Bedwetting Alarms… and Other Products

There are a ton of bedwetting products on the market. From bedwetting alarms, to smart phone apps, it’s tough to find the product that’s right for you and your child. We help you sort through it in this product review post.

BEDWETTING ALARMS

bedwetting alarms
Not this kind of alarm

If you and your sleep coach have decided to go the “conditioning” route, you will be wanting to find one of the best bedwetting alarms for you and for your child. There are a number of features I recommend you look for. Here’s a rundown of the various types:

  • Wearable devices: This is an all-in-one system with a sensor, a wire, and an alarm. The sensor attaches to the child’s underwear. The wire leads to an alarm that the child attaches to her shirt. When even the smallest amount of moisture touches the sensor, the alarm goes off and wakes the child (or at least the parents) and the child can go finish voiding in the toilet.
  • Wireless devices: These systems require the child to get out of bed to silence the alarm, which is either plugged into the wall or sits on a dresser or table. The act of getting out of bed can help the child condition herself for using the bathroom at night without the alarm!
  • Bell and pad systems: These older designs include a sensor pad that the child sleeps on, and a wire leading to an alarm. The pad needs to get wet to trigger the alarm, so the child must produce substantially more urine before the alarm can wake her

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Complain, complain!

bedwetting alarms
No one likes a complainer

There are pros and cons to all makes and models. For every product and design, there are some consumers who are dissatisfied because the device malfunctions. This is to be expected with any electronic device. The most typical complaint is that the alarm is too sensitive, goes off without becoming wet, and/or is difficult to turn off.

The next most typical complaint is that the system simply doesn’t work: the child still wets the bed and/or fails to wake up to the alarm. Almost without exception, parents give up before making a full effort to finish conditioning. The process takes 12 weeks, on average. The entire family must be committed to making the project work, and 12 weeks is a long time.

Do the Two-Step

The deep sleepers are actually the children most likely to be helped by these alarms. Families that decide to pursue conditioning must know that, at least in the early stages, the parents are very likely going to have to get up and wake the child when the alarm goes off. This is an important part of the process to teach the child to associate the alarm a full bladder and the need to get up and use the bathroom.

Many families report a “honeymoon” period. The device works great for two nights, and then the system appears to stop working. Like most of the advice I’ve given over the years, everything appears to work for two days. Then reality sinks in. I must emphasize that conditioning takes at least 12 weeks. Patience is essential.

The devices with the “two-step” process are better. They require that the child or parent remove the device and turn off the alarm.

And the Winner Is…

Based on my research, consumers favor products from Malem Medical above all other bedwetting alarms. Based in Nottingham, UK, Malem makes all three varieties (wearable, wireless, bell-and-pad), for prices all around $100 US. Malem products may not be the fanciest, or have the sharpest look, but they’re the most reliable and they get the job done.

BEDDING

There are two primary aims when thinking about bedding for your child: you want to protect the mattress and you want to limit the number of laundry loads! Here are the types of products you’ll be looking for:

Mattress Pads

bedwetting alarms
Better living through chemistry

The best mattress pads are “breathable”. By that, I mean they allow heat to pass through, but not liquid (which would defeat the purpose). For sleeping in summer, and for children who generate a lot of body heat, breathable mattress pads are the way to go. The most breathable material is polyurethane.

Next, you want to consider the number of layers in a mattress pad. Here, the more the better. The best pads have four layers. You pay more for the thicker pads, and you get what you pay for.

Go Vinyl!

A less-expensive option is the zippered vinyl mattress cover. It turns out this is the best solution for allergy sufferers who are concerned about dust mites. For the allergic child who wets the bed, this may be the two-bird-one-stone solution.

bedwetting alarms
Look out

It Went Through His Pads!!!

So you’ve protected the mattress. But what about the sheets? To reduce the amount of laundry you have to do, you might want to consider overlays, also known as underpads. This is somewhat of a misnomer, since these go over the sheets, and tuck between the mattress and box spring. You can wash these with the rest of the laundry.

The Top of the Line

How do (nice) hotels do it? Let’s face it, hotel beds get dirty, and the management cannot maintain high quality without premium mattress covers. These combine all the features of mattress pads, vinyl protectors and underpads.

