Bedwetting, also called nocturnal enuresis, has implications, which are often underestimated by both the community and those advising on its treatment. It places a huge burden on the whole family, as any parent of a child who wets the bed will testify! Parents often become very distressed and might even suspect that their child is deliberately causing mischief. They are not! Children can become anxious about their own ability to influence the outcome. Try as they might to help, they feel powerless to stop wetting the bed, and in time their self esteem may even suffer. Sleepovers with friends and school camps can become a source of considerable stress to the child. Many parents become resigned to the fact that they are unable to help their child. Doctors are often dismissive, offering only reassurance that the child will eventually outgrow the problem, when the family requires immediate help. Whilst bedwetting is a very common problem, it is often needlessly tolerated because of a certain reluctance to discuss what is an awkward and embarrassing subject for many people.
Don’t just wait for the problem to stop!
All children are different. Just as most of the developmental milestones vary from child to child, so does continence at night. Two thirds of children will have stopped bedwetting completely by five years of age. One third are still wetting at five, with the frequency varying from occasional bedwetting to wetting every night. If your child is five and still wetting regularly then it is time act. The parent must decide when they are ready to do something about the problem rather than waiting for the child to be ready. The first three steps of our program can be used with children as young as four years of age, however, we do not recommend starting a bedwetting alarm until children are about five years old.
Five and six year old children wetting most nights and all children seven years of age and over who are still bed wetting will generally need treatment to cure the problem. They are unlikely to outgrow the problem. Young children who are only wetting the bed occasionally are most likely to outgrow the problem.
Bedwetting problems are often attributed incorrectly to psychological problems. In our experience this is rarely the case. On the contrary, bedwetting may be the cause of psychological problems. It may give rise to feelings of shame, guilt, isolation and loss of self–esteem, especially in older children. Following treatment, a child′s emotional health improves, as does self–esteem.
It is very unusual for a child to have a physical abnormality causing the bedwetting problem.
Causes of bed wetting
- Small bladder capacity
This means the bladder is not large enough to hold all the urine produced overnight; this can be improved with our drinking program.
- Very deep sleep
This is very common in children who wet the bed. During the night their bladder sends a message to their brain saying it is full. The child needs to wake up and get up to the toilet, however they sleep through this signal;
- Large volumes of urine produced at night
Some children produce double the normal amount of urine at night so that even if their bladder capacity is normal it will not be big enough to hold all the urine they produce. Overnight these children often have abnormally low levels of the hormone vasopressin, also called antidiuretic hormone. Vasopressin is a hormone, which helps to concentrate the urine at night i.e. it reduces the volume of urine. These hormone levels can return to normal with treatment and
This can lead to pressure building up in the area around the bladder reducing the amount of urine the bladder can comfortably hold. It can also lead to tight muscles, which stop the bladder from relaxing and emptying fully when it should. With a bladder left half full it will easily fill up again.
Bed Wetting Treatment
What does a successful bedwetting program involve?
The Bedwetting Cured DVD explains how to treat the main causes of bedwetting with a five step program. It includes:
- a drinking program to improve the connection between the brain and the bladder and to gradually increase bladder capacity;
- information on foods and drinks which may be interfering with vasopressin, the hormone which concentrates the urine at night;
- information on the role of constipation;
- how to get the best results with a bedwetting alarm and
- information on medication although medication is rarely needed.
Bed Wetting Enuresis Alarms
The alarm has a sensor which detects any moisture and sounds when urine is released. The Alarm sound helps the “I’m full” message get through from the bladder to the brain. It is usually necessary to use the alarm for between four and eight weeks in conjunction with the other steps of the program. It is best to purchase rather than hire an alarm so that if there are any relapses they can be treated immediately leading to a final cure.
All bedwetting alarms are battery operated so there is no chance of an electric shock. Alarms have various sounds. Most emit a siren sound or loud noise when triggered. There is an alarm, which has the choice of the alarm sound or it can be recorded with the parent′s voice. This is a good option for young children who may be frightened by the alarm sound and may not want to use the alarm again. These alarms also have a flashing light and vibration. The loudest alarms are the Pad and Bell alarms.
