WIREDGOV

The National Institute for Health and Clinical Excellence (NICE) is developing advice for the NHS on how to treat and look after children who wet the bed. The draft clinical guideline is available from today (11 March) for public consultation.

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE said:

"Most children will experience some form of bedwetting as they grow up; however often only those aged seven and above are considered for treatment - before this age, it is generally perceived as a normal habit which the child will grow out of.

"While in most cases this will be true, this assumption does mean that many younger children must potentially endure the effects of this condition, such as feelings of low self-esteem or a lack of confidence, unnecessarily and for prolonged periods of time. Not only that, but for some children and teenagers, bedwetting may be a symptom of a more deep-rooted concern – such as a urinary tract infection, diabetes, a bladder problem, stress, constipation, or in rare cases, maltreatment.

"In our draft clinical guideline we have not specified a minimum age limit so that those younger children that are currently excluded from advice and services because of their age can be considered.There are a variety of ways that the NHS can help explore the possible causes of a child’s bedwetting and find a suitable treatment that works. These are outlined in our draft recommendations, which are now out for public consultation."

NICE’s draft guideline covers a range of approaches, from teaching simple behavioural techniques, such as the use of alarms, monitoring fluid intake, diet and toileting patterns - to more complicated care plans, such as using desmopressin (a hormone supplement that reduces the production of urine), and psychological interventions (such as parents rewarding the child for agreed behaviour rather than for dry nights).

The draft guideline is based on the evidence of what has previously worked effectively in the management of childhood bedwetting (known clinically as nocturnal enuresis).

Dr Macbeth added: “We realise that not all parents will need to seek advice every time their child has wet the bed, but if there are ever any concerns, it is important that these are brought to the attention of the health professional so that the possible causes and treatments can be discussed and explored. We hope that our final recommendations, once published, will guide healthcare professionals in treating this sensitive condition."

Anyone wishing to submit comments is invited to do so via the NICE website by 6 May 2010: http://guidance.nice.org.uk/CG/Wave15/79. NICE will then publish its final clinical guideline in October 2010.