My Recommendation

Which product you choose really depends on your budget and the amount of laundry you want to do. My best recommendation is to go most economical: a combination of a vinyl mattress cover and underpad. Vinyl makes for easy clean-ups, and has keeps dust mites away from the child. It will also extend the life of the mattress. The trick is finding the right size for your child’s bed. An underpad can substantially reduce the number of loads of laundry you (and your child!) need to do. This twin mattress vinyl cover is only $10. The best underpads are the “saddle” variety. They start at around $8.

BRIEFS

This is going to sound like an odd recommendation… because it is not a recommendation. I don’t like the idea of pull-ups or absorbent briefs for most children. The exception is children with special needs. The reason I don’t generally recommend briefs is because the point of bedwetting treatment is to teach the child to stay dry through the night! Pull-ups and other absorbent briefs defeat this purpose. The only instance in which I would recommend briefs would be for those that are paired with one of the bedwetting alarms. Also, children tend to be more comfortable in their own underwear at night. It’s uncomfortable enough to wear an alarm. Briefs only add to the discomfort.

STAIN REMOVERS

bedwetting alarms
You can’t see them, but they’re there

Everybody knows that urine stains sheets and mattresses. And a fair number of people know about the odor that urine can leave as well. However, few people know why urine stains leave an odor that’s hard to get rid of. The perpetrator is uric acid. It turns out that bacteria love uric acid. They use it as a food source. It’s the bacteria that cause the odor, not the urine itself. The key to getting rid of urine stains and odors is getting rid of the uric acid that the bacteria love to feed on. To get rid of uric acid, you need a cleaner that contains enzymes.

At Bedwettingstore.com, you can purchase two great products for stain/odor removal. Urine-Erase is a two-step system that requires no other cleaners. The only downside is that you’ll need probably an entire day to completely clean the mattress. A better choice may be OdorZyme, which is a one-step process.

DAYTIME WETTING REMINDERS

bedwetting alarms
Rodger that

These are basically wrist watches that vibrate to remind the child to go pee. You can adjust the settings to the interval you want: 2 hours, 3 hours, etc. They look just like regular digital watches and so no one but the child need know she’s wearing one! Reminder watches are especially useful as aids to a child who is learning to pay attention to her bladder signals, including children who wet during the day.

My favorite is the Rodger 8-Alarm Vibration Reminder. This one is cool-looking and doesn’t actually have the word “vibration” written on the face, so it truly looks like a normal wrist watch.

BEDWETTING BOOKS

It’s essential for parents to tell their children that their bedwetting is normal, that there are lots of other children who wet the bed, and that the problem can be fixed. But sometimes it’s difficult for parents to get his message across. Even for parents who are great at communicating these ideas, books are a great way to reinforce these important points. Bedwetting books, like bedwetting alarms, come in three varieties. There are books written primarily for parents, books just for kids, and books written for both parents and kids.

For Parents

My favorite is 7 Steps to Nighttime Dryness by Renee Mercer. Mercer is a pediatric nurse practitioner, a PNP, and I just love that you say this “Pee & Pee” (go ahead, say it out loud!). But it’s a terrific, easily accessible guide. Best of all, you can get the book as part of a kit that includes the Melem bedwetting alarms (and see KITS section below).

A bit less accessible, but more comprehensive and detailed is Getting to Dry, by Urologist Max Maizels.


For Kids

Prince Bravery & Grace – Attack of the Wet Knights. This one is a “little young” for pre-teens and adolescents, but for the 5-10 year olds, it’s a cute story with a happy ending, of course!


David’s Secret Soccer Goals. This is a great one for boys beyond “Prince Bravery” age. It’s a short chapter book, remarkably insightful and sensitive to the anxieties of pre-adolescent boys with bedwetting.


For Parents and Kids

Waking Up Dry, written by a Pediatrician, is an interesting hybrid, meant to be read together by parents and children. I like this approach because cooperation by parents and children is essential for successful mastery of bedwetting problems.

BEDWETTING APPS

bedwetting alarms
So many apps, so little time

By 2015, there were over 1000 bedwetting apps for smartphones. Which ones are best? Fortunately, a group in Australia who published a review in the Journal of Pediatric Urology found that only three of the 1000 were useful for parents and children.

