough to trigger a breathing mechanism called the phrenic reflex. This mechanism stimulates the large muscle of breathing, the diaphragm, to increased activity and the normal rhythm of breathing returns. If this mechanism is not working correctly, the carbon dioxide continues to increase and when it gets too high, “smooth” muscles begin to relax. Smooth muscles are the involuntary muscles of the body, those that function without our conscious control. The valve at the bottom of the urinary bladder is a smooth muscle, and when it relaxes the bladder simply does not retain its fluid, you might say it leaks throughout the night.

Now this is normal for infants, as the phrenic reflex is not fully developed at birth, but as the child grows, the reflex matures and soon most children can sleep all night and retain their urine. This reflex develops more slowly in boys, in the same way that boys mature sexually later than girls, and thus boys are more frequent bed wetters.

The bladder could be described as a muscular pouch that holds urine as it is discharged from the kidneys. The tubes from the kidneys are called ureters and the muscle that forms the valve that holds back the urine is called the sphincter muscle. The typical bed wetting child sleeps in a high state of carbon dioxide intoxication. This produces a deep sleep that appears almost comatose to the parents. It is very difficult to wake the child up to go to the bathroom. You almost have to manually lift the child up, lead him to the bathroom, command him to urinate, and lead him back to bed. Most commonly the bed is just as wet in the morning as it would have been had you not gotten the child up at all.

A bed wetting child is typically a very active child, often playing to exhaustion and when at sleep, sleeping in a very deep slumber with slow respiration. The child's sluggish, or immature phrenic reflex allows too much carbon dioxide to build up in the system. The bladder valve (sphincter)relaxes, and the bladder leaks throughout the night. No, the child does not voluntarily urinate in bed. The urine simply runs out involuntarily while he sleeps.

The Chiropractic Approach

Now in some children the phrenic reflex is simply slow to develop. In fact this slow development does at times run in families (hereditary factors), but in other children this reflex is disturbed by a vertebral misalignment termed by chiropractors a “subluxation”.

The phrenic nerves come out from between the 3rd, 4th and 5th cervical (neck) vertebra. Subluxation of these vertebrae can cause nerve interference, which can disturb the proper function of the phrenic reflex and cause bed wetting. Chiropractors correct vertebral subluxations, and thus influence the return of proper nerve function.

Unfortunately, there is really no way to tell if a child is simply slow in the development of the phrenic reflex, or if a subluxation is the direct cause of the problem. Chiropractic x-rays and examination can help pinpoint spinal problems, but the only real way to see if chiropractic care will help Nocturnal Enuresis is to actually try it. A series of chiropractic adjustments will generally determine whether or not chiropractic care will be of help. Some cases respond spontaneously with instant cessation of the bed wetting problem. In difficult cases it is sometimes wise to bring the child in for a series of spinal adjustments and then wait a few months and bring the child back in again for care. Your chiropractor can explain this to you. He will offer helpful suggestions which aid in controlling enuresis such as avoiding fluids before going to bed, preventing the child from excessive exhaustion and fatigue, etc.; but be assured that chiropractic care does offer a positive approach to solving Nocturnal Enuresis. In many children it has completely solved the problem. If your child is suffering the anguish of bed wetting consider chiropractic care.