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Bedwetting Solutions

December 2016

Bedwetting is a humiliating problem that many children and their parents face – many more than you might think! While most bedwetting resolves as the child matures, in the meantime it can wreak all kinds of havoc on a child and their family. It makes children feel incompetent and unable to participate in important social opportunities like sleep-overs. It makes parents feel ineffective and helpless, not to mention sleep-deprived. As challenging as this problem is, I am always gratified by how quickly and easily it can be overcome with just a few tools. What are they? A bedwetting alarm system and a few behavioral procedures.

The alarm system is comprised of a moisture sensor that gets attached to the front bottom of the child’s underwear, and an alarm that gets attached at the shoulder of their pajama top. The moisture sensor sets off the alarm as soon as the first drop of urine is detected. The alarm wakes the child, the process of which causes the child’s muscles to contract and stop the flow of urine. This doesn’t always happen right away, although it is often surprising to see how quickly the alarm system can eliminate bed-wetting in just a few short weeks. It can take several months, but the system is very effective – especially when combined with behavioral interventions.

The most important behavioral intervention is that your child must get up and go to the bathroom when the alarm goes off. Some children are very deep sleepers and at first they do not wake up in response to the alarm. In these cases, you need to get your child up so that she can go to the bathroom and at least attempt to urinate, even if she has already flooded her bed. Over time, she will begin to associate the feeling of a full bladder with the onset of the alarm, and she will begin to wake up earlier and earlier in the process of urination. This is not a conscious process that she thinks about or that can simply be explained to her rather than experienced. The association happens automatically through the experience of pairing urination with the sound of the alarm.

In addition to getting up and going to the bathroom, your child should take responsibility for cleaning up his bedding and replacing it with clean, dry bedding. No matter how young your child is, he can play an important role in taking care of this chore. The older he is, the more responsibility he should take in the actual washing and replacing of his bedding.

As with all skills you try to teach your child, it is essential to provide praise for making it through the night without wetting the bed. Your praise is a very important motivator that is crucial to the formation of your child’s sense of self-esteem and self-concept. Be specific and clear in your praise, and keep it nonjudgmental. Avoid statements like, “Look what a big boy you are!” because if your son has an accident the next night, this may cause him to be ashamed. Instead, try saying things like, “Look how you are learning to control your body!”, which builds a self-concept of having self-control and does not evoke the same sense of shame in the case of a setback.

In addition to your praise, which hopefully functions as positive reinforcement for your child, you may want to add an actual reward of some sort. Your choice of reward frequency will depend on the age of your child and how motivating your proffered reward is to her. You will need to think carefully about how long your child can delay gratification before a reward just isn’t meaningful anymore. The safest bet is to give a very small reward every morning your child is dry, like a piece of dried fruit or sugar-free gum or even candy, and then deliver a big reward for two solid weeks of dry nights.

There are a number of other things that you can do to help improve the bedwetting problem, like limiting fluid intake, ensuring that your child urinates before bed, waking them in the night in order to go to the bathroom, and even medication. Some of these things are easy to do and just make sense, like limiting fluids after a certain hour in the evening and establishing the habit of urinating before going to bed. However, getting up in the middle of the night to take your child to the bathroom and/or giving him medication (if there aren’t any clear medical reasons for the bedwetting) do not seem to be great solutions when we have such excellent and effective tools to use to solve this issue. This is one of those problems that you do not need to suffer through – so don’t! Give this package of ideas here a try – there is a very high probability that you will find success and conquer this important developmental hurdle.

Dr. Teri Bullis, Ph.D., BCBAI believe that every parent I’ve ever worked with loves their child and is doing the very best that they can. But while parenting is the toughest job anyone will ever have, children don’t come with a “how to” manual. I can provide those “how to” directions, tailored for your unique child and family situation.

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