My Dryness Tracker, a free app, includes a lot of compelling features, including a module that allows you to send results to the child’s physician.

Bedwetting Tracker, from Ireland, also comes loaded with extras including video, but is only available for the Android operating system.

My favorite is HapPee Time. It’s kid-friendly and includes a rewards page. This is the sticker-chart section that I discussed in the post on Bedwetting treatments. In general, any product that is useful for both parents and kids is a bonus.

KITS

To save some money, you can buy treatment kits that include bedwetting alarms, books, and special bedding as well. The best value includes some of the items I’ve already highlighted: the Malem bedwetting alarm, underpads, and “7 Steps to Nighttime Dryness”. You can find this kit online for about $130.

FINAL WORD

Bedwetting treatment is long and requires a ton of patience and good humor. Even the best products like the bedwetting alarms and and other things I’ve chosen are going to be a bad fit for someone. If you’ve done your homework and you’re certain there’s no medical reason for the bedwetting, you may just need to try several devices and methods, or combinations of methods until you find the right fit.

Bedwetting Case Study

One of my favorite clients of all time is a goofy 10-year old named Ronny. Outwardly, Ronny was a friendly, happy kid, who had lots of friends and was adored by his two younger sisters. But inwardly, Ronny was anxious about his bedwetting, which he had done forever as far as he knew.

bedwetting case study
Flower bed, wet

It really became a problem for him when his next youngest sister became dry through the night. When the youngest sister, Ronny’s baby sister as he called her became dry through the night as well, Ronny had had enough. He was wetting the bed 5 out of 7 nights per week. He begged his mother to help him. Ronny’s bedwetting case study would become an example of how hard work a perseverance can solve almost any problem.

Ronny: A Bedwetting Case Study

When Ronny’s mother called me the first time, one of the first questions I asked her was “have you seen Ronny’s pediatrician about this?”

She hadn’t, so I encourage the mother to call the doctor first. To tackle bedwetting it’s essential that you first rule-out the medical reasons why a child might wet the bed.

A month later, the mom called me back. Ronny had no medical issues, but the pediatrician had referred the boy to a urologist anyway (more on this later). The pediatrician didn’t see any reason why we couldn’t get started.

Round One: Reinforcement and Responsibility Training

I cannot remember a consultation where the child paid attention as closely as Ronny did. This kid was motivated. That’s always good sign; if the child isn’t fully on-board, you’re not likely to succeed. We started with a sensible sticker chart system (this was back before you could buy sticker chart apps for your phone). Ronny agreed that he’d strip his own bed in the morning, and he’d help his mom change the sheets. Ronny also took it upon himself to be in charge of laundry detergent, from choosing a brand at the supermarket, to measuring for each load, to keeping track of family usage.

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This was a terrific plan, but it didn’t work.  After two weeks, there were a few stickers, but not enough to make Ronny believe he was making any progress.

“He just sleeps so deeply,” his mother told me. I was sure this was true. It was probably part of the reason why Ronny was wetting in the first place. And it was a good sign that the problem would probably work itself out with time. But it was time for another tack.

Round Two: Bladder Training

Ronny really liked this idea. He got to pee into a urinal that was marked in milliliters. Ronny spent a few days learning about the metric system on the internet. He was motivated to hold his pee and to go for the record. And he did a great job at it.

bedwettng Case Study
Leaf bed, wet

But as motivated as Ronny was, it just didn’t work. He still wet the bed 3-5 nights per week.

Ronny’s mother was trying to keep cool, but I could tell that she was growing frustrated. On the other hand, the family had been living with Ronny’s bedwetting for a long time, and they were prepared for the long haul. So we carried on.

Round Three: Conditioning

I’ve had good luck with conditioning in the past. I was feeling confident that this was going to work. I explained the way it worked: about how the brain talks the bladder and how they learn to listen to each other’s messages. Ronny was pretty psyched about getting to wear a “potty pager” .

The family gave conditioning a good long try. This was noteworthy because the alarm was so loud that it woke both Ronny’s parents, 3 nights per week! It woke Ronny’s sisters as well.  It just didn’t wake up Ronny!

