Seemingly harmless bedwetting by children can lead to brutal beatings and even death by the people who should be protecting and caring for them.
Cape Town mom Nuriya Dramat admits that she has resorted to spanking her five-year-old for wetting the bed. However, she admitted that the frustration of having to clean up the mess during the wee hours of the morning was what upset her most.
"I spanked her because I took her to the bathroom before going to sleep, but she still wet the bed," she told Health24 before quickly adding: "I spanked her, but not so much as to leave marks on her body."
Dramat added, though, that she normally only raises her voice in frustration and anger, rather than hitting her daughter.
Brutal tales of deaths over peeing
But, in other cases, bedwetting can lead to brutal beatings and even death.
South Africa was recently shocked by the fatal beating – allegedly by her mother's boyfriend – of a 5-year-old girl who suffered an episode of enuresis, the medical term for bedwetting.
Read: What a doctor would do if a child suffered from enuresis
The child allegedly wet herself while she was asleep on a couch in Boitumelong in Bloemhof, News24 reported on January 1 2016.
The urine seeped into the couch and the mom's boyfriend allegedly beat the girl so severely that police and paramedics declared her dead when they arrived on the scene.
Incidents like this are however not unique to South Africa.
A mother and her boyfriend in Orlando, Florida, beat her three-year-old son for over an hour in 2011 for wetting his pants, according to the Daily Mail. The couple proceeded to order a pizza and put on a DVD while the little boy struggled for breath and eventually died.
In 2014 horrific footage surfaced of a Chinese stepmother viciously beating a toddler because she wet herself. The footage showed how the woman whipped the little girl 87 times with a branch, kicked her 14 times, and slapped her eight times.
In the same year, the New York Daily News ran a story about a three-year-old girl in Brooklyn, New York City, who was beaten to death by her mother's 20-year-old boyfriend after accidentally wetting herself.
Closer to home, last year, in Zimbabwe, a 29-year-old man beat his four-year-old son so severely for soiling himself that he died two days later, according to News Zimbabwe.
The police said the father assaulted the boy with a number of objects, including a hot iron rod and a pellet gun on his buttocks, legs and hands.
In a study Assessment of domestic violence against children and adolescents with enuresis by MC Sapi et al, published in the Journal of Pediatrics in September 2009, the authors interviewed 149 patients diagnosed with nocturnal enuresis (bedwetting at night).
They found that 89% of subjects suffered either verbal or physical aggression when they wet their beds or leaked urine, with 50% being verbally punished and 48% physically punished. The study showed that the main abuser was the mother and that the risk was higher for children with less-educated parents.
Spanking only worsens the situation
Parents beating their children over bathroom accidents is not uncommon, said Joan van Niekerk, president of the International Society for the Prevention of Child Abuse and Neglect and consultant on child rights and child protection.
"Punishment is rarely – if ever – successful," she told Health24, adding that there are numerous incidents of bedwetting provoking violence.
"The problem is that this usually makes problems like bedwetting more difficult to manage as children become anxious. This interferes with sleep, and when children do manage to fall asleep they are so tired that they sleep through the messages their body is giving them in terms of the need to pass urine; or they hold on until they can no longer do so, and they lose control," Van Niekerk explained.
She said parents or caregivers sometimes failed to recognise the impact of shouting or punishment on this problem.
The types of bedwetting
Clinical psychologist, Dr Ian Opperman, explained to Health24 that, according to theory, there were two types of bedwetting: primary and secondary bedwetting.
"Primary means that bedwetting has occurred since early childhood without a break, where there is no period during which the child does not wet his/her bed.
"Secondary bedwetting is when bedwetting occurs after at least six months of not wetting his/her bed, and is usually caused by a stressor such as a sudden change, a psychological factor, a physical factor such as infection etc."
Dr Opperman, who is in private practice in Johannesburg and serves on the Executive Committee of the Psychological Society of South Africa (PsySSA), said that unless children wet themselves as an act of defiance when awake, bedwetting was an involuntary act which they are not responsible for.
"Children naturally gain bladder control at night, however, this occurs at different ages."
Read: Bedwetting stems from physical causes, not psychological
Although bedwetting can be a symptom of an underlying disease or infection, in most cases there isn’t always an underlying disease or infection to explain it, said Dr Opperman.
"This of course does not mean that children who wet their beds are doing so on purpose. Children who wet the bed are not lazy, naughty, or disobedient."
Why parents beat their children for wetting themselves
Dr Opperman explained that parents become frustrated when they are woken up at night to change wet sheets and pyjamas and some conclude that the child wets his/her bed out of laziness or naughtiness.
"Disciplinary action under these circumstances are unforgivable and dangerous", he warned. "The child is already humiliated by waking up in a wet bed and this feeling becomes worse with age."
Parents need to understand the condition in order for them to know how to deal with it, said Dr Opperman.
"Parents need to reassure their children that it is just an accident, be patient, and try to conceal the problem from those who would laugh at the child. In addition to this, an interesting fact is that bedwetting is reportedly inherited."
He went on to state that often parents who used to experience difficulties with bedwetting had children who went through the same experience. "Usually children stop bedwetting around the same time that their parents stopped bedwetting when they were children."
Dr Opperman advised parents to attend parental guidance workshops or therapy to help guide them through this phase of development.
Deflecting the real problem
"There are too many examples of horrific murders and criminal attacks blamed on bedwetting, which distract from the more important emphasis on the more common and concerning issue of psychological and milder physical abuse of these children," noted Professor Michael Simpson, Health24 CyberShrink.
"For me, child psychological and much physical abuse arises from a frustrated and angry parent who, after provocation by such incidents, reacts inappropriately and strikes out at the kid, physically or verbally."
He said there are many separate elements involved in these situations.
"A parent who is stressed by joblessness or financial stress, who themselves are feeling belittled by bosses and others, who is seething with rage, and at risk of striking out at the child not because the child caused the main problems but because they're handy, smaller, and even more powerless."
Read: Bedwetting can be due to undiagnosed constipation
Professor Simpson pointed out that there can also be a situation of a parent who wants to believe that they're a perfect parent; and when the child seemingly deliberately and provocatively wets their bed, feels that their image as a skilled parent is challenged, and they don't know how to deal with it.
"I suspect there are some parents so abuse-prone, with such a hair-trigger for reacting violently, that bedwetting is more than enough to switch them to attack mode."
However, he added that it abuse at the hands of parents is not always as specific as bedwetting, saying that a child neglecting their chores, or routine self-care, can also be enough to tip parents over the edge.
Do you have concerns over bedwetting? Ask Health24's incontinence expert Prenevin Govender.
Why do children wet their beds? (Part 2)
What to do if your child wets the bed (Part 3)
Image: Boy sitting on the floor from iStock
New York Daily News: http://www.nydailynews.com/new-york/nyc-crime/brooklyn-girl-3-beaten-death-mother-boyfriend-article-1.1979178
News Zimbabwe: http://www.newzimbabwe.com/news-22604-Man+kills+son+for+soiling+pants/news.aspx
International Society for the Prevention of Child Abuse and Neglect
Assessment of domestic violence against children and adolescents with enuresis" MC Sapi at all, Journal of Pediatrics, September 2009