Bedwetting

Understanding a Common Problem

A Frustrating Problem

Another morning brings wet sheets, your child in tears, you at your wit's end.  Bedwetting, also called nighttime enuresis, affects many children, as well as teenagers and even some adults.  Although frustrating, it's usually not a sign of a serious problem. 

Is Something Wrong with My Child?

If you've ever asked yourself that question, you'll be glad to know the answer: probably not.  Children who wet the bed beyond age 5 generally have bladders that need more time to develop before they can gold urine throughout the night.  Some children also sleep so deeply that they don't' wake up even when their bladder is full and they need to use the bathroom.  If a child wets the bed after being dry for a while, the cause is often a stressful event such as birth of a sibling.  Rarely, bedwetting may be due to a physical problem.  Whatever the cause, bedwetting is not the child's fault, and getting mad or upset won't help.  But don't ignore the problem, either.  Talk to your child's doctor, who can help you develop a plan to cope with bedwetting and help your child become drier faster.

Getting Help

An evaluation helps rule out any underlying problems.  The doctor or nurse will talk to you and your child, examine your child, and possibly do some tests.  He or she may also ask questions to determine whether bedwetting has had an effect on your child's self-esteem and relationships with other children. 

Your Child's Evaluation

The doctor or nurse will probably begin by asking you and your child some questions.  You may be asked how often and how much your child urinates, the amount and color of your child's urine, and whether your child complains of symptoms such as burning or pain.  Mention any medical problems your child has.  Also mention if anyone else in the family wet the bed as a child, since bedwetting can run in families.  The doctor may then perform an exam to look for physical problems and test your child's urine for infection.  As part of the evaluation, you may be asked to keep a diary of your child's urination patterns for a few days.

Helping Your Child stay Dry

The best cure for bedwetting is time-time to let your child's body mature and develop.  Most children eventually grow out of bedwetting.  But the doctor may recommend some things to help your child become dry more quickly.

The Self-Awakening Routine

Your child must learn to wake up when he or she needs to urinate.  These suggestions may help:

·        Each evening, have your child lie on the bed and imagine he or she is sleeping and has to urinate.  Then have your child get up, walk to the bathroom, and try to urinate.  This helps him or her become used to getting out of bed to use the toilet.

·        If your child wakes up during the night for any reason, have him or her get out of bed and try to use the toilet.

·        If your child wakes up during the night and the bed is wet, let your child help change wet pajamas and sheets before returning to bed.

Bedwetting Alarms

Bedwetting alarms may help teach a child to wake up when he or she has to urinate.  Two kinds of alarms may help:

·        Specially designed bedwetting alarms are available at drugstores and medical supply stores.  These alarms contain a sensor that attaches either to the child's underwear or to a pad on the bed.  A noisy alarm may be worn around the wrist or on the shoulder close to the ear and when the child begins to urinate, the alarm buzzes to wake the child up.  Another type of sensor vibrates to wake the child up.  The child can then get out of bed and finish urinating into the toilet.

·        An alarm clock can be set for 3 to 4 hours after the child goes to bed.  The child is taught to get up and try to use the toilet when he or she hears the alarm.  This helps the child get used to waking up to urinate during the night. 

At first, your child may sleep through an alarm.  You may need to wake the child yourself when you hear the alarm and remind him or her to use the toilet.

Medications

Although they won't cure bedwetting, certain medications can help your child stay dry throughout the night.  Medications can be particularly useful for extra help during vacations or overnight stays away from home.  They work in different ways:

·        Pills or liquid medication may shorten deep stages of sleep or help the bladder hold more fluid.

·        Nasal sprays may decrease the amount of urine made by the bladder during the night.

Ask your child's doctor whether one of these medications would be appropriate for your child.  Medications can have side effects, so talk to your doctor about how they can be used safely.

Other Changes in Your Child's Routine

The doctor may also suggest one or more of these changes in your child's routine:

·        Limit beverages containing caffeine (such as colas and other sodas) and chocolate at dinnertime or in the evening.  Caffeine stimulates urination.

·        Ask your child's doctor whether to limit the amount of all liquids your child drinks in the evening.  This may help keep the bladder empty during the night.

·        Certain types of exercises may help the bladder hold more urine.  The doctor may suggest one or more exercises if he or she thinks they might help.

Coping with Bedwetting

Waking up each morning to wet sheets and pajamas can be upsetting.  But you can help make the problem of bedwetting less stressful for both you and your child.  Try some of the tips listed below.

Tips That May Help

·        Never punish your child for wetting the bed.  He or she can't control it.  Punishment can sometimes make bedwetting worse by increasing the sense of shame and embarrassment your child feels.

·        Use positive reinforcement to increase your child's self-confidence.  Praise your child for success and even for trying hard to stay dry.  Put up a calendar or chart and give your child a star or sticker for nights that he or she doesn't wet the bed.

·        Put night-lights in the bedroom, hallway and bathroom.  Lights may help your child feel safer getting up and walking to the bathroom during the night.

·        Get your child involved.  Encourage him or her to take responsibility for changing a wet bed during the night.

·        Protect the mattress with a waterproof cover.  Put an absorbent pad on the bed or keep extra sheets or dry towels in the child's room.  If the child wets during the night, he or she can get up and remove the pad, change the sheets, or put a dry towel over the wet spot.

·        Keep a plastic bag in the room to hold wet sheets and pajamas.

·        Make it as easy as possible for your child to spend the night away from home.  If he or she goes to a slumber party, hide a disposable diaper in the bottom of the sleeping bag, and have the child slip it on under his or her pajamas.  Also ask your doctor about medications that may help control bedwetting for a night or two.

Growing Up

Children mature at different rates.  Just as some kids walk, talk, or grow faster than others, some will stop bedwetting sooner.  That doesn't mean there's anything wrong with your child.  Patience and understanding can help your child overcome bedwetting more easily, without hurting his or her confidence or self-esteem.