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Advice for Parents

Beyond the Basics: Alternative Therapies for Bedwetting

It is not difficult to find alternatives to the traditional approaches to bedwetting (or nighttime wetting), but deciding whether to try them is something else entirely.

From acupuncture to homeopathy, there are a lot of options and still more questions. An open mind, independence and the willingness to sift through a lot of information are required of parents looking to treat their child's nighttime wetting.

Chiropractic Care

An oft-mentioned alternative approach to nighttime wetting, or enuresis, is chiropractic care. Although once seen as way out of the mainstream, chiropractic manipulation of the spine is now recognized as a medical treatment, so some insurance companies may cover these services.

Chiropractic care for nocturnal enuresis treats the bladder through manipulation of the lower spine and pelvis. Since the nerve supply to the muscles that control urinary emptying is connected to the brain through the spinal cord, it is believed that aligning the spine will correct any slow messaging or incomplete signals between the brain and the bladder.

And there is evidence to support this approach: A 1993 controlled study presented to the National Conference on Chiropractic & Pediatrics tracked 46 children who were treated by chiropractors over 14 weeks and compared the results to 15 control subjects. The treated children had 17.9% fewer nighttime accidents after treatment. This study confirmed findings of other research showing positive results from chiropractic care.

The idea, however, is still controversial. "Just bring it up at a conference of pediatricians or neurologists and watch the fireworks," says William Cockburn, a chiropractor in Whittier, CA, who has seen a 50% response in 30 days by enuretics in his family practice. He believes parents and chiropractors need to communicate better on causes and treatment options.

Some experts in chiropractic want more proof. "There is not a lot of clinical science literature on spinal manipulative therapy for kids who wet at night," says Joseph C. Keating of Phoenix, AZ, vice president of the Association for the History of Chiropractic, who has written often on the need for evidence-based research in chiropractic care. "Bear in mind that the spontaneous remission rate for enuretics is about 15% per year."

Hypnotherapy

Hypnosis is another option for parents seeking non-invasive methods of treatment for nighttime wetting.

The hypnotist works with the subconscious brain to make positive connections with the conscious goal of awakening to visit the toilet in the night. Instead of using negative reinforcements from an alarm system, the child is trained through self-hypnosis and visual imaging to respond to physical symptoms of a filling bladder before an accident. This method emphasizes relaxation, self-control and independence.

The National Kidney Foundation reports that children who can benefit from this treatment usually show improvement within four to six sessions, but they caution that more studies are needed to determine its true effectiveness.

Hypnosis exists on the edge of mainstream medicine. While it is generally acknowledged as a valid approach for some conditions, it is rarely recommended by pediatricians or other resources for parents seeking help with nighttime wetting.

That may be changing as medical researchers begin to gather data on hypnosis under controlled conditions. The University of Michigan's Department of Pediatrics has reported that hypnotherapy relieved nighttime enuresis by 43 to 73% over Imipramine — a drug prescribed to treat nighttime wetting — using a method described in Alison Mack's book Dry All Night (Little, Brown, 1990).

Hands-on Approaches

Between the very physical chiropractic approach and the very cerebral hypnosis approach are a number of alternatives that involve touch. Like many alternative and complementary health methodologies, these therapies seek to re-establish balances of energy within the body and are adapted to different problems and individuals.

Acupuncture, one of the most familiar therapies to Westerners, originated in China and is still practiced there. Using filament-thin needles, the acupuncturist targets the flows of energy in the body. A 2001 study of 50 children with primary enuresis reported 43 "completely dry" children within six months when treated by traditional Chinese acupuncture.

But treating needle-shy American children with acupuncture is a special challenge. "I don't wear a white lab coat," says Sarah A. Steed, a licensed acupuncturist in Sperryville, VA. Steed says she will sit on the floor with a child if it feels more comfortable and has even had a child fall asleep during treatment.

The idea of inserting needles in children is still a difficult sell for most American kids and for parents not familiar with it. Fortunately, there are other methods that follow some of the same underlying philosophies, which do not involve needles. These include acupressure, electropuncture, shiatsu and reflexology.

These therapies apply pressure to accessible parts of the body that correspond to the internal organs believed to be afflicted. With nighttime wetting, the organs targeted are usually the bladder and kidneys. Parents are often encouraged to learn these techniques from the therapist to be performed at home.

Homeopathy

Homeopathy is a 200-year-old therapy set in motion by a German physician skeptical of the apothecaries of his era. The process of diagnosis in homeopathy is much more extensive and individualized than with mainstream Western medicine. Two people with similar symptoms might be treated with entirely different remedies due to differences in mood, sleeping habits or symptoms elsewhere in the body.

Homeopathic remedies are based on a "rule of similars" and contain extremely diluted doses designed to stimulate the natural defenses of the body. Remedies often prescribed for enuresis are: Equisetum arvense, Causticum, Belladonna, Lycopodium and Pulsatilla.

Although homeopathy is widely agreed to cause no side effects, there is a longstanding antipathy between practitioners of homeopathy and mainstream medicine. Currently, advocates of both sides are coming together to perform science-based research. The World Health Organization cites homeopathy as second only to traditional Western medicine in use throughout the world.

What Is Right for My Child?

Remember, nighttime wetting is not your child's fault and is not the result of laziness. Choosing a strategy that fits your child's needs is something that you and your family will have to decide. Speaking with your physician is also a good idea before trying various treatments.

And keep in mind that all of the above therapies are experimental — some may work for your child while others may not. "We tried every kind of medical expert I could find as my daughter grew into a teenager," says a Virginia mom of a 14-year-old child who wets the bed. "Then we tried some alternative therapies. None has worked yet, but we will keep trying: We want our daughter to feel every angle has been explored."

If none of these methods seem right for you, or even if you are working through nighttime wetting with different approaches, using disposable underpants such as GoodNites® NightTime Underwear or GoodNites® TRU-FIT* Underwear as part of your plan is a non-invasive way to cope with enuresis. Waking up dry helps the child's self-esteem and cuts down on laundry for you.

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