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Get Straight Facts About Bedwetting

Getting the Facts Straight About Bedwetting in Special Needs Kids

Bedwetting is a sensitive topic that's often swept under the rug. Such silence leads to all sorts of misconceptions about the causes, treatments and other issues surrounding bedwetting, or enuresis, for both parents and kids.

Bedwetting is something you should talk about with your family, fellow parents and especially your doctor. By getting the facts straight you will be able to more effectively help your child work through this difficult problem.

The following are some of the most common misconceptions about bedwetting and special needs children and why they're not true.

Myth 1: It's the child's fault.

When something goes wrong, many people are quick to point a finger, needing a place to lay blame. "I think most people ... assume that someone is always to blame whether it's the child or the parent," says Dr. John Gaudet, a pediatrician in Hattiesburg, Miss.

But bedwetting is nobody's fault, especially not your child's. Who would want to wake up wet every morning?

"Parents may mistakenly assume that if a child can control urination during the day, there is no reason he or she should not be able to do so at night as well," says Dr. Amy Pakula, a neuro-developmental pediatrician in Atlanta, Ga. and professor at Emory University. "They may view their child's bedwetting as attention seeking, oppositional or passively defiant behavior. Others may simply feel that their child is too lazy to get out of bed and take care of business."

Myth 2: It's the parent's fault.

Instead of placing blame on their child, some parents may feel that it's their fault – because they were bedwetters themselves and passed it down, because they didn't toilet train them right or because they haven't handled it the "correct" way.

"Parents do not 'cause' a child to wet the bed," says Dr. Pakula.

While bedwetting can be genetic, passed down from parent to child, it is not your "fault." Instead of feeling guilty, why not use your experience to help your child get through this difficult time?

Bedwetting can be caused by any number of things from neurological problems, deep sleeping, slower development, bladder infections, unmanaged diabetes and more – but it's never done intentionally.

Myth 3: It's an unusual problem or a problem only in children with special needs.

According to the National Kidney Foundation, five to seven million children in the United States – special needs or not – wet their beds at night. Such statistics show that it's certainly not an unusual problem, and, in fact, it's likely that many of your child's friends are going through the same thing.

"I reassure parents that bedwetting is a common problem in childhood and not limited to children with special needs," says Dr. Pakula.

Myth 4: My child's bedwetting should improve at the same rate as his peers.

Children with special needs like autism, Down syndrome and ADHD may be slightly behind their non-special-needs peers in developing continence both day and night, according to Dr. Maurine Packard, assistant professor of pediatric neurology and development at Cornell University. "In general, it takes longer to toilet train special needs children," she says.

As a general rule of thumb, she suggests you speak with your doctor if your child hasn't developed nighttime continence within six months to a year after developing daytime continence.

Myth 5: My child's special need causes him to wet the bed.

This is true in some cases, but not in others. For example, children with nerve disorders such as spina bifida actually may never develop continence because the nerves controlling their urinary system are affected.

The best way to know for sure is to have your child evaluated by their physician to rule out any physical causes.

"Children with special needs are more likely to have rare medical conditions that may relate to enuresis; therefore, a comprehensive medical evaluation is especially important," says Dr. Pakula.

Myth 6: It's a serious problem.

Bedwetting itself is never a serious problem. Many children experience it, and it's not even considered a problem at all until the child reaches the age of 5 or 6, according to Dr. Pakula.

"Most children, including children with special needs, eventually either outgrow bedwetting or overcome bedwetting with treatment," says Dr. Pakula.

Bedwetting can, however, signal a more serious problem, particularly if your child starts to wet the bed after having been dry at night. Urinary tract infections and unchecked diabetes can both cause bedwetting, as can sexual abuse, stress (such as a death, move or new baby) or bullying.

Cate, the mother of a 7-year-old with a rare disorder called Cohen's syndrome, which causes seizures and speech-language problems, says her son began wetting the bed after being dry for an entire summer. After meeting with doctors, they're still not quite sure what's causing the bedwetting, but, she says, her doctors are not too concerned about it yet. "In the scheme of things, when you look at the other issues to be dealt with, it is not that big of a deal," she says. "It's not our highest priority at this point to deal with it."

It's best to check with your doctor if your child begins bedwetting after being dry to try and determine the cause.

Myth 7: Bedwetting can be cured.

Bedwetting rarely can be cured, but there are a variety of ways to help manage it.

The first step is to talk with your doctor if your child is still wet at night after six months to a year of being dry during the day, says Dr. Packard. The doctor should do a physical exam to rule out any medical causes such as a bladder infection.

When choosing a technique to manage enuresis, be sure to take your child's special needs into consideration. "Children with special needs and enuresis are no less treatable than are their typically-developing peers with enuresis; however, one does need to take the child's special needs into consideration when choosing therapy," says Dr. Pakula. For example, she says she would consider the child's cognitive level, nighttime fears, sleep disorders and behaviors before recommending a treatment.

Using absorbent underpants such as GoodNites® Underpants is also a good option to save children the embarrassment of waking up wet and to save parents the wear and tear of daily sheet washing. Cate says that's how they're currently managing their son's bedwetting. "He simply wears a pair of GoodNites® Underpants every night," she says. "We make him go to the bathroom before bed and limit drinks after 7, but nothing else." They've chosen to avoid medication at this time, because doctors say it could further stunt his development.

And for most kids, bedwetting goes away on its own. "Sometimes bedwetting resolves without significant intervention of treatment even in the special needs population," says Dr. Pakula.

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