BEDWETTING
What every parent needs to know about bedwetting and self-esteem
January 26, 2009
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ANN DOUGLAS
PARENTCENTRAL.CA
Wondering what you can do to prevent bedwetting from affecting your child's self-esteem? Here are some practical ways to provide your child with comfort, support, and reassurance on the journey to dryness:
Ensure that sure your child understands that bedwetting is not something he should feel embarrassed or ashamed about. We're talking about biology, not behavior after all. "Tell your child you know it's not her fault and let her know that many children take longer to develop the control needed to stay dry all night," says Chaya Kulkarni, vice president, professional and parent education for Invest in Kids.
Explain bedwetting to your child in a way that he can understand. You might use an analogy like this one to explain why bedwetting happens and why most kids eventually grow out of it:
Your bladder is like a water balloon. When the balloon is full of urine and ready to be emptied, it sends a message to your brain telling you to go to the bathroom so that the muscles that hold the balloon shut can release the contents of the balloon. In order for you to stay dry at night, a lot of body systems have to work together. Your bladder has to be capable of holding all the urine that your kidneys produce and of sending a signal to the brain to tell it that it's ready to be emptied. At that point, your brain has to make an important decision: either to tell the muscles to hold your bladder closed until morning or to wake you up so that you can get out of bed and head to the bathroom to empty your bladder in the middle of the night. (Adapted from a similar analogy developed by the U.S.-based National Kidney Foundation.)
Respect your child's privacy when it comes to the bedwetting issue. Try to avoid discussing wet laundry and related issues in front of siblings and other relatives; and insist that other family members treat the bedwetting issue with similar sensitivity and respect.
Avoid techniques that attempt to reward or punish a child for dry or wet nights. Not only are such techniques tremendously unfair (since we're talking biology, not behavior, they are likely to backfire by stressing out your child). As the Canadian Paediatric Society notes, "It may be difficult to convince a child that a wet night is nothing to be ashamed of when dry nights are rewarded. The failure to achieve dry nights leading to stars or stickers may contribute to poor self-esteem....The goal of treatment is largely to reduce problems with frustration, conflict and poor self-esteem and, thus, behavioural therapies for enuresis may do more harm than good. "
Encourage your child to limit the consumption of fluids at bedtime, to go to the bathroom right before he goes to bed, and not to go overboard with liquids during the rest of the day.
You'll also want to bear in mind that what your child drinks is just as important as how much he drinks. Caffeinated beverages should be avoided because caffeine acts as a diuretic, flushing water from the body.
Ensure that your child is getting adequate rest. An overly tired child is more likely to wet the bed because his sleep patterns differ from those of a reasonably well-rested child.
Avoid techniques that aren't backed by solid evidence. Take the often touted process of "lifting," for example, in which parents are advised to rouse children from sleep and carry them to the bathroom. The technique doesn't work and it is stressful for both parents and kids, explains Mark Feldman, MD, Chair of the Canadian Paediatric Society's Community Pediatrics Committee, and a pediatrician at St Joseph's Health Centre and the Hospital for Sick Children: "The child may have already wet the bed by the time the parent goes to wake up the child or the child may wet the bed later on. This technique doesn't prevent bedwetting and it makes the entire process more stressful for both parents and kids."
Use a highly-absorbent disposable underpants product to reduce the amount of laundry associated with bedwetting. It's important to use a disposable children can pull on and off themselves, rather than diapers, because they allow for independence at night. What's more, most kids associate diaper with babies and will find it upsetting, even humiliating, to be asked to wear a diaper. They may even perceive it as some sort of punishment.
Protect your child's mattress by covering the mattress with a hospital-grade waterproof mattress protector—and consider placing a highly absorbent towel underneath the mattress protector to provide a little added protection. If your child wets the bed regularly, you may want to get in the habit of making up the bed in layers (waterproof layer plus sheet plus waterproof layer plus sheet) so what your child can simply strip off one layer if he wets the bed in the night. That will help him to regain a little sense of control over a frustrating situation that he really can't help, and it will minimize middle-of-the-night sleep disruptions.
Troubleshoot potential obstacles in the night. Plug a night light in the hall or the bathroom so your child can easily find his way in the night. Don't overdo it with the lights in your child's bedroom, however. You don't want to interfere with your child's sleep cycle.
Leave out a towel and a change of clothes (something your child can slip on easily, without help) in case your child wets the bed repeatedly. Helping everyone get as much sleep as possible while minimizing the fuss associated with the bedwetting episode is the number one priority.
Help your child wash up in the morning, to eliminate any lingering odor of urine. Older children may want to take a quick shower before heading off to school.
Don't allow bedwetting to become the focus of your interactions with your child. Zero in on all the other things that make him the unique and wonderful person he is. That will encourage him to focus on issues other than the bedwetting, giving his confidence an important boost.
Want more bedwetting help?
Peruse the rest of our bedwetting section
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Bedwetting treatments explained
Coping tips for sleepovers, car trips, family travel and more
Bedwetting causes — the modern parent's guide
Bedwetting drugs may cause serious side effects