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Wet No More: 9 Tips for Helping Your Child Beat Bedwetting

June 16, 2011
forParentsOnline.com

If your child stays dry during the day but wets at night, the situation is likely to be confusing and frustrating for everyone involved. You're wondering if you're doing something wrong, your child is embarrassed, and you're all missing the sleep you'd like to be getting instead of cleaning up middle-of-the-night messes. And in addition to the immediate consequences, there are other ramifications: Your child may not be comfortable attending sleepovers, sleep-away camps, and some vacations, and his or her self-esteem might end up suffering. Still, you figure, what can you do other than wait it out?

According to Renee Mercer, you may be able to do more about nighttime wetting than you think. In fact, your child may be able to experience dry nights in as little as a few months.

"Many parents think that bedwetting is something that can't be controlled and that their child will just have to grow out of it - or they blame themselves or their child for the recurring problem," says Mercer, a certified pediatric nurse practitioner and the author of the new book Seven Steps to Nighttime Dryness: A Practical Guide for Parents of Children with Bedwetting. "And because many parents don't talk to their children's pediatrician about bedwetting, they don't realize that all of those assumptions are false."

Mercer, who has more than 25 years of experience in pediatrics and specializes in enuresis, or bedwetting, is adamant that bedwetting is not a sign of poor parenting or of a lazy child since it is not done consciously. Actually, nearly one in 20 children under the age of 10 wet their beds, so you're not alone in living with this often-frustrating condition.

"To put bedwetting into perspective, I often tell parents that, depending on their child's age, bedwetting is as or more common than ADHD," Mercer notes.

It's true. According to a 2007 study by the Centers for Disease Control and Prevention, 6.6 percent of children from ages four to 10 are diagnosed with ADHD. Compare that to 13 percent of six-year-olds who wet the bed, which decreases to 8 percent of eight-year-olds, and 5 percent of 10-year-olds.

Fact Box

Ten Tall Tales about Bedwetting?

It turns out that conventional wisdom isn't always so wise when it comes to bedwetting. T aken from Seven Steps to Nighttime Dryness: A Practical Guide for Parents of Children with Bedwetting, here are 10 myths to leave behind on your journey to dry nights.

1. You have to wait for your child to outgrow bedwetting. There are safe, effective techniques to help your child stop wetting the bed, so there is no need to wait what might be years for the problem to "go away" on its own.

2. Most bedwetting children have mental or physical problems. Only three in 100 children who urinate while sleeping have a physical or urologic cause for it. Likewise, psychological problems rarely cause bedwetting.

3. If a child is a sound sleeper, a bedwetting alarm won't work for her. It's true that bedwetting children are less likely to be woken by external stimuli than their parentsand that's OK. Initially, the alarm is meant to prompt Mom or Dad to accompany their child to the bathroom.

4. If your child doesn't tell you he's bothered by his bedwetting, he probably doesn't care if he's wet. The fact is, no child wants to wake up in a wet bed. Your child might not have spoken up because he's embarrassed or because he doesn't believe anything can be done.

5. Bedwetting is nothing but a pesky problem that will eventually go away. You might not have thought about it, but bedwetting can impact your family financially and emotionally. For example, one or two extra loads of laundry can cost up to $700 a year. Furthermore, bedwetting can negatively affect your child's self-esteem. Don't brush bedwetting off - it's worth the effort to overcome it now.

6. My child is alone in having this problem. In a class of 25 eight-year-olds, for example, at least one or two children besides your child are likely to wet the bed.

7. Bedwetting occurred because I left my child in disposable pants too long. Most children are day toilet trained between ages two and four, but daytime bladder control has no bearing on nighttime wetting. Using disposable pants at night can actually decrease parent frustration until a treatment program is in place.

8. Parents should restrict privileges or punish their children. Bedwetting is not something that your child can consciously control, so punishing her will be counterproductive. Instead, deal with wetting in a supportive manner.

