By Marisa Baschuk
If you are tired of washing and drying bed-sheets from constant wetting, you are not alone.
Bedwetting is common in young children. Most children become dry at night between the ages of 3 to 5. But, 20% of five year olds still wet the bed at night. Most of these children will stop wetting in early primary school, but 1% will continue into their teens.
Children do not wet the bed on purpose; it is not under their control. Getting angry or upset with them or offering rewards for dry nights will not help.
The best way to deal with bed-wetting in young children is to give lots of reassurance that bedwetting is normal and common and they will grow out of it. Talking about an adult in their life who was also a bed-wetter usually puts children at ease and not feeling so alone. Reading books can also help (Dippy’s sleepover by Jane Clarke, Sammy the Elephant and Mr Carmel by Joyce Mills or David’s Secret Soccer Goals by Caroline Devine).
Restricting sugary or caffeine-infused drinks can also help.
Bedwetting, known in medical terms as nocturnal enuresis, tends to run in families. The causes could be varied – it may be, simply, the brain has not learnt to make the connection between feeling of a full bladder and needing to void. It may be that the child has not yet started to produce the Antidiuretic Hormone (ADH). ADH concentrates the urine overnight so our bladders don’t become so full. Some believe that children who are deep sleepers simply don’t wake up to go to the toilet.
Urinary tract infections, constipation and other health conditions may also cause bed-wetting. Before starting any treatment, it is essential to have a health check to ensure there are no other medical reasons for the wetting.
Wearing night-nappies makes bedwetting more manageable for everyone, but may also extend the bedwetting as it takes away the discomfort of waking up in a cold, wet bed. Likewise, restricting fluids at night may reduce wetting, but fails to teach your child to deal with a full bladder (and could lead to dehydration).
Some children will have a period of dryness, and begin to wet the bed again at a later stage. Often, these episodes are triggered by a stressful event in their life such as parental separation, starting kindergarten or moving home. Most children will stop wetting again when the stress levels reduce.
Tips for dealing with wet sheets:
• Making the bed twice – mattress protector, sheet and again, mattress protector and sheet makes it easier to handle wet accidents at night, as the first layer can be peeled off and the bed is made – ready to go back to sleep.
• Use a Kylie bed-wetting sheet. These are 1×1 m absorbent sheets that sit on the bed over the child’s sheet.
Tips for encouraging dry nights
• Give your child lots of reassurance that it won’t last forever.
• For children over 6 years, do bed-checks for a week and work out about what time of night your child is wetting. If you find a regular pattern, you can then wake up your child half an hour earlier than the estimated time. Take your child to the toilet, but make sure your child is fully awake to void in the toilet.
• Have a reward system for remembering to go to the toilet before bed.
• Get older children to take ownership of their wetting by asking them to remove their wet sheets and take them to the laundry. Explain to your child that this is not a punishment, it is about taking responsibility for their issue.
From age six, many children become self-conscious about bed-wetting, particularly when doing sleep-overs or school camps. If your child starts to show signs of distress, seek professional help.
Doctors sometimes recommend a synthetic DHA medication to help children stay dry. This can be helpful short-term, such as when your child is going on school camp – but not recommended long-term as it does not teach your child how to stop the bedwetting. If you are going to try this, make sure you do so weeks before the event. It does not work for all children.
For children over 6 years of age, the most effective treatment is the Bell and Pad alarm. This consists of a mat with small electrodes, placed under the child on the bed. These electrodes are very sensitive to moisture, and set off a high-pitched alarm at the first urine drop. This wakes the child up immediately and teaches them to wake up and go to the toilet instead. Within 6 to 10 weeks of this treatment, 80% of children become dry. Some children will start to wet again within 6 months, but a quick response with another stint of the bell and pad tends to deal with this.
Where to get help
There are specialised clinics for enuresis in both the private and public sectors. Specialists can include Continence Nurses, Psychologists or Paediatricians. The first point of call is your GP.
Marisa Baschuk
Psychologist
Moving Mindsets
www.movingmindsets.com.au