Strategies to Help Kids Overcome Bedwetting

As parents there are plenty of difficult areas that crop up with childrearing that we look to other parents or close friends to for advice and answers.  However, when the situation involves a problem that might cause us to feel a little anxious or embarrassed, we’re not as likely to want to share this for fear of being judged or scrutinized.

One such topic that falls into this socially uncomfortable category is that of bedwetting.  Believe it or not, bedwetting, also called Nocturnal Enuresis, is not an abnormality and therefore should not be seen as one. It is a bladder disorder that can be treated effectively and totally. As a parent, it is your responsibility to see to it that you help your child overcome this condition to normal development.

Our Mom’s Council recently received an e-mail from a parent that is struggling with her 12-year-old son still having accidents most nights and was hoping we could offer some suggestions or personal stories of our own about this often hush-hush topic.  Without wanting to publicly announce which families are or have dealt with this issue, here’s some information we hope will be helpful to others in this same situation. (And yes, I have personal experience with this — two out of our eight kids — so I know the drill quite well.)

Understanding the Causes of Bedwetting

According to Dr. Howard Bennett, a clinical professor of pediatrics at George Washington University Medical Center and author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting, the combination of several factors is the usual culprit that leads to bedwetting:

Stress --  Children who have engaged in a very active daytime like being involved in many school activities, getting overwhelmed by meeting new acquaintances, getting overjoyed by a new toy or present may experience bedwetting. Adults also experience this and in most cases triggered by a dream.

Undeveloped bladder --  A young child may not be able to control the activities of his/her bladder particularly urinating. The bladder, being not yet fully developed, may not have enough capacity to hold urine that results in wetting. While your child grows, this may be developed and bedwetting should no longer be a problem. Children also do not normally wake up in the middle of the night when their bladder is already full.

Bedwetting is a medical problem — it happens because a child’s brain and bladder are not communicating with each other at night. 

Hormonal imbalance --  One theory on why children wet the bed at night is that they do not have enough production of anti-diuretic hormone or ADH at night. ADH helps reduce urine secretion. Like the previous theory, this will develop as your child matures.

Feeling constipated -- Studies show that children who suffer from persistent constipation would also likely to wet bed. The hard stool is what may irritate the bladder. If your child complains of stomach pain and is feeling like bowel has not been completely emptied, he is likely to be suffering from constipation.

Reaction to food -- Caffeinated drinks like coffee, soda, and tea pumps the production of urine in the kidneys. Avoid giving your child these bedwetting inducers.

Hereditary --  Bedwetting among children may be caused by some factors that are genetically-linked. Statistics show 1 out of 7 children who has late development in bladder control have siblings or other close relative who suffered nocturnal enuresis.

Bedwetting is more common in boys than girls --  Prior to age 13, boys wet the bed twice as often as girls. By the time adolescence rolls around, these numbers equal out. Interestingly, girls are more likely than boys to have other bladder symptoms, such as urgency, frequency, or daytime wetting.

Practical Tips for Coping with Bedwetting

The following tips were recommended by our council members, one who was a bedwetter herself, as well as a local pediatrician. 

Bedwetting can go away on its own -- Every year, 15 percent of children older than 5 who wet the bed become dry with no intervention. Doctors don't know for sure what causes bedwetting or why it stops, but it is often a natural part of development, and kids usually grow out of it. Most of the time bedwetting is not a sign of any deeper medical or emotional issues.

How to tell if your child is motivated to work on becoming dry at night
There are four signs you can look for to see if your child is ready to work on becoming dry:

1. He/she starts to notice that he’s wet in the morning and doesn’t like it.
2. He/she tells you he doesn’t want to wear Pull-Ups anymore.
3. He/she tells you he wants to be dry at night.
4. He/she doesn’t want to go on sleepovers because he’s wet at night. 

Establish a Solid Bedtime Routine --   Guide your child in doing activities that will prevent them from bedwetting. These may include reducing their drinks before bedtime, directing them to the toilet before they sleep, and reminding them that they can always use the toilet if they needed it and that you have already made sure there are no hindrances on their way there even if nature calls in the middle of the night. Being consistent in this routine can help train them to get into some good habits while they are working through the bedwetting challenge.

Bedtime Stories can also be Helpful.   Start with something ordinary: “Once upon a time, a boy named Jack was walking down the street…” and feel free to ramble wherever your imagination takes you. If you get stuck, say “And can you guess what happened next?” Often, your child will chime in with a suggestion or plot twist of his own – a good way to find out what’s on his mind.

The Bedwetting Alarm -- The bedwetting alarm is the product that yields the best results for most families. This device teaches the child’s brain to pay attention to his bladder while sleeping. Bedwetting alarms have two basic parts. (1) a wetness sensor that detects urine and (2) an alarm unit that produces a loud sound when a child wets the bed.

The alarm’s sensor has the ability to detect small amounts of moisture. When a child wets the bed, the urine in his underpants turns on the alarm. When the alarm goes off it awakens the child so he can go to the bathroom and finish urinating in the toilet. After weeks of hearing the alarm, the child’s brain learns to pay attention to the full bladder signals and he wakes up before wetting the bed.

Drugs Used to Treat Bedwetting 
Dr. Bennett explains that the medication that is prescribed most frequently is called desmopressin (brand name: DDAVP). Desmopressin is a manufactured form of the hormone the brain produces to decrease urine production at night. The effects of desmopressin only last for a short period of time, and children usually relapse when medication is stopped. For this reason, doctors generally recommend this for sleepovers, vacations, or special occasions.

Encouraging Your Child Through the Bedwetting Stage

Dr. Bennett recommends the following strategies to help ease your child’s anxiety:

• Do not punish or shame children for being wet at night.
• Remind children that bedwetting is no one’s fault.
• Let children know that lots of kids have the same problem.
• Let children know if anyone in the family wet the bed growing up.
• Maintain a low-key attitude after wetting episodes.
• Praise children for success in any of the following areas: waking up at night to urinate, having smaller wet spots or having a dry night.
• Encourage children to go on sleepovers.

Enlist Child’s Help for Cleanup

Enlisting your child to do the cleanup the next morning he wakes up wet is important. This will teach the child a sense of responsibility by making him rinse his or her pants or even the bed covers. Explain that this is not punishment but taking responsibility.

If bedwetting is persistent, you may want to have your mattress covered with waterproof material.

Our council members all agreed that one of the best gifts we can give our children is a comfortable, safe night’s sleep. By cuddling with them or gently stroking their forehead before they go to sleep, telling them that we love them, and reassuring them that bedwetting is a normal part of growing up and that it's not going to last forever may actually help them relax and have a higher self-esteem during this frustrating time. 

Remember, unless there is a serious medical condition associated with bedwetting—“This too shall pass.”

If you have any advice for other parents who are experiencing a bedwetting problem, please let us know in the comment section or by e-mailing me at CB091987@aol.com or by contacting our Editor, Stephen Greenwell at Stephen.Greenwell@patch.com

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