The family actually went through two potty pagers. Ronny somehow broke the wire to the first one during sleep. He was indeed a deep sleeper.bedwetting Case Study

Meanwhile…

I wasn’t aware at the time, but while we were working through the various trials of bedwetting fixes for Ronny, his family had been taking him to see specialists as recommended by his pediatrician. He went from his primary care pediatrician to a urologist, who referred Ronny to an endocrinologist, who referred Ronny to a developmental pediatrician. All but the last one performed tests on Ronny. At least one test involved a catheter, to which Ronny did not take kindly, understandably.

If this game of “medical hot potato” sounds familiar, it should. All too often people are sucked into the whirlpool of medical specialists and testing, often for common, self-limiting problems like Ronny’s. It’s a symptom of our culture of over-treatment.  This culture, combined with the common myth of the un-healthy child, is always present in the background at Sleep, Baby! It’s an unfortunate pairing that I’ve been arguing against for years.

Round Four: Medication

At this point, Ronny’s mother was willing to talk medication with the pediatrician. Happily, this pediatrician agreed that medical treatment of bedwetting should be used in low doses and only for short periods of time. Ronny wanted to have sleep-overs, like his friends were having, and wanted at least the possibility of going away on weekends with family friends.

Ronny and his parents understood that medication was not a quick fix, and that it would be only a temporary measure to get him through important social events.

Happy Ending

Almost two years later, I got a call from Ronny’s mother. She wanted me to know that Ronny was now dry through the night, at 12 years old. His confidence was back up. He was having sleep-overs every few months, and was even planning to go to a sleep away camp that summer. For an awful moment, I thought that Ronny’s mom was calling me to say “thanks for nothing”. In fact, her agenda was entirely different: It turns out that ever since we began “reinforcement and responsibility training”, Ronny had been helping with laundry, especially the detergent detail. Mom got a good giggle out of this but also felt grateful. And she wanted to let me know. We didn’t solve Ronny’s bedwetting: that solved itself! But we helped Ronny become a responsible partner in running his household.

That’s a win in my book.

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How To Treat Bedwetting

Since the dawn of recorded history, bedwetting has been seen as a problem requiring the help of a specialist. The indispensable Dick Ferber documents “cures” for bedwetting from as early as A.D. 77. But bedwetting is unusual among maladies with long histories. Ancient remedies for such common problems as colic and constipation have given way to prescription medications. Not so for bedwetting. “Boiled mice” and “hedgehog testicles” have not been replaced by “modern” medicines. Instead, in the 21st century we treat bedwetting primarily with behavior modification. In other words, you no longer need a specialist, you treat bedwetting yourself!

treat bedwetting
Hedgehog LOVES behavior modification!

Four Major Methods to Treat Bedwetting

Virtually all treatments for bedwetting fall into four categories: reinforcement and responsibility training; bladder training; conditioning; and medication. But all of these methods, including medication, require that parents and the child all cooperate to solve the problem together. If the child is not “with the program”, you have very little chance of success. Likewise for parents: all the child’s caregivers must agree to be patient, persistent, and above all, prepared to deal with many setbacks along the way.

Before you begin any such plan, it’s important to see the child’s doctor to rule out any medical reasons for bedwetting.

Reinforcement and Responsibility Training

Reinforcement and responsibility training is based on the theory that a child who feels responsible for taking care of her general needs during the day is more likely to take care of herself at night as well.

treat bedwetting
Everyone loves a gold star

You begin by sitting down with the child and coming up with a (short!) list of things the child can take responsibility for in the house: washing dishes, walking the dog, etc. But the one item that absolutely is on the list is taking responsibility for the bedwetting episodes themselves. This is not punishment, it’s giving the child ownership of the problem. It can be explained as a privilege that “big kids” are able to do and, most importantly, will be rewarded for doing. People respond much better to positive reinforcement for good behavior than they do to punishment for bad behavior.

So yes, you involve the child in changing the sheets and doing the laundry, but mostly, reinforcement and responsibility is about the rewards. And since the second half of the 20th century, this has meant sticker charts.

