Oh, the days of toilet training! You encourage, praise, even bribe--and wait for little successes. Then your child is dry all day, and SO proud!

And then you begin to wonder: when will he be dry all NIGHT? Morning after morning he wakes up with heavy, wet diapers. The books say that part comes last in some children, so you wait. After a couple of years, you realize you have a bedwetter.

Nighttime bedwetting, called nocturnal enuresis, becomes a problem when a child reaches five years of age. By that time children should have control of their bladders and be able to recognize their bodies’ signals to urinate.

Boys are more than twice as likely as girls to have a bedwetting problem, and often children of bedwetters will be bedwetters themselves. The causes are many and varied, and doctors encourage parents to have their child examined if they have not had many dry nights by age 5. When it’s not a medical problem, it is usually because the child is sleeping so heavily he does not recognize the signals to go to the bathroom.

Help Your Child To Train Himself by Making a Few Adjustments

  • Limit the amount of fluids before bedtime. Without making a big deal of it (because taking something away makes you want it more), have your child stop drinking about an hour before going to bed. 
  • Wake your child during the night to go to the bathroom (perhaps right before you turn in). 
  • Have a system of rewards for dry nights. (Try stars on a calendar and special treats for so many stars earned.) However, since children cannot help this problem, some may become discouraged when their rewards are very few and far between. If that’s the case, discontinue the rewards.

Rule Out Other Reasons

Visit the pediatrician when your child is 5 or 6. She will want to rule out any physical or psychological reasons for nocturnal enuresis. Talking to the doctor will help your child see he is not alone. She will recommend several different methods to help him overcome his problem.

  • An alarm system can be purchased from a pharmacy. One type is a pad underneath the child that rings when wetness touches it. It should wake the child and train him to shut off the flow of urine as soon as the alarm sounds. Another type of alarm is a sensor, slipped into a pouch that is sewn onto the underwear. As soon as the sensor detects one droplet of urine, it beeps and trains the child to jump right up to head to the bathroom. 
  • A nose spray, desmopressin, is prescribed by a pediatrician and is not intended for every-night use. The body’s natural occurring hormone, vasopressin, tells the kidneys to concentrate the body’s urine while sleeping. This spray will concentrate the urine and stop the bladder from getting too full at night. It is only to be used occasionally, perhaps for a special overnight visit or camping trip. 
  • Some chiropractors claim to successfully treat bedwetters when vertebral subluxations (nerve interferences) are corrected. Many medical insurance plans do not cover chiropractics, so be sure to check first to see if you are covered.

Encourage Instead of Discourage

The late actor Michael Landon (“Pa” in "Little House on the Prairie") recounted that his mother made him feel ashamed. She had him wash his own sheets and hang them out his window every time he wet the bed. He would run as fast as he could all the way home from school to yank the sheets out of the window before his schoolmates could see them. Imagine the shame he felt.

This kind of treatment borders on psychological abuse. It’s discouraging to wake up wet and smelly morning after morning. To scold or treat a child as if he is naughty only adds to the pain.

Instead, tell your child you will work with him to help him overcome the problem. Show him how to strip his own bed (by the time he’s five, he should be able to), and then tell him you know he’ll do better over time.

Don’t Make it a Big Issue

If he sleeps on the top bunk of a bed, move him to the lower bunk or to someplace easier to get out of at night. It’s also a strain on parents to have to make up the top bunk with fresh sheets every day.

If he wakes up wet and cold in the middle of the night, have a couple of extra big towels and blankets ready. Instead of changing sheets, layer towels and blankets on the other end of the bed, and give him some clean underwear and pajamas to change into. (You can gather up the whole mess the next morning.) Leave him with a loving word so he doesn’t lie there hearing your anger ringing in his ears.

If your bedwetter has siblings, tell them how they can encourage. Forbid them fromo teasing or embarrassing.

Have Extras Ready

Waterproof mattress covers are inexpensive but can tear easily, especially if you’ve thrown them in the dryer, where they can become brittle. Buy an extra so the other one can air dry.

Extra sets of sheets and blankets will come in handy, so you aren’t washing sheets in the middle of the night. Instruct your child what to do with his wet things in the morning and expect him to do his part.

Be sure to have clean pajamas and underwear on hand, too.

Be Ready for Sleepovers

The thought of camping trips and slumber parties can be frightening to bedwetters. Stores carry disposable overnight underpants for bedwetters of various ages and sizes. Pack two in his overnight bag, plus a small trash bag for the morning. Instruct him to change discreetly in the bathroom (and to go to the bathroom and not drink a lot) right before bedtime. He should have a baggy pair of pajamas that won’t reveal the bulky overnight underpants.

When my sons were bedwetters, I called the mom a day or two before the sleepover. I told her that this was a source of embarrassment for my child and that I needed her to be discreet but helpful. More than half the time the mom would tell me one of her own children--perhaps even the host child himself--was a bedwetter! For a combined twelve years with two bedwetters, we never had an embarrassing moment at a sleepover when planning ahead.

Those overnight underpants became every-night pants when our sons got bigger and their urine output increased.

With a loving, patient approach to the problem, you and your child can get through the trials of bedwetting. Just be patient and let him know you love him no matter what. 

 

Shaunna Howat is a freelance writer and editor and mother of three, and she teaches part time.