9. Puberty will end bedwetting. While it's true that the number of children who wet their beds decreases with age, 1 percent of eighteen-year-olds continue to deal with this issue. Since puberty doesn't "cure" bedwetting, there's no reason to wait for your child to reach the teen years before starting treatment.

10. Medication is a sure cure for bedwetting. Short-term medications can work well in situations when a child has to be dry (for example, camps or sleepovers), but it rarely helps a child permanently overcome bedwetting. In fact, children who use alarms are nine times more likely to become dry and stay dry than those who rely on medication alone.

"The good news is, you can start treating bedwetting and potentially decrease how long it lasts by years," promises Mercer. "Through a series of easy-to-tackle steps and with the help of a bedwetting alarm, you can work with your child to achieve dry nights in as little as 10 weeks. So if you start now, you'll both be able to rest easy much earlier than you ever expected."

Read on to learn about some of the bedwetting best practices that Mercer has developed over the years:

Make your job easier now. As you ease into the steps that will help your child stop bedwetting, do what you can to make nights, mornings, and cleanups as easy as possible on yourself and on your child. If you aren't already doing so, decrease your workload by using disposable pants, waterproof pads, vinyl mattress covers, etc.

"In addition to buying products that make life just a little bit easier, you can also get into some helpful habits," Mercer says. "For example, you may occasionally wake your child and take her to the bathroom before you go to bed - especially if her Pull-ups tend to leak, or if you have houseguests who may be disturbed by midnight cleanups. This might not ensure dryness, but it will be one less urination in bed. Also, place a clean pair of pajamas and underwear by your child's bed to make middle-of-the-night cleanups easier."

Get the whole family on board. This isn't just your child's challenge to overcome - he'll need your continued help, support, and encouragement. Keep in mind that you'll be waking up during the night as your child learns to establish a nighttime routine, as well as helping him get used to any alarms he might use and monitoring his food and liquid intakes before bed.

"Committing as a family to getting over bedwetting is crucial," Mercer confirms. "In addition to making sure that you - the child's parent or guardian - are on board, it's also a good idea to make sure that siblings know what's going on (and not to discuss it with their friends or to tease), and to enlist grandparents, or perhaps an aunt and uncle, to help with 'practice' sleepovers."

Establish a bedtime routine. Some children are more likely to experience a pattern of dryness when they have a regular nightly routine. To the extent that it's possible, try to start working toward dryness at a time when no disruptive events such as holidays, vacations, moves, the birth of a sibling, etc. are on the horizon.

"I recommend eating dinner at the same time each night and drinking only water afterwards," instructs Mercer. "Don't restrict fluids entirely; just stay away from soda and sugary drinks. Children should also urinate twice before bedtime and be involved in any pre-bed rituals such as placing extra pajamas behind the bed and attaching the bedwetting alarm."

Refrain from punishment. It is crucial to realize that kids do not wet their beds voluntarily. Bedwetting can be caused by a multitude of factors, including genetics, small functional bladder capacity, food sensitivities, high nighttime urine production, and even constipation - but a wet spot in the morning is not a result of your child being too "lazy" to get out of bed. For this reason, punishing a child for bedwetting is ineffectual, and potentially harmful.

"Children very, very rarely wet their beds on purpose," confirms Mercer. "In fact, most feel frustrated, embarrassed, and upset when they wake up to wet sheets. Punishing your child for not having a dry night will only compound these feelings and hurt his self-esteem. Being encouraging and supportive is always the route to go."

Invest in an alarm. a bedwetting alarm, that is! Unlike conventional alarm clocks, bedwetting alarms don't ring at a pre-set time. A moisture sensor triggers the alarm, which wakes you and your child. At this point, you can make sure that your child gets up and goes to the bathroom. And after a few weeks of associating the alarm with the need to urinate, your child's brain will begin to understand the feeling of a full bladder, and she'll wake up on her own.