The sticker chart concept sounds easy. And in theory, it is easy. You set clear and achievable goals, chart progress, and provide a reasonable (not extravagant) reward for success. Easier said than done. If you’re going to do reinforcement and responsibility training, you need to have a very solid sticker chart plan in place and never deviate from it! This is an area where a sleep coach can really help you get it right. There are a lot of pitfalls to avoid, so get help before you put up that chart!

Bladder Training

Some parents do bladder training at the same time as reinforcement and responsibility training. I recommend doing one at a time. Any of these methods, done right, is a lot for a child. Any one of the methods might work, so there’s no need to do them together.

I don’t recommend restricting fluids either. That method doesn’t seem to work, and it’s difficult for children. It’s difficult for people! Instead, have the child drink normally throughout the day, but avoid large amounts of fluid at bedtime.

Once a day, encourage the child to hold her pee for as long as possible, and then have her pee in a container that allows you to measure volume.  Try to go for the record every day. Also, once a day, have the child practice stopping and starting the flow of urine. These exercises help increase tolerable bladder capacity and bladder control.

When she’s dry for a few nights in a row, try increasing the amount she drinks during the day! This will help “train” her bladder to get even better at holding urine.

Conditioning

treat bedwetting
Yup. Kinda like THIS

This is the type of solution that involves gadgets. The child might enjoy the idea of wearing a little device to bed. There are many on the market and I’ll be discussing some of them in a future post. Most of these gadgets have two parts: one that detects wetness, and a really loud alarm.

The detector usually gets clipped to the child’s underwear. As soon as the child pees in bed, the electrical circuit is closed and now the alarm is powered to set off. Don’t worry, no child has ever been shocked by her “potty alarm”!

There’s some kind of connector, with or without a wire, to an alarm, which is sometimes designed to clip to the child’s shirt. Once the circuit is switched on, the alarm rings and makes a loud screech that could wake the dead!

What happens next: The brain talks to the bladder and says something like this: “Don’t ever do anything like that to me again!” With time, usually a short period of time, the brain and the bladder become friends and child learns to hold in the stream of urine before it starts.

Just like with bladder training, once the child becomes dry at night, increase her fluids during the day to “overtrain” the bladder.

The brain talks to the bladder and says something like this: “Don’t ever do anything like that to me again!”

As with any of these techniques, the key to success is consistency. Don’t deviate from the plan and don’t give up too soon!

Medication

treat bedwetting
The last resort

If you’ve given all these methods a good shot; if you’ve been consistent, stuck to a plan, given it a good few weeks and you’ve still made no headway, it may be time to head back to the doctor. Medication should be seen as a last resort only. Too many parents believe that medication is a “quick fix” for a problem that was medical to begin with. Neither thing is true. All medications have side-effects. These should be explained thoroughly to you before you give them to your child. If the doctor doesn’t do it, I encourage you to look up the side-effects on the internet.

Medications for bedwetting work best in low doses, and for brief periods. They are most useful in situations where the child is going to need to be dry for one night, or a few nights at most. For example, the child may be invited to a sleep-over, or a weekend away. As a long-term solution, medications are not the answer. The benefits wear off fairly quickly, but the side-effects do not.

Lifting

This term refers to picking your child up at 11 PM or so, carrying her to the bathroom, and placing her on the potty. Sometimes lifting can be the only technique you need to treat bedwetting, especially if the child wets once per night at a predictable time. Ferber believes that lifting can actually prevent your child from learning to train her own bladder, since she is not getting up on her own to go to the bathroom!

Dietary Changes

Despite what you may have heard, there are no changes to diet, special foods, etc., that successfully treat bedwetting. However, I firmly believe that good diet works together with healthy exercise to make sleep better, just as good sleep helps you exercise better! We will address the effects of diet on sleep in future posts.

 

Bedwetting: What Causes It?

Managing bedwetting starts with understanding what causes bedwetting. There are many possible causes, although in truth, most of the causes are mysterious. The good news is that in most cases it’s not necessary to know the true cause, because so much bedwetting is “functional“, which is to say that it ‘just happens’ in a perfectly normally functioning child! Most functional bedwetting goes away on its own without any intervention.

