Do your older children wet the bed? Go on, admit it. There’s no need to hide under the covers any longer… Is there? I, um, have a “friend.” Both her kids, ages five and eight, wake up pee-soaked. Every. Single. Night. My poor “friend” — we’ll call her Nadia — is more than frustrated about her “laundry problem.” She has spent years exploring every emotion that comes with being the parents of bedwetters: the “I just have to be patient; my kids are late bloomers” phase; the “Where did I go wrong as a parent?” phase; the “I blame my husband’s genes” phase; and, finally, the “Come on already!” phase.
The era of sleepovers and sleep-away camp is upon them, and in this age, where cyberbullying is a reality, Nadia and her partner fear that coming clean about soiled sheets will haunt their kids into their teen years. But what she hopes above all is that they’ll finally stop wetting the bed by then.
Parents of bedwetters are often given the impression that there’s nothing to be done about it, and that their children will eventually outgrow their nocturnal enuresis (that’s the fancy medical term for bedwetting). While this is largely true, how can we — the moms and dads who grew up with a can-do, Type-A mentality — sit back and wait? Here’s some good news: There are a lot of things parents can do to help their child in his or her quest to stay dry.
When is bedwetting a problem?
“From a medical perspective, nocturnal enuresis isn’t considered an issue until children are over the age of seven,” says Walid Farhat, a staff urologist at the Hospital for Sick Children in Toronto.
Farhat is seeing fewer patients these days, largely due to a clinic at SickKids run by three nurse practitioners: Abby Varghese, Katherine Williams and Cathy Daniels. Williams reassures parents that enuresis only becomes an issue when your child voices a concern or begins to have self-esteem issues relating to nighttime wetness.
In extreme measures, once every option has been considered on how to modify the behaviour of the child and family, they might look to prescription drugs, such as DDAVP (which stops the kidneys from producing a lot of urine). But Farhat says that, in his experience, medication is only useful in the short-term for children who require dryness for social events such as sleepovers, or for teenagers who suffer from self-esteem issues.
Common causes for bedwetting
Once a visit to the family doctor rules out any true medical or emotional reason for bedwetting, be confident your wet one will most likely grow out of it due to the following:
Genetics: If you or your co-parent wet the bed as a child, chances are higher that your child will do the same. Sandie M’s son wet the bed until grade six and she considers herself a bedwetting survivor. “I spent many, many years dealing with this troublesome, embarrassing and heartbreaking issue. I personally wet the bed until I was eight years old, and my son’s father wet the bed until he was 10.”
Physiology: Many kids who experience nocturnal enuresis have bodies that just haven’t reached that milestone of nighttime dryness yet. They may have an overactive or immature bladder, or their kidneys are producing too much urine at night when they should be in sleep mode. And for some kids who are deep sleepers, their bodies may just find it harder to pick up the signal when their bladder is full and try to get the brain to wake up at night.
Constipation: In some cases, when kids are 10 years and older, Williams finds backed-up bowels can often be the cause of bedwetting. Farhat suggests making sure your kids get the right amount of fibre in their diets.
Daytime problems: Both Farhat and Williams also explain that most parents who come to see them have children experiencing some very obvious daytime problems. “Although your child may not be wetting themselves during the day, pay specific attention to your children’s daytime voiding habits,” suggests Williams.
The world today is not set up for kids to go to the bathroom when they get the urge. Nadia’s eight-year-old son, Ben, complains that when he asks to use the bathroom, his teacher often tells him to wait because going “pee” means he might miss the whole lesson. “Kids who wet the bed are often the kids who wait until the last second to go during the day,” says Farhat. “Life is very exciting now with TV, video games and iPads. Kids need to be reminded to take bathroom breaks.”
How to help your bedwetter
Fortunately, there’s a lot we can do to help our kids through this phase. “The easiest, most inexpensive and effective course of action is behaviour modification,” emphasizes Farhat, who says he sees a success rate of 75 percent.
Commit to the cause: Everyone involved, from the child to parents, grandparents and siblings, needs to be completely committed to the goal of staying dry. Half-hearted attempts to follow the process will get half the results and sometimes prolong the training process.
Encourage, don’t reprimand: Never punish or shame a child who wets the bed. This often makes the problem worse. Your child is not wetting the bed due to laziness or spite.
Avoid training pants: The two biggest sources of frustration for parents of bedwetters are the extra loads of laundry and the cost of disposable nighttime training pants. Farhat feels that training pants can potentially give children a false sense of security, “because it makes children feel like they can wet themselves and still stay dry.” Most experts recommend “diapering the bed and not the child.”
Retrain the bladder: Remind your child to take bathroom breaks about every two hours during the day. Get your child’s teacher on board so that it’s a “before recess, at lunch, before recess” pee program at school. “Get the bladder on a good schedule,” says Williams, “Think of it as physiotherapy for your bladder.” Farhat tells families with older children to make going to the bathroom a game. He suggests buying a watch or device that beeps every two hours to set reminders.
Stay hydrated: While parents of bedwetters are typically told to limit fluids before bed, Williams says this works for some kids but not all. Encourage your child to drink lots of fluids during the day. Farhat suggests a 40-40-20 rule: 40 percent of fluids between 8 a.m. and noon, 40 percent between lunch and dinner, and 20 percent between dinner and bedtime.
Williams says juice can make things worse because sugar is an irritant to the bladder. “Water is by far the best. Make the drink fun; use a fun cup, something small and not overwhelming.”
Chart successes: Teach older children to be responsible for their wetting events. While according to Williams, “doing laundry never made anyone stop wetting the bed,” she says that changing sheets more frequently and putting on clean PJs without help gives children ownership of their situation. Farhat says parents should celebrate dry nights by offering rewards to encourage the child to keep trying.
Some parents and specialists have seen great results with the use of bedwetting alarms.
A version of this article appeared in our February 2013 issue with the headline “High & dry,” p. 26.