Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Bed Wetting, Old Maxims and New Medicines

Category: Child Care


Bed wetting is a very common problem in early childhood. In almost all cases, children who bed wet are not doing it on purpose but are actually sleeping so deeply that they cannot wake up to properly empty their bladder. The tendency to bed wet is frequently genetic and if you take a careful history you will find that Mom or Dad or Aunt or Uncle or Grandparents had the same problem until they were in the third or fourth grade.

Along with sleeping in a deep stage of sleep, each child has a different bladder capacity and ability to control that bladder. It is very common for children to have bed-wetting problems until about the age of six. Some children continue to have the problem well into school years and even into junior high. A first step in checking on your child would be to have a good physical examination done by a pediatrician and make sure that there is no obvious physical problem or urinary tract infection problem. If there is any sign of this, the pediatrician will probably run a few tests and consult a urologist. In the majority of cases, there is no physical problem and the cure of bed wetting is best done through a patient plan of positive encouragement and behavior modification.

Never punish your child for bed wetting. Remember, it is not done in defiance. Never embarrass your child about bed wetting. Be careful not to discuss it in front of a child's friends or even other family members. This can leave deep emotional scars and the child may take a long time to get over them. Help your child who has a bed wetting problem to overcome it with these helpful tips until they finally outgrow it.

1. Reduce liquids after supper and perhaps have supper earlier.

2. Wake your child up to go to the bathroom just before you go to sleep at night.

3. Be patient and don't expect major changes right away.

4. Remember not to punish the child or embarrass them.

5. Constantly encourage the child by whispering in their ear at night that you know that they can be clean and dry in the morning and that you know that they will try their best.

6. Offer them a reward such as a gold star on a calendar. When they receive so many gold stars for so many dry nights they get a special trip to the store, the movies, or the park with Mom or Dad to reinforce their efforts.

7. Let them take some responsibility in the wetting such as changing the sheet and placing it in the washing machine when they have a wet night.

I believe the above methods are very important in ultimately helping your child to overcome bed wetting or enuresis. There are several other methods available such as alarms and bells as well as several medicines. Two of the most commonly used medicines are Tofranil and DDAVP spray. Tofranil is a tablet which helps to effect the level of sleep as well as the bladder holding capacity and works in a high percentage of the cases. Another medicine which has been available for the past few years and seems to work very well in most cases is a hormone spray called DDAVP spray. By spraying one or two whiffs of this in the nostrils prior to bed, about 70% of children will stop bed wetting within several days. This is an expensive medicine and the affect will not always last once you stop using it. All these things need to be taken into consideration in choosing a plan of attack to cure your child's bed wetting. I strongly recommend consultation with your pediatrician or family doctor or urologist and, most of all, patience, love, and support for your child.