Parents may not consider bedwetting a childhood illness, but it is nevertheless a medical condition that can cause significant psychological trauma for a child. It is no less serious than any other chronic medical condition. It deserves to be brought to the attention of the pediatrician because treatment options do exist for this condition.
Since no one is born with voluntary bladder control, it is a universal and normal condition for a child to bed wet until she becomes potty trained. Most pediatricians do not consider it to be a problem until the child reaches the age of six or seven. Even though it is extremely common, it can be a source of embarrassment and tension in the family. When dealing with this issue, it is essential not to blame your child when there has been an accident in bed. In all likelihood, she is embarrassed enough already about what happened.
When accidents happen, take a deep breath and relax. You may be somewhat upset by the prospect of having to change the sheets for the fourth time in a week, but you should not make the task of cleaning up your first priority. Instead, the first thing you should do is to comfort your child and reassure her that it is okay and she has not done anything wrong. Most of all, it is important to remember that bedwetting is a self-limiting problem. It is going to go away, sooner or later. When it may happen is tricky to determine for each individual, but it generally becomes less common as the child gets older. Most children grow out of this problem by age fifteen.
Even though it may seem like a lost cause at first, there are actually many things you can do to minimize the frequency of bedwetting.
Change the Nighttime Routine
First of all, your child should not drink any type of fluid in the two hours prior to bedtime. This rule may be impractical to follow since suppertime falls late for many families, but try your best to adhere to this schedule. It goes a long way in lessening the frustration and saving time laundering sheets. If the child is thirsty and begs for something to drink, it is okay for him to chew some ice chips or take a small sip of water prior to going to sleep. But don't allow this little exception to be abused. If your child asks repeatedly for something to drink, you have to put your foot down and request that he go to bed. Once is reasonable; twice is a sign that your child may be trying to take advantage of the system.
Secondly, limit your child's consumption of caffeinated drinks. Ideally, children should not have any soda or tea at all, but if it is a special occasion, they can have a moderate amount of these drinks during the day. Caffeine is a powerful diuretic. It directly stimulates the kidneys to produce more urine.
Finally, you should incorporate visiting the potty just prior to going to bed as part of the bedtime ritual. This at least ensures an empty bladder at the beginning of sleep, and hopefully translates into a dry night. In fact, this is a good idea not only for children with a bedwetting problem but for every member of the family. If everyone empties his bladder prior to retiring, the bedwetting child won't feel that he is being singled out.
Some experts suggest that a parent wake the child up in the middle of the night and take him to the potty. Though this might curtail some incidences of bedwetting, many pediatricians believe it is too disruptive, for both the parent and the child. If you don't mind waking up on a regular basis, you could try this method to see how well it works for your child.
Bells and Whistles
If fluid restriction and bedtime voiding do not help your child with the bedwetting problem, another effective means of curtailing this habit is the use of specialized electronic alarms. These alarms have a sensor that is secured to your child's underwear and a small speaker that emits an audible alert when the sensor detects moisture.
Pediatricians recommend a medical evaluation to rule out possible urinary-tract infection or kidney problems for any child who still experience bedwetting after the age of six. The investigation usually involves a brief interview followed by a physical examination and a quick analysis of your child's urine specimen. Invasive and painful blood tests are usually unnecessary.
When the alarm goes off, your child may or may not wake up. It is the parent's job to wake the child and lead him to the bathroom to use the toilet. The process of training your child to respond to the alarm may take quite a long time, but it is generally effective for many bedwetters. Be patient, as it can take as long as eight to sixteen weeks before your child can wake up on his own and eventually stop wetting the bed altogether. More than half of the children who are rid of their bed-wetting do not experience any relapse of the problem after they master control of their bladders. Nevertheless, the alarm is not universally successful. If it does not work for your child, there are other options to pursue.
The Role of Medication
Not all parents feel comfortable with the idea of altering their child's hormone level to control bedwetting. It's perfectly fine if you are reluctant to try this approach, but many parents swear by it and it has brought happiness and salvation to their households. It is an option that should be at least considered if all else has failed.
Before you dismiss the possibility of using these medications, keep in mind that they are safe and nonaddictive. At the same time, is not typically recommended that they be taken on a daily basis. They are generally prescribed for use only on special occasions, like a pajama party or sleepover at a friend's house. Used in the short term and episodically, they are extremely effective.
The medication is called DDAVP, or desmopressin. This medication is a chemical that is very similar to the natural hormones synthesized by the brain to regulate urine production. It comes in a liquid form, which is sprayed in the nose, or in a tablet form.
Unlike the older generation of medications for bedwetting, DDAVP is safer and has fewer side effects. It might cause a mild stomach upset and headache in some children, but this is not common. Even though it works quite well on a short-term basis, its effect tends to wear off after chronic use. After a week or two, the dose must be increased for the medication to maintain its efficacy. Because children's bodies generally get used to the medicine fairly quickly, most pediatricians recommend using this medication for temporary relief only.