Small pin on alarms
Clip-on alarms, attach to the pyjama top near the shoulder. A lead runs from the alarm to the sensor, which is placed between two pairs of underpants or underpants with pull-ups over the top. It will sound as soon as the sensor becomes wet, even with a few drops.
A waterproof mattress overlay can go under the child to keep the sheets dry. The overlay optional and is not connected in any way to the use of the alarm, however, they will save on washing and changing the sheets.
Pad and Bell Alarm
The pad on the bed and the alarm box is placed on the bedside table. A lead connects the two. Nothing is attached to the child. The alarm sounds once the wetness has reached the pad. Some of these alarms cost about $2000 and so are usually hired meaning that the alarm is often not available if it is needed again for a relapse. There may also be a six to twelve month waiting list on these alarms. We now have an inexpensive Pad and Bell alarm. It is extremely loud and has a music option which is not as loud.
Why Bedwetting enuresis alarms don’t work
Many people have tried alarms previously without success. The common reasons for failure are
- Using an alarm alone without the initial steps of the Bedwetting Cured DVD program;
- Not getting correct instruction. It is necessary for the parent to go into the child’s room when the alarm sounds. They must wake the child if the child doesn’t wake initially and then the child must turn off the alarm and
- Hiring an alarm and returning it before the child is cured. Some programs have a time limit on keeping an alarm. It is necessary to keep the alarm for about 12 months because it is common for a child to have an initial cure and then to have one or two relapses before being completely cured. The alarm must be used again if the child has a relapse.
Is there any medication that can help?
The most commonly prescribed medication for bedwetting is desmopressin, brand name Minirin. It is a synthetic hormone and has similar actions to the hormone vasopressin, (antidiuretic hormone). Desmopressin helps to reduce the volume of urine produced at night. This medication may reduce the number of wet nights in some children and even stop the bedwetting completely in a few. The main problem with desmopressin is that it is very common for the bedwetting to return as soon as the medication is stopped. The bedwetting alarm is more likely than medication to result in a permanent cure. Medication can be trialed and if it works then it can be used for holidays and school camps.
Does bedwetting run in families?
Yes, there is a tendency for bedwetting to run in families. This does not in any way alter the treatment used to cure the problem.
Is bedwetting more common in boys?
Yes it is more common in boys but is just as much of a problem whether it is in a girl or boy. The treatment is the same in both.
Will I need to purchase any equipment?
A bedwetting alarm may be needed to cure the problem. Washable waterproof mattress overlays go under the child and prevent the bottom sheet getting wet. Waterproof quilt covers prevent the quilt getting wet and only need to be sponged down. They can be machine washed if necessary.
Teenage and adult bedwetting
Our experience has shown treatment can be just as successful with teenagers and adults. Adults need to be aware that alcohol can contribute to bed wetting by suppressing the hormone vasopressin (antidiuretic hormone), which reduces the volume of urine produced at night. Following treatment it should be possible to consume alcohol and not wet the bed.
Bedwetting – What not to do
- We do not recommend measuring and charting urine and fluid intake. This is time consuming and messy and will only tell you what you will find out very quickly when you start the drinking program;
- Getting children up at night to go to the toilet will not cure the problem even if it leads to a dry bed in the morning. You will still be doing this in a year’s time;
- We do not recommend holding on as long as possible before going to the toilet as children tend to leave it until the last possible moment to go. It can discourage them from drinking adequately and can also lead to daytime wetting accidents and
- Reducing fluids in the evening without following a comprehensive drinking program will only lead to a thirsty and disgruntled child not a dry bed.
Many parents can hardly believe that their child could be waking to a dry bed every morning. Results from our anonymous survey sent to customers 12 months after purchasing the Bedwetting Cured Kit showed long term results were very good. The worst outcome was a 93% reduction in wet nights and most achieved complete success i.e. no wet nights in the previous six months.