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Bedwetting

Bedwetting is a near and dear topic to me. I wet my bed until I was 9 years old and believe this issue encouraged me to become a pediatrician. Several of my children are or were bedwetters.

Twenty five percent of all five year olds wet their beds every night. (I joke this means 50% of five year old boys). Typical bedwetters are male, sleep like bricks (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.

What should we do?


1.) Restrict fluids after dinner
2.) 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 go to the bathroom again).
3.) Ask them to sit when they go to the bathroom (many boys do not completely empty their bladder when they stand).

What can we try?

Alarms: Bed wetting alarms can help end bedwetting. Unfortunately, the typical story of a family that purchases a alarm goes like this: 1.) the alarm arrives in the mail 2.) the excited overtired family hooks up the alarm 3.) at 2AM the children urinates and activates the alarm 4.) everyone in the house but the bedwetter wakes up 5.) tired parents finally get up and turn off alarm 6.) exhausted parents throw away alarm.

If you want to have success with a bedwetting alarm, I’d start with an alarm clock. Each morning have the child wake to a buzzer 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. When the bedwetting alarm goes off the child must 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 with bedwetting age, they begin to face the stigma of being a “bedwetter”. This social pressure often helps motive children to fix the problem. Medication can help children maintain their dignity and stay dry on “important nights”: vacation, sleep overs, or camp.

Bedwetting medication should only be used for short time periods. There are several medications that physicians can prescribe to help with bedwetting. When I do prescribe a medication for bedwetting, I prefer DDAVP. DDAVP is safe and effective. The dose varies so it is best to try it a few nights before relying on it’s effect.

Reward charts: Punishments and rewards are of no benefit. “True bedwetters” have no control over their bedwetting and “trying harder” does not help. It is reasonable to ask the child to help with the bedwetting laundry.

No pull ups after 6 years old
6 and up - brings sheets to the laundry room (parents make bed)
10 and up - brings sheets to the laundry room and makes bed after accidents

When should he be better?

Fifteen percent of bedwetters get better each year. By 8 or 9 years old, your child should be improving and wetting less nights than he was previously. As long as their is gradual improvement, the best treatment is support and monitoring. If your child’s bedwetting is atypical or is not improving see your health care provider.

 

 

Written July 5, 2010 by
Dr. Gordon, Orlando Pediatrician

 

 

 

 

 

gregorygordonmd.com is intended to help parents understand the needs and behaviors of children. The information presented in the site is the opinion of Gregory Gordon, M.D.and does not reflect the opinion of his partners. This website is owned exclusively by Doctors insights LLC. The advice in this site does not apply to all children. Always consult your healthcare provider for your individual needs.

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