Imipramine (trade name Tofranil)
Imipramine is an antidepressant
prescribed for bed wetters. It has
a high success rate but also a high
repeat rate and is only prescribed
under strict medical supervision
because 40 percent of patients
present with side effects such
as anxiety and behavioural or
personality changes.
Anticholinergic (trade name Ditropan)
Anticholinergic helps to relax the
nerves of the bladder muscles, which
means children can hold urine for
longer. It doesn’t normally work for
nocturnal enuresis, unless there are
also symptoms by day.
Desmopressin (trade name DDAVP)
Desmopressin decreases the amount
of urine that’s produced and works
for about seven to 10 hours after it’s
been taken – long enough to ensure
a dry night. Desmopressin is only
prescribed for children older than six,
and also only after all avenues have
been exhausted. It’s only prescribed
for short periods, such as when your
child wants to sleep over at a friend’s
or when you’re going on holiday.
“Children usually react fast when
they start using desmopressin, but it
has a high repeat figure – it means
the agent only works while they’re
using it. It’s not a long-term solution
and most children start wetting their
beds again once they stop with the
medication,” Dr Botha explains.
BABY FILES: TODDLER YB
JULY & AUGUST 2019 | 75
before dressing her in clean pyjamas.
✓ Don’t make your child feel bad by
saying things like: “Only babies
we a r n appie s.”
✓ Try and cut out caffeine (including
Ceylon tea, chocolate and Coke)
because it will make your child
produce more urine.
✓ Buy some DryNites Pyjama Pants.
These discreet pull-ups come in two
sizes and in boy and girl designs.
✓ Open the windows nice and wide in the
morning, and spray aerosol so it doesn’t
smell like wee all day.
✓ Put a dry almanac on the wall and
give your child cute stickers she can stick
on herself for the nights she remains
dr y. Reward her with a small gift or
an outing if she stays dry for a specific
number of nights.
✓ Tell your child if one of you also wet
your bed when you were children.
Reassure her that it gets better over time
and that you no longer wet your bed.
✓ If your child also has accidents during
the day, it could be a sign of a bladder
infection. First eliminate this possible
cause before addressing the bed-wetting.
If nothing works for you, you might
have to give nature itself a chance
to solve the problem. Most children
outgrow enuresis. If you bother
too much, you’ll just further upset
your child.
GADGETS ON THE MARKET
Conditioning therapy (think of Pavlov’s
dog) in the form of an enuresis alarm
works very well.
It’s an alarm that starts vibrating when
an electrode in the child’s underwear
Medication is usually a last resort and only with children older than seven.
The remedies that could be prescribed include:
becomes wet so that she wakes up and
finishes weeing in the toilet. “Your child
becomes conditioned over time to wake
up and get up at the first sign of a full
bladder,” Dr Botha says.
The alarms are on the expensive side –
about R800 – and you need to find out if
your medical aid will pay for it.
Ask your urologist about the
medication options that will see urine
production decrease. But although
medication starts working quite
quickly, the percentage of children who
regress once they stop taking the meds
is quite high. YB