Bedwetting can damage the child’s self-image and confidence. The best way to prevent this is to be supportive. Parents should reassure the child that bedwetting is a common problem and that they are confident that the child will overcome the problem.
Bed-wetting can create embarrassment and anxiety in the child, it usually is not caused by a serious medical problem. In some cases, treatment for bed-wetting may not even be necessary. If your child is younger than 5 years of age and has no other symptoms, your doctor will likely suggest taking a ‘wait and see’ approach. This is because most children 5 years and older spontaneously stop bed-wetting on their own. However, if your child is older than 5 and is still wetting the bed, the decision to treat becomes more complicated and will depend on the attitudes of the child, the parents/caregivers, and the doctor.
First Step
Before starting any treatment, you should have the child’s doctor will rule out any underlying medical as the cause of bedwetting. If an underlying medical condition is to blame, treating the condition should put an end to bedwetting. If there is no medical explanation for why your child continues to wet the bed, there are many treatment approaches to try, including behavioral modifications, medications, and even surgery for children with anatomical problems. This information is to provide a non-medical approach only after you have talked to your child’s doctor.
Keep in mind, for any treatment to be successful, commitment and consistent follow through are required on the part of the child and the parent. There are several different types of behavioral modifications that can be used.
Positive Reinforcement Systems
Using a positive reinforcement system, the child is rewarded for displaying a desired behavior. No action is taken for the display of undesired behavior. In the case of bedwetting, when a child has a dry night, he or she will receive a point or sticker (thus, a positive reinforcement.) After a pre-determined number of points or stickers have been accumulated, a prize is given to the child. You do not want to make the goal too challenging for the child – you want them to succeed. Afterall, you want them to maintain their motivation. Think about a weight loss program. If you begin dieting and after a week do not see any results, what is the likelihood that you will continue your weight loss goals? You would be much more motivated if you saw a loss of one or two pounds, wouldn’t you?
Awakening Programs
There are two types of awakening programs: self-awakening and parent-awakening. Self-awakening programs are designed for children who are capable of getting up at night to use the toilet, but do not seem to understand its importance. Parent-awakening programs can be used if self-awakening programs fail.
How to use this program – One technique is to have your child practice the sequence of events involved in getting up from bed to use the toilet during the night prior to going to bed each night. Another strategy is daytime practice. When your child feels the urge to urinate, s/he should go to bed and pretend he or she is sleeping. S/he should then wait a few minutes and get out of bed to use the toilet.
If your child has trouble with the self-awakening approach, you may need to awaken the child to go to the bathroom. In the parent-awakening approach, it is recommended that a parent or caregiver awaken the child, typically at the parents’ bedtime, and have them go to the bathroom. For this to be successful, the child must locate the bathroom on their own and the child needs to be gradually conditioned to awaken easily with sound only. When this is done for 7 nights in a row, the child is either cured or ready to re-try self-awakening or alarms.
Bedwetting Alarms
Bedwetting alarms have become the popular form of treatment. Up to 70%-90% of children stop bedwetting after using these alarms for 4-6 months.
The principle of bedwetting alarms is that the wetness of the urine bridges a gap in a sensor located on a pad on the bed or attached to your child’s clothes. When the sensor gets wet, an alarm will go off. Your child will then awaken, shut off the alarm, go to the bathroom to finish urinating in the toilet, return to the bedroom, change clothes and the bedding, wipe down the sensor, reset the alarm, and return to sleep.
These alarms take time to work; and, for them to be effective, the child must WANT to use them. The child should use the alarm for a few weeks or even months before considering it a failure. Typically, Doctors prefer trying alarms first before going to medication since the alarm system has no side effects.
In Clsoing, beware of devices or other treatments that promise a quick “cure” for bedwetting. There really is no such thing. Terminating bedwetting is, for most children, a matter of patience, motivation, and time. Like any other behavior, you cannot force your child to stop this behavior. There are other behavioral treatments that may also be available and appropriate for your child. Talk to your doctor about the different options.
Rules to live by when working with a child with a bed wetting problem. Avoid blaming or punishing your child. Remember, your child cannot control the bedwetting, and blaming and punishing just make the problem worse. Help your child understand that the responsibility for being dry is his or hers and not that of the parents. Reassure your child that you want to help him or her overcome the problem. In addition, have your child help in the clean-up process. Reassure and encourage your child often. Do not make an issue out the bedwetting each time it happens. No one is allowed to tease the child about the bedwetting, including those outside the immediate family. Do not discuss the bedwetting in front of other family members. To promote healthy self esteem it is very important to decrease negativity and terminate all shaming of the child. Keep your emotions in check to assist your child to succeed.
