Techniques to Help Bedwetters
If you have a child who wets the bed, there's no doubt you've gotten lots of advice on how to help him from friends, the Internet, your doctor or your family. While there are some things that you definitely want to avoid, such as teasing by siblings, scolding or discipline, and even medication unless it's absolutely necessary, there are other techniques that are not quite so black and white.
Parents and doctors swear by some methods, while others would never even think about trying them. Consider the pros and cons of each, talk with your doctor and see if any might be right for your family.
Some pediatricians, in line with the American Academy of Pediatrics (AAP), may tell you as a first line of defense to try limiting the amount of fluid your child drinks before bedtime. There's a fine line, however, between restricting and limiting fluids, and you certainly don't want your child to go thirsty or get dehydrated.
"Never restrict fluid intake," says Dr. Eric Jones, assistant professor of urology at Texas Children's Hospital in Houston. Instead, he recommends having your child drink the majority, maybe 80 percent, of their fluids before 5 p.m.
For W.C. Hoecke, father of 7-year-old Karl who wets the bed, limiting fluids is not even a consideration. The family lives in the hot climate of South Carolina, and he doesn't want to take any chances of Karl becoming dehydrated. "I'm just going to wait until he's developed," says Hoecke. For now, Karl wears absorbent underpants to bed.
Dr. Pradeep Nagaraju, interim chief of urology at Mt. Sinai Hospital in Chicago, Ill., however, says restricting liquids won't hurt your child so long as you just do it before bedtime. "It's not a harmful way to begin with restricting fluids about two hours before bedtime, but it's not been shown to be that successful," he says.
If you don't want to cut off your child's fluids, you might try adjusting the type of fluid he is drinking. For example, many doctors recommend limiting your child's intake of drinks that contain caffeine, a natural diuretic. Dr. Stanley Hellerstein, professor of pediatrics at The Children's Mercy Hospital in Kansas City, Mo., recommends avoiding the following:
- Caffeinated drinks such as tea, coffee and those containing chocolate and soda
- Drinks with carbonation including soda, flavored water or diet drinks
- Citrus juices such as orange, lemon, grapefruit and tomato
It's OK to drink water, apple juice, juices without citrus fruits, cranberry juice, nectars or milk, he says.
Reprimanding your child for wetting the bed is, of course, never appropriate, but many doctors say that rewarding them is. Rewards usually take the form of a star chart, with stars posted for every day that the child is dry. Once she has a certain number of stars, perhaps she gets a special treat.
"Parents should not punish a child for wetting, but emphasize rewards to help learn new behaviors," says Dr. Mark Stein, chief of psychology and professor of psychiatry and pediatrics at Children's National Medical Center in Washington, D.C.
"I think [star charts] can be beneficial," says Dr. Nagaraju. "It's shown to have some efficacy..." He adds that it helps children get rid of the guilt associated with wetting the bed.
*Alyson of Mount Kisco, N.Y., however, says using a star chart did not work for her son Ryan, 8, who struggles with bedwetting. She says he started to get upset when he didn't get a star, and she felt bad rewarding him for something over which he had no control. "To make it a reward or punishment, that didn't work because either way it was a let down for him," she says.
Waking Your Child up at Night
Many parents of bedwetting children feel that if they wake their child up to use the bathroom several times during the night, they will prevent accidents. Logically, it makes sense, but it's not always helpful.
"My stepdaughter was a heavy sleeper at that age and seemed to sleep right through the urge to use the bathroom," says Laurie, a mother in Kansas. "In fact, she'd wake up cold and soaked in the morning and wonder how she got that way. We tried many things, from waking her at 2 a.m. and carrying her to the bathroom to using an underwear alarm that would sound if it got wet. In the end, the solutions were as stressful as the problem. We began having her wear GoodNites® to bed, and we were all more relaxed."
Alyson also felt trying to wake up her son to use the bathroom was too much of an ordeal. She said he was very hard to awaken, and when he did wake up, he was very irritable. He was also waking up tired, so the family decided it was not working for them. "The more I make a big deal out of it, the more it becomes a big issue for him," she says.
Dr. Nagaraju, however, feels that it's not a bad idea. He suggests waking up the child once – maybe as you're on your way to bed – so, he says, "They get into going through the ritual of using the bathroom."
The National Kidney Foundation cautions that while waking your child up to use the bathroom may help keep the bed dry, it rarely helps a child stop bedwetting.
Child Participation in Clean-up
Should you have your child help wash and change her sheets, or is that cruel since she can't control it? That's a decision you and your family must make.
The AAP does recommend letting your child help with clean-up, saying that it teaches responsibility and may keep others in your family from knowing every time she wets the bed. They do warn, however, that if other siblings do not have similar chores that your child may perceive it as a punishment.
That's why Alyson chose not to have her son wash his sheets. "I don't make anyone else wash their sheets," she says. "I kind of felt that was a punishment for something he can't control."
Dr. Nagaraju thinks that having children older than 5 wash their own sheets is a good idea. He says that children should be given responsibility, and he thinks that it helps them try harder to become aware.
And if sheet washing is a big issue in your house simply because of the frequency, consider using absorbent underpants, which keep sheets dry and laundry to a minimum. "We went through months of sheet washing and then found real comfort in the GoodNites®," says C.J., a mother in Utah whose teenage stepson wet the bed. "It was easier for all of us."
But no matter how you choose to handle the situation, remember the most important thing is to help your child handle bedwetting with dignity, so be sure not to do anything that might negatively affect his self-esteem. Also, be sure to check with your doctor first and go with your gut – if it doesn't feel right, don't do it.
*Last name excluded to protect privacy.