What Causes Bedwetting

  1. Heredity – If either parent wet the bed as a child, there’s about a 50% chance his child will too.  The chances jump to almost 75% if both parents were wetters. We assume from this fact that there is some genetics involved in bedwetting, but that’s about all we can say. There is no identified gene for bedwetting!
  2. Immature Bladder – In order to stay dry through the night, a child needs to feel when her bladder is full, and respond by getting up and going to void, hopefully in the toilet.  In some children, this sequence of full bladder-signal to the brain-go to the bathroom is not fully developed until later ages. In some children, the issue may be a hormone called Antidiuretic Hormone (ADH).  Children with low ADH fill their bladders more quickly than others and have to pee more often. There’s no specific treatment for this. It gets better on its own with time.
  3. Small Bladder Capacity – When people complain that they have the bladder the size of a walnut, sometimes they are not far off.  Some children have smaller than normal bladders. Others have normal sized bladders that simply “feel full” and begin to try to empty before they are truly full.
  4. Sleep Stage Problem – Many parents have told me that they believe their children wet the bed because they “just sleep so deeply!” Some of these parents are right… partially.  It’s true that children get into much deeper Stage IV sleep than adults do.  These children often do not arouse fully from sleep and instead enter a half-sleep-half-awake state in which they might wet the bed.  These are also the children who sleep walk and sleep talk.  This tends to improve between ages 7-18, about the time that bedwetting goes away.
  5. Emotional Factors – These factors are not clearly defined, but certain psychological stressors can lead to bedwetting in some children. These most often occur in secondary bedwetting, that is, bedwetting that begins in a child who had been previously dry for long periods.
  6. Environment/Early Childhood ExperienceRichard Ferber refers to studies in which lower income children, middle children, and children faced with early stresses such as divorce tend to wet the bed longer than other children.  These stressors do not always cause bedwetting. The contribution of these environmental factors is very small, however. Ferber advises parents not to blame themselves for their child’s bedwetting. Chances are environment had very little to do with it.
  7. Medical Factors – There are a fair number of medical problems that can lead to bedwetting.  That’s why it’s important to see your pediatrician before you try to solve your child’s bedwetting problem. If the medical problems are addressed, the bedwetting problem is taken care of!
    1.  Urinary Tract Infections: This is a fairly common cause of bedwetting. Some young girls will wet their underwear during the day as well when they have a UTI.what causes bedwetting
    2. Diabetes: As with UTIs, Type I diabetes is a cause of secondary bedwetting. This is why it’s especially important to see a doctor for a previously-dry child who starts wetting the bed.
    3. Neurological Problems – Most of these problems are already known to parents and doctors before the issue of bedwetting is ever addressed. This is because these neurological problems are usually present at birth, such as spinal cord defects. Occasionally, however, such problems are not known until the child “presents” with primary bedwetting!
    4. Other Sleep Problems – Many children with obstructive sleep apnea (OSA) wet the bed. The reason may have to do with the fact that children with OSA do not have a normal expected sleep pattern. They cannot achieve deep levels of sleep, or stay in them long, because they must arouse themselves frequently to keep breathing!

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Once the possible medical causes are ruled out, the parents and the child can set out on the sometimes long, sometimes difficult, but always rewarding path to staying dry during the night. We will address management of bedwetting in a future post.

 

 

 

 

 

 

 

Bedwetting Facts

Bedwetting is a different kind of sleep problem.  All the other problems that I talk about at Sleep, Baby! are distressing mostly to parents. Bedwetting is different because it’s really distressing to the child, too. Bedwetting can affect the child’s relationship with her entire family. And it can even affect her relationship with friends and her community. So it’s especially important to understand bedwetting facts.

Bedwetting Facts

Fact 1: Bedwetting is very common. A child who wets the bed prior to age five is not even considered to have a problem at all! As you can see from the graph, 15% of five year olds still wet the bed. Remember this is after toilet training! 7-10% of 7-year olds wet the bed as well. By age 10, 3% of parents report their children wetting the bed, and even 1% of 18-year olds.  Many children who are terribly embarrassed by their wetting do not know how common bedwetting is! One estimate is that 90% of children who wet the bed do not know that other children do this. You cannot overestimate how reassuring it is to a child to know they are not alone by any means.

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bedwetting facts
Fizzy or flat, sir?

