Reduced Caffeine intake can improve bed wetting in school kids: BMJ

A new study published in BMJ Paediatrics shows that restricting caffeine may assist to lessen primary monosymptomatic nocturnal enuresis (PMNE) or its symptoms.

The most typical kind of nocturnal enuresis (NE) in children of school age is primary monosymptomatic NE. Although there are several drugs that may be used to treat PMNE, behavioral interventions—such as eliminating constipation before night, consuming less salt, protein, and fluids during dinner, especially before bed—are the first-line treatments. According to several studies, coffee has diuretic effects and increases urine output, which aggravates incontinence. Evidence regarding caffeine's detrimental impact on pediatric enuresis is either understudied or poorly understood. As a result, Sadra Rezakhaniha and colleagues carried out this study to find out how caffeine limitation affects the severity and improvement of primary monosymptomatic nocturnal enuresis.

From 2021 to 2023, two referral hospitals in Tehran, Iran, participated in this randomized clinical study. For this study, 534 PMNE kids between the ages of 6 and 15 (one group of 267) were involved. The feed frequency questionnaire recorded how much caffeine was consumed, and Nutrition 4 software assessed how much was consumed. The daily caffeine intake in the intervention group was less than 30 mg, compared to 80–110 mg in the control group. One month later, all kids were invited to come back and examine the data that had been recorded.

The key findings of this study were:

1. The intervention and control groups' respective mean ages were 10.92.3 and 10.52.5 years.

2. Prior to caffeine limitation, the intervention and control groups' respective mean bed-wetting rates were 3.5 (SD 1.7) and 3.4 (SD 1.9) times/week and, 1 month later, 2.3 (SD 1.8) and 3.2 (SD 1.9) times/week, respectively (p=0.001).

3. Restricting caffeine in the intervention group considerably lessened the severity of enuresis.

4. With RR 0.615 at 95% CI 0.521 to 0.726, p=0.001, 54 children (20.2%) in the caffeine restriction group improved (dry at night), compared to 18 children (6.7%) in the control group.

5. Children's enuresis was greatly decreased by caffeine restriction, with a 7.417 number-needed-to-treat benefit.

One of the first-line management strategies for PMNE is the constructive restriction of caffeine and, the first method for defining hints for enhancing PMNE and severity was through this study.

Reference:

Rezakhaniha, S., Rezakhaniha, B., & Siroosbakht, S. (2023). Limited caffeine consumption as first-line treatment in managing primary monosymptomatic enuresis in children: how effective is it? A randomised clinical trial. In BMJ Paediatrics Open (Vol. 7, Issue 1, p. e001899). BMJ. https://doi.org/10.1136/bmjpo-2023-001899