Wet The Bed? It's Okay.

This week's guest columnist is Dr. Frank Betanski, a family practice resident at the University Hospital & Clinics here in Lafayette. If you have kids, especially a son, you may know the feeling: waking your child in the morning, pulling back the sheets, and getting the pungent smell I call the "Ammonia Sunrise."  Nocturnal Enuresis (fancy words for bedwetting) is a common problem. Parents of kids who wet the bed come in feeling frustrated and helpless.  The kid has been potty trained for years- except at night!  Bedwetting takes a toll on the patients too. Embarrassed to go on sleepovers, they feel left out. Summer camp or overnight visits to relatives can also be sources of stress rather than anticipation.  I have even heard parents broadcasting their daughter's daily accident tally at preschool pick-up!  That's not helping the embarrassment, mom and dad! Let's start with facts: 1) Bedwetting is defined as urination that happens at an inappropriate time and place.  2)The diagnosis of Nocturnal Enuresis is not made until 5 years old; nighttime dryness is actually the final stage of potty training.  3) At 5 years old, one in five children still wet the bed.  4)  Its genetic, not psychological.  If mom or dad wet the bed, there's a good chance the child will too. Bedwetting was once thought to be a psychological condition.  We now know that children who wet the bed do not have emotional problems.  Bedwetting is not an act of rebellion or laziness.  It is so common that it can hardly be called "abnormal." Bedwetting is also not a result of harder-sleeping children.  Sleep studies have shown that children who wet the bed sleep no deeper than other kids.  Surveys of parents, however, show that they still think their kids who wet the bed are "deep sleepers!" How can you treat bedwetting?  The best treatment is the bedwetting alarm.  Originally developed in 1938, it is now found at most shopping centers.  The alarm has been shown to be 75% effective.  The alarm has sensors in the child's pajama bottoms that detect wetness.  When the child begins to urinate, the alarm wakes the child up.  He then gets out of bed and finishes peeing in the toilet. The idea is that the child learns to wake up when he feels a full bladder and goes pee in the bathroom before going in the bed. The bedwetting alarm also has a high "found in the trash" rate- 20% of parents get frustrated when the device does not train the child right away, and toss it.  This is because the bedwetting alarm is a training tool, not the training!  Parents have some work to do to make it effective. First, parents shouldn't fuss at their children when they wet the bed.  Its not their fault! Reassure that they are not misbehaving.  Praise them when they help clean up and change the sheets: it's an opportunity to teach responsibility.  When the child is awakened by the alarm and has some urine left over to pee into the toilet, it's high-five time!  They may not be dry-all-night yet, but they are on their way.  Be patient- it takes many nights for the alarm to help. Limit fluids, especially caffeinated drinks, before bedtime.  Certainly no sodas or sugary juices at dinner or after.  These drinks are so tasty that children will drink and drink and take in more fluids than they need.  You don't want a bursting bladder after bedtime. Some parents wake their kids up to use the bathroom one or two hours after they fall asleep.  For sleepovers have your child wear a pull-up.  This sounds odd but can make a big difference.  If they are embarrassed about the pull-up, send them in loose-fitting PJs- no one needs to know. Sometimes kids are prescribed medicines to stop bedwetting, but the American Academy of Pediatrics cautions that these drugs are a last resort and not recommended for children under 5 years old.  These medicines may help in the short term, but do not solve the problem in the long run. When to see your doctor?  When the child has had nighttime dryness, and then begins to wet the bed again.  This can be a sign of a new medical problem such as urine infection, diabetes, constipation, or stress. But if your child has wet the bed since successful daytime potty training, don't stress. Teach them to help clean up, and that it's okay.