Hi Reader

Dad Joke: I used to have a job at a calendar factory, but I got fired because I took a couple of days off.

Song of the Week: Hey Soul Sister, Train​

So, if your initial paediatric training was anything like mine, the management section of nocturnal enuresis (NE) probably looked a lot like this…

"Something’s not right, don’t drink just before bed, adjust what you find and get the parents to pop down to the local arts and crafts shop for a little paintbrush and have at that ol’ Galant Reflex”…sound familiar?

And if that’s your current protocol, I reckon you feel that same little feeling of dread I used to feel when you see an NE patient booked into your schedule.

But the truth is there is so much we can offer, if we just take a little time to upskill and get familiar with the latest information and make connections between our systems.

And above all else…always have a plan!!!

Here’s mine

✅My first question to an NE child is…”do you snore”, sounds a bit left field but obstructive sleep apnoea can be a major contributor to NE and the physiology of the connection is solid. Signs of allergy?

✅I look at their skull shape and palate position because research like Carotenuto et al. notes an orofacial subgroup linked to sleep related breathing disorders and NE.

✅I ask about volume of wee, concentration of wee, timing of the night wets (all of these can lead me in different directions regarding causative factors).

✅Next up is bloods for Vitamin D, B12 and Omega 3’s, I also look into their gut habits for possible constipation

✅Then I get into the pelvic floor, test their lumbopelvic endurance. Karaaslan et al. shows linkages between increased lumbar lordosis, pelvic anteversion and NE.

✅Do I look at primitive reflexes? Of course! But not for a specific reflex. NE has to do with delayed development and that needs a wide picture of primitive and postural reflex assessment (a little more than the old paintbrush business).

Having a plan empowers you to:

• Know how to explain what’s going on
• Explain what you can do help
• How long that might take

We’ve just put together a particular training on Enuresis over at Connected Paediatrics that will equip you with the tools you need to get rid of that little feeling of dread and get results with your NE kids in practice.

Here is a response I got on our Masterclass WhatsApp group 2 days after the training from a well-seasoned Paediatric chiro who took the training live.

“Good morning gang.. just FYI, I have a 6-year-old Primary Monosymptomatic kid in practice. No retained reflexes as far as I could see, so I was stumped. Had the odd dry night but consistently wet his whole life, slept with the bedside light on too. After Wednesday’s enuresis talk …. Thursday night, half the amount of urine and then the next 2 nights have been dry!! 🤯🤯🎉🎉 Thanks so much for all your efforts and knowledge Mike!”

Chat soon

Mike

Here's a list of dates for my upcoming seminars:

• 7 & 8 June 2025 - Common Infant Conditions, Chester, UK
• 6 & 7 Sept 2025 - Paeds in Motion Part 1 (The Young Child) Wales, UK (bookings with michellebushell3@hotmail.co.uk for this one.)
• 31 Oct 2025 - Student Paediatric Chiropractic Evening, Newcastle, UK
• 1 & 2 Nov 2025 - Management of the Neonate, Newcastle, UK

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info@connectedpaediatrics.com
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Connected Paediatrics – Dr Mike Marinus is a registered paediatric chiropractor treating babies and children and helping chiropractors learn effective paediatric techniques that they can use in their practice

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