Coping With Bedwetting

Bedwetting 315

Wetting the bed while spending the night at a friend’s house can be embarrassing. Waking up nightly to change the sheets can be frustrating. Worrying about wetting the bed at summer camp can be frightening.

An unpleasant and often distressing problem, bedwetting is very common, and it affects millions of children worldwide.

Toilet training is a learned skill that depends on a child’s physical development, behavior patterns and social influences. Between ages 2 and 3, most children can sense when their bladder is full and then urinate voluntarily, signaling their readiness for toilet training, which children complete at different rates.

Although most children are successfully potty trained by age 5, 15 percent still wet their beds. While the occasional accident is normal, when a child wets the bed, or clothes, more than twice a week for at least three months, it is called enuresis. If the accidents occur only at night, it’s called bedwetting, or nocturnal enuresis. The rate of bedwetting declines to 5 percent at 10 years old, and is more common in boys.

Why it Happens
There are many possible causes of bedwetting. Rarely (2- 3 percent of the time) it is caused by an underlying medical condition, such as a urinary tract infection, problem with the bladder or urinary tract, constipation, or problems making the right concentration of urine. Stress or disruptive experiences can cause a child who was previously dry to start having enuresis. Genetics may play a role in enuresis: Children whose parents were bedwetters are more likely to be bedwetters themselves.
And, children who wet may be more likely to be “deep-sleepers” and are less likely to wake up when their bladders are full at night.

It is important to talk to your child’s doctor if you think he has enuresis, or the wetting causes any distress for your child or family. Your doctor can offer helpful strategies and treatments to deal with bedwetting and can determine whether it is caused by a medical condition.

There are two main treatment strategies: medication and behavior therapy. Medication has good short-term success and is useful for times when the child may sleep outside the home, such as spending the night at a friend’s house. However, most kids will continue to wet their beds after the medication is stopped.

A more successful treatment option for nighttime wetting is a enuresis alarm. This small, portable device is placed in the bed or the underpants of the child. The alarm emits a sound and/or vibration when wetting triggers it. The purpose of the enuresis alarm is to awaken the child as early as possible after wetting occurs.

A enuresis alarm conditions the child to be attuned to the sensation of a full bladder and increase his ability to wake up. Two-thirds of children cease bedwetting for 14 consecutive nights with alarm use compared to no treatment.
The long-term cure rate ranges from 68 percent to 84 percent. Some 10-15 percent of children may have a relapse, but they typically respond to a short course of reconditioning with the alarms. Bedwetting alarms are sold at many commercial retailers and can be found online.

Other strategies for helping children with bedwetting include: limiting liquids before bedtime, encouraging bathroom use before bedtime, waking the child during the night to empty the bladder, placing nightlights in the bathroom or hallway so that the child can easily find the way, covering the child’s mattress with plastic to make clean-up easier, praising the child on dry mornings and setting up a reward system for a reasonable number of dry nights.

How it Affects the Family
Enuresis may have significant psychological implications for children and contribute to family conflict. Children with enuresis may feel humiliated, socially isolated, fearful and ashamed. Many will avoid certain social situations, particularly when overnight stays with peers are involved.

As a result, bedwetting can affect social skills and school performance. And parents of bedwetters typically experience more stress than their friends who do not have children with enuresis.

Some parents punish their children for bedwetting, which can cause more stress for the child and family. It is important to remember that children rarely wet on purpose and usually feel ashamed about the incident. A child should never be made to feel guilty about something he cannot control. Children respond better to hearing praise for trying to stay dry — even when accidents occur — and encouragement that they can try again the next night.

Even though enuresis is a common childhood medical condition, parents often are often reluctant to seek medical attention. Also, many doctors do not routinely ask about bedwetting.
We encourage you to talk to your doctor about it. Don’t wait! Just think how excited your child will be when he can spend the night at a friend’s house for the first time.