"In my opinion, a bedwetting alarm is crucial if you're serious about stopping bedwetting," Mercer asserts. "It functions as the middleman your child has hitherto been lacking because it helps her brain and bladder 'talk' to each other at night. There are many different types and styles of alarms, ranging in price from around $60 to $200. Your goal is to find one that your child likes and accepts, and that works reliably for her. Oh, and most families find that the money they save on disposable pants and laundry detergent quickly pays for the alarm."

Record your child's progress. During your efforts to achieve nighttime dryness, track your child's progress from the time you start to use a bedwetting alarm. As accurately as you can, record the frequency of his bedwetting episodes, the size of the wet spot, the time the alarm sounds, and the number of dry nights in a row he achieves. Also, keep a log of what he eats and drinks, how tired he is, and if he's sick - these things can help you identify possible bedwetting triggers.

"Keeping records during bedwetting treatment is actually a vital part of achieving dryness," asserts Mercer. "I recommend using charts to keep track of everything, and jotting down the previous night's occurrences first thing in the morning so that you aren't trying to remember what happened days or weeks later. Tracking these things can help you identify patterns, and seeing progress in writing can be a great motivator for you and your child."

Create a reward system. A little incentive never hurt anyone, and when it comes to bedwetting, having a reward system in place can keep your child motivated and help her to persevere when she becomes discouraged. Set up a system that acknowledges both cooperation with your evening and nighttime routine (something your child can control) and dry nights (something she can't).

"I recommend tailoring your reward system based on your child's age," Mercer shares. "Younger kids, ages six to seven especially, respond well to visual rewards like stickers on a chart. Older kids might prefer a mutually agreed-upon reward every week or so for the effort that they put into using and responding to the alarm, for example. I've found that a nice sleeping bag for sleepovers and camps can be a great reward after so many nights dry."

Do a sleep-away trial run. Once your child has achieved dryness, consider doing a "trial run sleepover" with grandparents or another trusted relative before leaping right into overnight birthday parties and camps. In many cases, this allows children to get used to sleeping in an unfamiliar place without worrying they might slip up and have a wet night.

"During this trial run - and anytime your child sleeps away from home if she's not confident she'll remain dry - pack disposable pants and a waterproof sleeping bag liner so that the outside of the bag and the floor will remain dry if she has a wet night," advises Mercer. "Also, if you are considering using a short-term medication like desmopressin (it decreases the amount of urine produced at night), a trial-run sleepover is a good time to see how it will affect your child."

Stay the course. Your child will probably experience some victories as well as some setbacks on the journey to dry nights. Remember that each child progresses at his or her own rate, and that most continue to wet nightly and have little, if any, independent response to the alarm the first few weeks. Don't be discouraged - eventually, you will see a decrease in the frequency of wetting episodes.

"This is why it's important to record and track progress," points out Mercer. "Celebrate small steps on the path to dryness, and expect to do much of the 'work' of getting your child out of bed and to the bathroom when the alarm sounds at first. And remember that before you stop using the alarm, your child should have 14 consecutive nights of dryness with nightly alarm use, and 14 additional dry nights using the alarm every other night."

"Ultimately, each child and each family is uniquebut there is hope that wetting can be 'put to bed' once and for all," promises Mercer. "Be patient, remain informed, and continue to encourage your child. And sooner than you ever thought possible, your child's bedwetting can be solved. Here's to positive, dry nights!"

Renee Mercer is a certified pediatric nurse practitioner specializing in the treatment of children with enuresis, or bedwetting, in Elkridge, Md. Seven Steps to Nighttime Dryness: A Practical Guide for Parents of Children with Bedwetting, Second Edition (Brookeville Media LLC, 2011, ISBN: 978-0-9740688-2-4, $14.95, www.bedwettinghandbook.com) is available at bookstores nationwide and from major online booksellers, as well as from the website.

 
 

 

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