Dreaming of dry?
Bed-wetting is more common than you might think
Friday, December 21, 2007
You’ve tried everything you can think of—no drinks after 8 p.m., alarms, rubber sheets—and still your child can’t get through the night without wetting the bed.
Your patience is wearing thin and your child’s self-esteem is suffering.
One suburban mom knows exactly how you feel. Sheila, whose last name is being withheld for privacy, has a 5-year-old son who still has accidents at night.
"I get up during the night and make sure to get him to the potty," she says. "About once a week, I do not catch him in time and he has already wet himself."
Bed-wetting is a confusing issue. If your child can hold it during the day why can’t he hold it at night? Is there something wrong with him? Will he outgrow it? How can he live a normal life with such a big secret?
But bed-wetting is more common than you might think. So don’t let your shame or your child’s embarrassment keep you from seeking help.
Why is it happening?
Forty percent of preschoolers experience nighttime wetness and by age 5, 10 to 15 percent still wet the bed, according to MayoClinic.com. Also called enuresis, bed-wetting is not only more common in boys, but is more prevalent in children whose parents also wet the bed.
"Many factors contribute to bed-wetting," says Dr. Max Maizels, attending urologist at Children’s Memorial Hospital in Chicago and head of its Try for Dry program.
Deep sleep, a small bladder, food and beverage sensitivities, constipation and ADHD contribute to bed-wetting. Psychological reasons for bed-wetting are rare and are usually related to abuse.
"Kids don’t wet the bed because they are crazy," Maizels says. "It’s just as physiological as appendicitis."
A normal bladder holds about 9 ounces of urine, but some children’s bladders hold less than half that amount. In a deep sleep, a child with a small bladder might not wake in time to get to the bathroom.
Sensitivities to sugar, artificial colors and other products can irritate the bladder. Constipation affects the bladder when unrelieved waste presses on the bladder. Hyperactivity also leads to bladder stimulation.
Treatments range from simple behavior modifications to a combination of approaches. Dr. Eva Alessia, a pediatrician on staff at Rush-Copley Medical Center in Aurora, advises parents to start with the basics.
"Limit fluids a couple of hours before bedtime," Alessia says.
Another alternative would be to wake your child up during the night to use the bathroom. If he is in a deep sleep, he may not recognize the urge to urinate. By waking up your child, you are teaching him that it is OK to get up at night to use the toilet.
"Set your own alarm," says Maizels, also the co-author of Getting to Dry: How to Help Your Child Overcome Bed-wetting. "Wake up your child at 10 p.m., 2 a.m. and 5 a.m. and take your child to the toilet."
Parents can also buy alarms to encourage their child to wake up when their bladder is past full. Most alarms contain a sensor placed in the underwear. When the sensor feels wetness, an audible alarm sounds to rouse the sleeping child so they know to use the bathroom. Unfortunately, sometimes these alarms wake everyone in the house except the child.
If you try these combinations and your child still has difficulty with bed-wetting, the next step should be consulting a urologist.
A urologist can determine whether the problem arises from the size of your child’s bladder and offer options from prescribing medication to advising on alarms.
At the Try for Dry program at Children’s Memorial Hospital, doctors work together to combine approaches for halting bed-wetting in children, teenagers and adults.
Because every child has different circumstances leading to bed-wetting, doctors attempt to uncover and treat all of the underlying issues.
"We offer many treatments directed towards solving the problems," Maizels says. "The use of an alarm only doesn’t work well at all. It isn’t a fast fix, but combined with other treatments, it works extremely well."
Fighting the stigma
There’s no doubt that bed-wetting carries a stigma. Kids may be afraid to attend sleepovers or have friends over. They may feel ashamed because in their minds only babies wear diapers.
Some kids are even subjected to ridicule and punishment by their parents, but that hurts, rather than helps the problem.
"Parents believe that once a child is trained that they shouldn’t have this problem," Alessia says. "But they should never punish a child for bed-wetting."
Sheila knows her son feels bad about his bed-wetting.
"He is somewhat embarrassed because he will not tell us he wet himself. We have to ask him and then he tells us," she says.
Parents should have an ongoing conversation with their children about the topic. Let them know there are other children out there who have the same problem. Involve them in solving their bed-wetting issues by keeping them informed about choices.
Giving a child the gift of love, in spite of an embarrassing problem they have no control over, goes a long way towards improving their self-confidence. A child who believes in himself will not only be able to overcome the stigma associated with bed-wetting, but will succeed when faced by challenges for the rest of his life.
Michelle Sussman is a mom of two, wife and writer in Bolingbrook. Contact her at firstname.lastname@example.org.