Ask Dr. Gordon:
What should I do besides
invest in plastic sheets?
Bedwetting is a near and dear topic for me. Confession: I wet my bed until I was 9 years old and this experience encouraged me to become a pediatrician.
Several of my children are or were bedwetters. In fact, 25 percent of all five year olds wet their beds every night. (I joke this means 50 percent of five year old boys!)
Typical bedwetters are male, sleep like bricks (which means they are close to impossible to wake up), have a family history of bedwetting (usually the father), and wet in the first couple hours after falling asleep.
So what should parents do besides invest in plastic sheeting?
- Restrict fluids after dinner.
- Ask them to go to bathroom twice before bedtime (typically go to the bathroom and brush teeth, then read a book and say prayers, then use the bathroom again).
- Ask them to sit when they use the bathroom (many boys do not completely empty their bladder when they stand).
- Avoid pull ups after age six.
These methods are the most tried and true for helping eliminate bedwetting, though there are a few others you can try.
Alarms: Bed wetting alarms can help end bedwetting, though unfortunately, the typical story of a family that purchases an alarm looks a little something like this:
- The alarm arrives in the mail.
- The excited and overtired family hooks up the alarm.
- At 2 a.m. the children urinates and activates the alarm.
- Everyone in the house but the bedwetter wakes up.
- Tired parents finally get up and turn off alarm.
- Exhausted parents throw away alarm.
If you want to have success with a bedwetting alarm, I’d start with a simple alarm clock. Each morning have the child wake to the buzzer setting on the alarm clock. The child must learn to wake to the buzzer and turn it off himself. After the child has been trained with an alarm clock, you can try the bedwetting alarm.
to have success
with a bedwetting alarm, I’d start
with a simple
When the bedwetting alarm goes off it is important for the child to turn it off himself. If the child does not wake up, the parents should wake the child and ask him to turn it off. It takes serious family dedication to have success with an alarm.
Medication: Medications do not cure bedwetting, but they can help a child stay dry overnight. As children who are bedwetters age, they begin to face the stigma of being a “bedwetter.” This social pressure often helps motivate children to fix the problem, but when it doesn’t, medication can help children maintain their dignity and stay dry on “important” nights such as vacations, sleep overs or camp.
Bedwetting medication should only be used for short time periods. There are several medications that physicians can prescribe. When I do prescribe a medication for bedwetting, I prefer DDAVP, which is safe and effective. The dose varies so it is best to try it a few nights before relying on its effect or dismissing it as an option.
Reward charts: Punishments and rewards are of no benefit. True bedwetters have no control over their bedwetting and “trying harder” does not help. However, it is reasonable to ask an older bedwetting child to help with the soiled linens. Just try and make sure it isn’t viewed as a punishment.
For example, a child 6 and up can bring sheets to the laundry room while you remake the bed. A child 10 and up can bring sheets to the laundry room and remake the bed after accidents.
When should you see improvement?
Fifteen percent of bedwetters get better each year. By 8 or 9 years old, your child should be improving and wetting fewer nights than he was previously. As long as there is gradual improvement, the best treatment is support and monitoring. If your child’s bedwetting is atypical or is not improving, please see your health care provider.
Dr. Gregory Gordon grew up in Gainesville, Florida. He attended the University of Florida for both his undergraduate and medical degrees. After he completed his pediatric residency at the University of Alabama at Birmingham, he joined Pediatric Associates of Orlando.
Dr. Gordon is the proud father of seven children. He is the Vice President of the “The Gift of Swimming” (a local charity that provides swim lessons to Orlando’s needy children). In early 2010, encouraged by his patients, he started gregorygordonmd.com to share some of his pediatric and parenting experience.
Originally posted 5/13/2012