A Girl's Guide to Help With Bedwetting
Parents know that girls and boys are different in lots of ways. What many parents don't realize is that bedwetting can be more emotionally upsetting for a girl at an earlier age than it is for a boy.
Dr. Patrick C. Friman, a clinical psychologist and director of Girls' and Boys' Town Outpatient Behavioral Pediatrics and Family Services in Boys Town, Neb., says that Dr. F.C. Verhulst, a noted psychiatrist and researcher, made the case 10 years ago to change the diagnostic criteria of bedwetting treatment to age 5 for girls and age 8 for boys because he thought the epidemiology was so different. In other words, it's more developmentally out of line for a girl to wet the bed at age 5 than it is for a boy.
"Girls mature emotionally more quickly and are ultimately more sensitive to the social implications of bedwetting than their male peers," Dr. Friman says. "Because of that, I do think there's a difference in how bedwetting impacts girls and the depth of the feeling that they have about it. For that reason I will take bedwetting girls into treatment when they're 5 or 6 whereas I'll wait until 7 or 8 for boys because it takes them that long to care."
Enuresis and Emotions
Hope*, from Washington, D.C., says her daughter suffered through bedwetting until she was about 9, and she was extremely upset by it at a very young age, to the point that Hope worried her daughter would carry the psychological scars for life.
"One day we took her do the doctor when she was still fairly young – 5 or 6 – and he just said she'd grow out of it," Hope says. "It was terrible. She was sad and we were sad for her. As first-time parents you don't really know what's right or wrong and we listened to him, but in hindsight I wish I hadn't because she was very conscious of it and it did impact her. Even the few things he did suggest seemed to just make her feel humiliated, like she was doing this on purpose."
Taking your daughter's bedwetting seriously before the generally accepted timeframe can save her from having her bad feelings about wetting the bed negated. And if your daughter is obviously distraught about her bedwetting, then she's also highly motivated to change, which is important because Dr. Friman points out that dealing with bedwetting requires a lot of cooperation on the part of the child.
One reason bedwetting can become a more urgent issue for girls is that girls tend to start having sleepovers at a very young age, Dr. Friman says. This brings up the embarrassment or worry factor on the part of a young girl that she may have an accident.
Hope says that sleepovers were a big issue for her daughter. "She was so worried [about having an accident] that she didn't want to go on play dates or sleepovers," she says. "When we had sleepovers here she and I had this big thing we would do where I would distract her friends and she could sneak in and put a Pull-Up® on."
Dr. Friman acknowledges that navigating these social situations can be tricky for a girl who wets the bed, but he notes that the girl's parent can get involved to communicate with the parents of the child holding the sleepover that there may be an accident. If this is done very discreetly, no one needs to be the wiser. However, he also points out that children often don't wet the bed at all when they're in a different house. The combination of excitement, the party atmosphere and, possibly, nerves keep them from the deep sleep that's often connected with bedwetting.
One more point that Dr. Friman likes to make to parents is that it's not their job to have a fear of sleepovers. "The avoidance of sleepovers because of a fear of bedwetting may not necessarily come from the child at first, but from the parent," Dr. Friman says. "A child might not know that it's a big deal but the parents do. You have to be careful of how you pass that along to the child without making them feel that there's something wrong with them."
Bedwetting and UTIs
One issue girls may face that boys don't is the problem of acquiring a UTI, or urinary tract infection.
Dr. Lyle Danuloff, consultant for the Enuresis Treatment Center in Michigan, says UTIs are common in girls who wet the bed due to deep sleep because the wetness doesn't wake them up and they lie in their urine all night. "I recommend that a parent get up in the night and check the bed if possible," Dr. Danuloff says. "If the girl is wet, changing her sheets and putting her into dry clothes will help to head off a possible UTI."
There are also irritation issues to the skin for extremely sound sleepers, but Dr. Danuloff says there are a lot of good creams on the market to protect the skin. Be sure to check first with your child's pediatrician to be sure whatever cream or ointment you choose is safe.
Remember Hope? She worried that her daughter would be scarred for life by her extreme distress from a very young age about her bedwetting. Now, she says, "The psychological effects of the bedwetting drama, thankfully, haven't lasted. In fact, she's 12 now and we were reminded of her bedwetting experience a few days ago. She said, 'Oh, I almost forgot about that.' That was a relief, because we were definitely concerned that it would stick with her."
Dr. Friman assures all parents that it won't.
"These are kids," Dr. Friman says. "Accidents happen in class and at night and there's no way to have that not happen, but if a kid is otherwise pretty well established and has love and stability at home the repercussions won't be long lasting. By the time she's been dry a month the child will be so absorbed by the day-to-day unfolding of her life that the bedwetting won't mean a thing."
* Last name withheld to protect privacy.