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Bedwetting in Older Children

How to Overcome Bedwetting in Older Children

Howard J. Bennett, MD

There is no magic age when children could be ready to work on becoming dry at night. However, most children show some concern about the problem by the time they are 7 years old. Treatment options vary depending on the child’s age, the frequency of wetting and the impact on the family. I suggest working together with your pediatrician to discover what’s best for you and your family.

Practical Tips

There are a number of practical measures parents can use to make it easier to deal with bedwetting. They include a mattress cover, odor eliminators or room fresheners, and underpads to make it easier to deal with wet bedding.

Sleepovers

Many children avoid going on sleepovers because they are afraid someone will discover they wet the bed. GoodNites pants can be used to make sleepovers a success. They are discreet and easy to use with designs on the pant that are age appropriate for older kids. I devote an entire chapter to this issue in my book Waking Up Dry.

Restricting Fluids

Limiting a child’s fluid intake after dinner is meant to reduce his urine production at night. This is not very effective and may be perceived as a punishment by the child. I only recommend limiting fluids if a child wants to try it.

Nighttime Waking

Many parents help children stay dry by taking them to the bathroom a few hours after they go to sleep. As long as children do not fight getting up, this is an effective measure parents can use until a child becomes dry on her own or is ready to start a bedwetting program.

Motivational Therapy

This is a basic intervention that includes the following elements:

  • Encourage the child to take some responsibility for his bedwetting, such as urinating before bed and putting wet pajamas in the laundry basket.
  • Give the child positive reinforcement for dry nights. This is done by encouraging the child make a calendar to monitor his progress and by giving her stickers for dry nights.

Bladder Therapy

Bladder therapy has changed over time. In the past, doctors encouraged children to hold back urine during the day in order to enlarge their bladder capacity. This is no longer recommended because it is difficult for children to hold back their urine and there is little research to support the efficacy of the approach.

Current bladder therapy focuses on having children pay more attention to bladder function. Children are encouraged to increase their fluid intake during the day, to think about the sensation of a full bladder, to respond to their bladder at the first signal and to fully empty their bladder each time they have to go.

Bedwetting Alarm

The bedwetting alarm is designed to wake a child from sleep when he wets the bed. There are multiple factors that contribute to the success of alarms, including support for the family and kids from their doctor and the type of bedwetting the child has. If a child is old enough and has the motivation to use it correctly, the bedwetting alarm can be the most effective treatment for bedwetting with success rates approaching 75% for some children.

The bedwetting alarm has two basic parts: a wetness sensor that detects urine and an alarm unit that buzzes after the child wets the bed. Some models also have the ability to vibrate when they go off. When a child wets at night, the urine in his underpants turns on the alarm, creating a loud sound. When the alarm goes off it wakes the child up so he can go to the bathroom and finish urinating in the toilet. After weeks of hearing the alarm, the child learns to pay attention to his bladder signals and wakes up before wetting the bed. Over time, most children stop waking up at night to pee. This happens because the bladder learns to hold all of its urine until morning.

Although effective, the bedwetting alarm requires a lot of motivation on the part of the child and parents, and I do not recommend this type of intervention for younger kids. Most children sleep through the alarm at the beginning of the program, so a parent needs to be involved the get the child up.

Medication

There are a few medications doctors use to treat bedwetting. The effects are not long lasting and children often relapse when medication is stopped. For this reason, doctors generally recommend medication for short-term use such as sleep away camps or to control a child’s symptoms if other measures have failed.

Conclusion

Although bedwetting eventually goes away on its own, there is no reason to wait for this to happen if your child is motivated to become dry and you can do something to speed up the process. After you see the doctor, he may recommend different things to help you become dry at night. Although medication sometimes helps, the bedwetting alarm is the most effective treatment. It’s important to speak with your doctor to discuss what’s best for your family.

Dr. Bennett is the author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting and Max Archer, Kid Detective: The Case of the Wet Bed.

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