Breastfeeding and Nocturnal Enuresis

Can Nursing Prevent Childhood Bedwetting?

By Teri Brown

 
A study published in the journal Pediatrics gives breastfeeding advocates another weapon in their arsenal. The study, headed by Dr. Joseph G. Barone, chief of pediatric urology at Robert Wood Johnson Medical School, concludes that breastfeeding longer than three months may protect against bedwetting during childhood.

This makes complete sense to Heather Cook, mother of two from Calgary, Canada. “This doesn’t surprise me,” she says. “Kids who are breastfed or who co-sleep tend to sleep lighter. Since many kids who wet the bed are deep sleepers or don’t wake when they have the urge to go, it stands to reason that their early life of waking more often would predispose them to waking more often during the night when they have to go to the bathroom.”

If a connection does exist between childhood nocturnal bedwetting and breastfeeding, one has to wonder why.

The news also makes sense to breastfeeding mother Sissel Chapman from Alberta, Canada. “My youngest daughter was dry at night before she was weaned,” Chapman says. “She was dry all night at 2 1/2 years, and we didn’t try to make it happen; we just discovered her diaper was never wet and went on to let her sleep without.”

The Connection: Breastfeeding and Nocturnal Bedwetting

If such a connection does exist between childhood nocturnal bed wetting and breastfeeding, one has to wonder why. Dr. Barone believes it has to do with development. “Bedwetting is associated with developmental delay and breastfeeding to developmental advantage,” he says. “Since they are both related to development, we asked if breastfeeding might provide a developmental advantage as far as the development of bedwetting is concerned.”

According to Dr. Barone, there are many developmental advantages that are associated with breastfeeding, including better vision and improved cognition. This study supports the hypothesis that breastfeeding is also protective against the development of bedwetting, though additional studies are needed to confirm these preliminary findings.

Dr. Carol Steltenkamp, associate professor of pediatrics for the University of Kentucky’s Kentucky Children’s Hospital, believes it may be due to improved neurodevelopment. “Essentially, what the authors suggest in their results and conclusions is that clinical evidence strongly suggests that many cases of nocturnal enuresis result from delayed neurodevelopment,” she says. “Multiple previously-published studies align improved neurodevelopment with breastfeeding. Neurodevelopmental maturation is essential to prevent the development of nocturnal enuresis.” However, Dr. Steltenkamp is quick to point out that the study does not prove this; it merely says that a connection could exist.

What’s Ahead

Dr. Barone agrees. The issue needs more study before a conclusion can be reached concerning the connection between breastfeeding and a decrease in childhood nocturnal bedwetting. “This was a pilot study to see if this is something that needs to be examined in more detail,” he says. “We have recently submitted a grant to the National Institutes of Health requesting funding to answer this question definitively. If we receive that funding, we will be able to answer the question for sure. The definitive study will take five years to complete once the funding is received.”

Though the study shows some possible links between breastfeeding and a decrease in nocturnal enuresis in children, some mothers aren’t convinced. “I breastfed all of my children past three months, and two of them wet the bed into first grade (one still does), however infrequently,” says Jennifer McDougall, mother of four from Alberta, Canada. “It’s a mystery to me why kids wet the bed, but I think there are many factors including personality, how deep they sleep, diet and drink and birth order.”

Though nocturnal enuresis in children can be affected by many different things, the possibility that breastfeeding may decrease childhood nocturnal enuresis is just one more positive to add to a growing list of reasons to breastfeed.

The Fine Print

  • The study itself was a pilot study, designed to see if further investigation is warranted.
  • The study had a small number of participants (55 in the case study and 117 in the control group).
  • The authors did not control for family history of bedwetting, although they did note that some cases of bedwetting tend to run in families.
  • The study is retrospective, relying on parental memory of length of time for breastfeeding, formula introduction, etc.
  • The study concluded that breastfeeding longer than three months may protect against bedwetting during childhood. (Breast milk supplemented with formula did not make a difference in the rate of enuresis.)
  • The authors of the study are waiting funding to investigate the issue further.

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