Fact 2: There are two types of bedwetting, primary and secondary. Primary bedwetting (officially called “primary nocturnal enuresis”) refers to a child who has never been dry at night. Secondary bedwetting refers to a child who had been dry for several months, but then starts wetting again at night. With these children, it’s more likely that some kind of medical issue is involved. But if a medical problem is ruled out, then you can manage secondary bedwetting the same way as primary, and with equally good results. For 99% of children who wet the bed, there is no underlying medical reason at all. That doesn’t mean that bedwetting is an easy problem to fix: far from it! It just means that with hard work and perseverance, any family can solve bedwetting!

Fact 3: Bedwetting can have a severe impact on a child.  The child is often the first one to realize that she has wet the bed. Richard Ferber, in the book for which he is famous, gives the best description of the problem bedwetting poses for a child. He writes that if a child wets the bed, but

…magically nothing got wet, then enuresis would not be a problem at all. We are not troubled by a child who quietly gets up for a drink of water most nights, but we would be if she often spilled it in her bed. Thus enuresis only becomes a ‘problem’ when your child is old enough to be out of diapers.

bedwetting facts
It’s only water?

Ferber also emphasizes that bedwetting differs from other sleep-related episodes like sleepwalking or night terrors in that the child doesn’t know she sleepwalked or had a night terror. You don’t need to tell a child she has wet the bed. Her pajamas and sheets already told her! With sleepwalking and night terrors, her parents may be worried about the child and will show an appropriate amount of concern.  With bedwetting, however, the parents may  assume (incorrectly) that the child was aware of what she was doing, so they may respond with anger and frustration instead of concern.  Children notice these things, and they can develop deep feelings of shame and embarrassment.

For older children and adolescents, the feelings of shame and embarrassment can be much worse. Sleep-overs at friends’ houses are out of the question. The same goes for Summer camp.  So you can see that a child’s social development, especially relationships with peers, can be severely harmed by bedwetting.  If the child should be so unfortunate as to have an older sibling who knows about the wetting and tells others at school, the problem can become a source of vicious bullying.

bedwetting facts
Warning

Fact 4: Bedwetting can have an impact on the entire family. Some families handle the problem better than others. Parents who don’t understand the true nature of bedwetting often respond with hostility, even with punishment. These families require much more in-depth explanation and counseling on how to manage bedwetting in their homes. Often, if we can explain that the bedwetting is not the child’s fault, that they are not doing it on purpose, and that the child can be extremely ashamed of the behavior, then parents will often understand and can become willing partners with the child to solve the bedwetting.

Other parents handle bedwetting quite well.  These are often families where one or both parents were bedwetters themselves. There’s a strong element of heredity in bedwetting.  If there is one parent with a history of bedwetting, the child has about a 45% chance of wetting also. If both parents wet the bed, the odds increase to 75%. Often, one parent may not tell the other that he or she was a bedwetter, but if they do communicate about this, chances are they will respond to their bedwetting child with more sympathy. These families tend to require a lot less counseling regarding managing the emotional side of bedwetting.  They are well aware of all the bedwetting facts. It’s likely experienced shame and embarrassment themselves as children.

A Beginning Approach to Bedwetting

bedwetting facts
The stuff of dreams
  • Understand basic bedwetting facts. Bedwetting is a normal part of a child’s development and it is fairly common. Explaining this to a child can go a long way toward helping enlist the child in becoming dry through the night.
  • If the child is older than 5, it may be worthwhile to seek the advice of a pediatrician to help rule out medical causes of the bedwetting.  If there’s no medical cause, as is most often the case, then you can set off with your child on the road to dryness.  Prepare for the long haul.
  • Understand that your child may be suffering extreme feelings of shame and embarrassment over her bedwetting.  You may have played a part in the development of these feelings, but not necessarily. It’s important to encourage your child to discuss these feelings with you. Doing so will help her get to her goals.
  • Finally, it’s important to understand that a child’s bedwetting has an impact on the entire family, and on the child’s place among her peers. Be honest with yourself as a parent about the ways bedwetting makes you feel about your child and your parenting.  There may be some patching things up you’ll need to do. This doesn’t mean you failed.  We all mess up. What’s important is how you deal with your messes.