By Renee Mercer, RN, MSN, CPNP & Founder of BedwettingStore.com
The development of urinary control is a maturational process. Everyone is born wetting the bed. As children grow and develop, so does their ability to control their bladder. Between the ages of 1 and 2, they have a gradual enlargement of bladder capacity and begin to sense when their bladder is full. When they are 3 and 4, they learn to void, or inhibit voiding, voluntarily. By the age of 5, the majority of children have an adult pattern of urinary control and the maturation of the bladder is complete. However, about 20% of children have not developed this pattern and are still having bedwetting episodes. As your bedwetting child grows older, chances increase that intervention will stop the nighttime wetting in a few weeks rather than waiting years for bedwetting to just disappear.
Although only 3% of children who wet the bed have a medical reason for doing so, it’s important to make sure medical problems aren’t contributing to the wet nights. If your child develops a bedwetting problem, talk to her healthcare provider to rule out medical issues.
There are many steps that you can take to stop your child’s bedwetting problem. Here’s a list of some common methods of eliminating bedwetting, some of which are effective and some that should be avoided:
1. Restricting fluids: This is only effective for about 15% of bedwetting children, since fluid consumption is usually not the cause of the problem. You also run the risk of dehydrating your child. A better way to maintain adequate hydration is to move overall fluid intake to earlier in the day. Make sure your child avoids caffeinated beverages, milk, and juice before bedtime and encourage him to empty his bladder before retiring. Also, encourage him to double void before bedtime. This means that he should urinate, wait several seconds (about 15), and then urinate again.
2. Punishment: Bedwetting is something that your child doesn’t have control over. Punishing her will most likely lead to poor self-esteem, increased anxiety, and a subsequent continuation of the problem.
3. Waking child or setting alarm clock: This is according to the parent’s schedule and does little to help your child develop the ability to wake up to a full bladder.
4. Drug therapy: DDAVP is a synthetic version of vasopressin (a natural hormone) and is administered as a small pill. DDAVP decreases the amount of urine produced at night and stops wetting in about half of the children who take it. The dosage varies between 1-3 tablets per night. Oxybutinin (Ditropan) is a medication used to treat overactive bladder. This can be helpful in children who experience urgency or frequency in the daytime as well as nighttime wetting. While medications may provide a temporary solution to bedwetting, most children begin wetting once they stop taking them.
5. Bedwetting alarms: Over time, these moisture-sensing alarms can improve your child’s sensitivity to the feeling of a full bladder. Because these devices train your child to recognize a full bladder, their effects will last long after treatment. The alarms’ success rate is higher and relapse rate lower than any other type of therapy. Choose from wearable alarms, pad-type alarms, and wireless alarm kits at www.BedwettingStore.com. One of the advantages of bedwetting alarm treatment is that, after the first couple of weeks of the parent responding to the alarm and waking the child up, the child should then be better able to recognize the sound of the alarm and the feeling of bladder fullness. When you think he’s ready, encourage him to get up on his own to use the bathroom at the sound of the alarm. If you’re not using moisture-sensing alarms, have your child wear protective undergarments to bed. Disposable pull-ups can be disposed of easily and conveniently, and reusable absorbent undergarments are machine washable and dryable.
More About Renee Mercer, RN, MSN, CPNP: Renee Mercer has spent 13 years as a pediatric nurse practitioner in Maryland specializing in helping children achieve overnight dryness. Mercer knows how stressful bedwetting can be for families and how this problem can negatively impact a child’s self-esteem. She founded The Bedwetting Store www.BedwettingStore.com to share her knowledge and to advise parents on effective treatments to help children stop wetting the bed. She is also the author of Seven Steps to Nighttime Dryness. In this easy-to-read book, she answers common questions such as “Did I do something to cause this problem?”, “How long until my child outgrows bedwetting?”, “Will my child ever be able to go to a sleepover without worrying?”, and “What can I do to speed up this process?” This book is a must-read for any parent with a child who is struggling with bedwetting.