Bedwetting?
When Should You Start To Worry?
When my children were born, everyone assured me girls are so much easier to potty train than boys.
One day, just before my son’s third birthday, he figured out how to use the potty. Within two weeks, he went from having a soaked diaper every night to being completely dry. After a month, we tossed the pull-ups, and he’s been accident-free ever since.
When my daughter was born a few months later, I was convinced potty training her was going to be a snap. After all, girls are easier than boys, right?
Sure enough, she was ready to ditch the diaper at 2 and a half. But, only during the day. Three years later, she’s still wearing pull-ups to bed, and she’s wet nine nights out of 10.
Although I frequently find myself wondering why she just can’t get the hang of staying dry, local pediatricians assure me she’s actually very typical.
Dr. Robert Hines, a pediatrician at Southwestern Medical Clinic in Stevensville, Mich., says by age 3, 95 percent of children are potty trained – during the day. It’s not until age 6 that 95 percent of children are consistently dry at night.
“If you’re over 6, then you’re out of the normal range for bedwetting,” he says.
But, even after age 6, kids still are likely to outgrow bedwetting on their own. Dr. Hines says as each year passes, 10 percent of the kids who are still urinating at night outgrow it on their own.
Bedwetting tends to run in families. So if a parent struggled with this issue, the kids are more likely to have trouble staying dry. Children who sleep deeply, like my daughter, are also more inclined to wet the bed.
When to Talk to Your Doctor
While wetting the bed after age 6 is not unusual, it’s still a good idea to talk to your child’s pediatrician about it at her annual physical.
Dr. Amy Shah-Shine, a pediatrician at St. Joseph Pediatrics in St. Joseph, Mich., says your child’s doctor will likely check to make sure an underlying medical condition is not causing the bedwetting. Constipation, nervous system issues and urinary tract infections can all cause bedwetting.
If your child is suddenly wetting the bed after being dry at night, you should probably call your doctor, Dr. Shah-Shine says. Children who are drinking a lot during the day and then wetting the bed at night may have diabetes. Major stressors like a divorce or a bully at school can also cause children to revert to bedwetting.
Although most cases of bedwetting resolve themselves with time, there are still things parents can do.
Positive Reinforcement
Positive reinforcement is vital, Dr. Shah-Shine says, adding, “You cannot punish the child for this. It is not something that they are doing wrong.”
Just like with daytime potty training, daily sticker charts with a large reward at the end can work wonders.
Change Bathroom Routines
Dr. Mukund Shah, a pediatrician at St. Joseph Pediatrics, suggests that parents begin limiting liquids after dinner. He also encourages parents to have their children wait a little while before going to the bathroom to help increase their bladder capacity.
Parents also need to send their child to the bathroom before bed. In addition, parents can wake bedwetters up and take them to the bathroom before the parent heads to bed.
Dr. Shah-Shine also suggests parents encourage their children to drink and urinate regularly during the day. Many children, especially girls, don’t drink enough at school and avoid using the restroom. Then they try to squeeze an entire day’s worth of fluids into the early evening hours.
Take Away the Pull-Ups
“Pull-ups can be a hindrance,” Dr. Shah-Shine says.
Because children don’t feel wet when they wear pull-ups, they often do not realize they have urinated.
Dr. Hines recommends taking kids out of pull-ups when they stay dry at night about half the time. He tells parents to make their child’s bed, and then put down a waterproof barrier and top it with a second set of sheets to make nighttime changes easier. When the child wets the bed, have him help strip off the wet sheets.
“It’s not a punitive thing to make the kids take part in pulling off that bedding,” he said. “It’s just a thing to try to motivate them that much more.”
Bedwetting Alarm
Studies have shown bedwetting alarms to be one of the most effective ways to stop nighttime urination, Dr. Hines says. Typically, children wear a sensor that sounds an alarm when it detects liquid. If the child is a deep sleeper, she may not realize she has a full bladder. Eventually, the alarm conditions her to wake up before she needs to go.
“That truly kind of matures the brain-bladder connection,” Dr. Hines says.
The problem with the alarms is they may wake up everyone in the house, except the deep-sleeping bedwetter.
Dr. Shah-Shine says she recommends the alarms for older children who want to stop wetting the bed. “The child has to be motivated to want to use it,” she says. “I wouldn’t necessarily recommend it for a 5-year-old, per se.”
Stevensville mother Kerry Wilson says a bedwetting alarm worked for her family. “It was annoying, but fixed the problem in very little time,” she says.
Medication
For older children who are still wetting the bed, doctors can also prescribe a drug called DDAVP. Its generic name is demopressin acetate. The drug uses synthetic hormones to reduce the amount of urine the body produces. All three doctors indicate the drug typically does not stop bedwetting long-term. However, it can be highly effective as a short-term solution for an older child who is concerned about wetting the bed at camp or while spending the night at a friend’s house.
“I tend to use those only for kids who need them, like for camp,” Dr. Shah-Hines says.
All three doctors also say while bedwetting can be annoying, parents should not be overly concerned about it.
“I’ve never seen a 20-year-old bedwetter,” Dr. Hines says. “Of all the kid issues, this is not a serious thing. Doing nothing is a valid option for this.”
