Bed wetting in older children is more common than most people think. In fact, around 5% of 10 year-olds and 2% of 15 year-olds wake up in a wet bed on a regular basis. Sadly, the older the child, the more likely they are to suffer the negative effects of bedwetting, such as:
- Shame and embarrassment
- Poor self-esteem
- Social isolation – they avoid staying at their mates’ places and going on school trips
- Fear of being exposed as a bedwetter and the teasing and bullying that may result
Your bedwetting child or teen needs your love and understanding
Be kind. Medical experts agree that the worst thing a parent can do is give their child a hard time for wetting the bed. Like any distressing condition or situation, bedwetting requires patience and reassurance, not punishment or shaming.
Respect your child’s privacy and dignity. There’s no need for your friends or workmates to know there’s a bedwetting problem in your family. But having said that, friends and extended family can sometimes be a good source of information if you are aware of any who have managed the same situation.
The underlying causes.
A Priimary Bedwetting, i.e., where the child has never been consistently dry at night and wets at least once a month.
More than 50 years of international research has established the following facts as the causes of bedwetting.
1. It is genetically based - if one parent was a bedwetter, there is a 40% chance of a child of the parent being a bedwetter, and if both were bedwetters, it climbs to 70%. But, it can skip generations and so it may take some wider family searching to find others who have had the problem.
2. Bedwetters sleep very heavily – but actually no heavier than many who are not bedwetters. While heavy sleeping is a fact, it is not in itself the cause.
3. Bedwetters produce too much urine at night - all parents note that the bedwetter produces a large amount of urine and will often decide that the child drinks too much in the early evening and stops the child drinking after a certain time. But limiting drinks makes no difference because the cause for producing a large amount of urine is almost certainly connected to the genetics of bedwetting. I will explain.
When we go to sleep our brain produces a hormone (anti-diuretic hormone named vasopressin) which signals to the kidneys to produce less urine. There is less of that hormone produced in the brains of bedwetters, and so their kidneys are still under "daytime mode" and produce too much urine at night. Limiting drinks will not change that.
B Secondary bedwetting – i.e, when a child has achieved night time dryness for at least 6 months and then begins wetting the bed. This group makes up around 2% of the total.
Common causes are stress, urinary tract infection, diabetes, obstructed breathing (perhaps due to tonsillitis), altered sleep or eating patterns, constipation.
If you suspect that your child has secondary bedwetting then a medical examination is always recommended, in fact that should be the first step with any bedwetting.
You can check this information out on other sites, e.g, http://www.drgreene.com/fact/fast-facts-about-bed-wetting
Effective management and treatment.
There are only two treatments recognised in the medical literature and research, medication and using a bedwetting alarm.
1. Medication. The most common medication is an artifical form of the brain hormone that cuts down the production of urine (called desmopressin). Research shows that it has a good rate of success in stopping bedwetting while being used, but there is little evidence of it continuing to be effective when the medication is stopped.
It is also important to be aware of the side effects that this medication can cause , and that careful supervision of the child must be given when this medication is being used, it has the potential to be dangerous if the child drinks too much after taking it.
If you are interested in this approach, please research it carefully including the FDA guidelines in the use of this medication in the USA and the TGA guidelines for Australia.
2. Bedwetting alarms.
This is an alarm that has a sensor put in the child's underwear, or the sensor is part of a special sheet under the child, and connected to an alarm, either by a wire, or wirelessly.
How does it work. When the child starts to wet, the sensor becomes wet and triggers the alarm to start beeping loudly. This wakes the child and over a period of a few weeks the child's brain connects the increase in bladder pressure that was occuring when being woken by the alarm.
What you will notice is that the child wakes more and more quickly until waking occurs before the alarm. Which means that the child is now waking to go to the bathroom in the normal way without wetting the bed.
But then the magic happens. Many parents notice that their child is wetting maybe 2 or even 3 times a night and they worry that even after training the child will have to get up 2 or 3 times a night. In fact what happens is that the number of times of wetting goes down and the child learns to wake more quickly, and when they no longer need the alarm to wake, they have moved to the mature pattern of going to the bathroom just once, or not at all, during the night.
It appears that using the alarm has helped the brain increase the supply of the vasopressin hormone during the night.
So, it appears that the alarm does more than teach the child's brain to wake to go to the bathroom, it is a complete brain training system.
The key to success is a child or teenager who understands the mechanism behind bedwetting treatment, who realises there is no instant cure and that it requires persistence and committment. But remember, that's what any important life task requires
Other Aspects of Management during treatment
- Protect your child or teen’s mattress with a waterproof cover
- Use a blanket that can go straight into the washing machine and dries quickly. For now, avoid a feather or wool blanket
- Don’t use an electric blanket
- Stash clean pyjamas, and sheets in your child’s room so there can be quick and easy changes during the night
- Allow your child to manage the clean-up themselves if it makes them feel better. That includes stripping and remaking the bed, and operating the washing machine. Some older children don’t want Mum or Dad fussing over them.
However you end up dealing with bedwetting in older children and teenagers, remember that this is a difficult time for them and ensure that you’re always patient and understanding.