Over five million school-aged children have problems with bedwetting. They have no trouble with bladder control in the day time, but have ‘accidents’ at night. This is a medical condition (officially called primary nocturnal enuresis, or PNE) with deep emotional repercussions. Children who bedwet often feel embarrassed, ashamed, and insecure. If parents don’t seek treatment—and provide a supportive, positive environment—they can develop life-long issues with self-confidence.
Here are some tips on how to help your child with a bedwetting problem. Don’t worry, you and your family will get through this. The trick is to be informed, to remain patient, and to be proactive.
1. Understand the problem.
Many parents think that bedwetting is an emotional problem, caused by stress or a wrong ‘attitude’ (one survey showed that 22% of the parents thought their kids were just too lazy to get up and go to the bathroom!)
Stress can cause a few isolated incidents of bedwetting, but true PNE (which lasts for six months or more) is rooted in physical, developmental and physiological factors. So there’s nothing ‘wrong’ with your child—he’s not emotionally unstable!—and you’re not a ‘bad’ parent.
The best thing to do is to bring your child to a doctor, who will diagnose the cause of PNE. These can include an imbalance in the bladder muscles, hormonal imbalance (people produce more urine at night because of the antidiuretic hormone or ADH) or deeper sleeping patterns.
2. Don’t blame the child (or let him blame himself).
Your child can’t control bedwetting, and getting angry at him is as pointless (and mean) as getting mad at him for sneezing! In fact, punishing him will only aggravate the problem.
You also have to assure your child that it’s not his fault, and ask the doctor to explain (in simple terms) about the medical reasons for bedwetting. Then, provide constant assurance and support. Encourage your child, and when there’s an ‘accident’ don’t make a big deal out of it.
3. Talk to other members of the family.
Your partner and your other children need to be supportive, too. Explain the situation to them and firmly enforce a ‘no teasing’ rule. Also ask them to please keep the situation private, and not to talk about it with other relatives and friends. They need to respect your child’s privacy.
4. Prevent feelings of helplessness.
Your child may feel like he’s not in control of his condition, and that he can’t do anything to solve the problem. Empower him. Assure him that you’re looking for ways to solve the problem, and finding a doctor is the first step. Also ask him to help with the clean-up process after an ‘accident’ and involve him in ‘brainstorming’ on ideas on how to make the situation easier for everyone.
5. Make clean-up as easy and convenient as possible.
Get waterproof bed covers, and sheets that are absorbent and easy to wash. Room deodorizers also help.
6. Minimize the need to urinate.
Take as many steps as possible to lower the risk of an accident. For example, don’t give your child any fluids late at night—the last drink should be two hours before he goes to bed. He should also go to the bathroom before sleeping.
7. Wake your child at night.
It may take a while for your child to be able to wake up when he needs to urinate. So an easier goal is to prevent accidents by getting up in the middle of the night for a ‘scheduled’ bathroom break. You can set an alarm, and to make things easier for him, clear the path from his bed to the bathroom. Leave a light on in the corridor, or install small lights. You can also get a small portable toilet and put it in his room.
8. Explore different treatments.
Talk to your doctor about possible ways of controlling and treating your child’s case. There are drug treatments like imipramine, which has a 30% success rate but needs to be monitored closely by a doctor because of potentially dangerous side effects. Others take desmopressin, a nasal spray that is thought to be safer.
However, drug treatments don’t actually ‘cure’ bedwetting, and the problem often returns once the child stops taking the medicine. That’s why many doctors also prescribe behavioral treatments that train your child to recognize the need to urinate or to anticipate it. These include Retention Control Training (your child strengthens bladder muscles by postponing the need to pee for gradually increasing amounts of time) and Moisture Alarms that go off and wake up your child when he starts to wet the bed (these have a high success ratio and less relapses, though it takes longer to see effects). Some parents report success with alternative treatment methods like hypnosis and acupuncture.
Research on these different options and weigh the pros and cons. Discuss them with your doctor, your partner, and your child, so you can choose (or combine) methods that work best for you and your child.