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Bedwetting in Children: When to Worry

Bedwetting

My 4 year old wet her bed the other night. She hasn’t wet her bed since we stopped using pull-ups a few months ago, but I suspect that her new routine of no nap and earlier bedtime has made her sleep both deeper and longer. And so she wet the bed. Fortunately, we already had a plastic cover on her mattress. Equally important, she wasn’t embarrassed by bedwetting, just surprised that it could happen.

Even the most conservative expert would agree that it is common for 4 year olds to wet the bed, and some studies indicate that at least 40% of 4 year olds are bedwetters. Bedwetting in preschool age children is defined as two or more bedwetting episodes in one month. My daughter will likely outgrow her bedwetting in a few months. Bedwetting at this age is largely agreed to be due to immaturity.

Unless your child is over 6 (some experts even say over 7) years old, and bedwetting more than twice a month, there is little or no reason to be concerned or even to discuss it with your pediatrician. If your child is wetting the bed and is under 6 years old, here are some tips to make this time easier:

? Protect the mattress with a waterproof cover.

? Keep clean, dry sheets easily accessible in the child’s room if necessary

? Explain to the child that her brain is still maturing enough to signal to her bladder while she is still asleep (our child loves anything that sounds scientific)

? Reassure the child that this happens to everyone and bedwetting won’t last long

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? Avoid food and drink that contain caffeine (even chocolate!)

? Make sure the child empties his or her bladder before going to sleep

Most doctors and other experts on bedwetting recommend waiting it out at this age.
But what if your child continues bedwetting into grade school…..and beyond? It is estimated that at least 8% of 8 year olds are classified as bedwetters. And a mere 1% of children wet the bed into their teens.

Discuss the bedwetting with the child’s doctor. Sometimes there are underlying causes for the bedwetting such as diabetes or a urinary tract infection. The doctor can also provide additional support for you and your child. There is a lot of shame and embarrassment associated with bedwetting in older children. The children may be teased about the bedwetting, especially in a multi-child family where secrets are hard to keep. It is up to you, the parent, to make sure that everyone in the family knows that teasing the bedwetter is off limits!

The older the child, the more capable they are of managing the effects of their bedwetting. Help your child by keeping clean sheets and dry pajamas easily available so he can change his own bed. Show the child how to wash his own sheets and pajamas. Be as matter of fact as possible while helping your child. Making his own bed and doing his laundry are empowering, not punishments.

Remain calm yourself. Probably the most lasting effect of bedwetting in a school-age child is the shame and sense of doing something wrong. You as the parent may experience some of this embarrassment yourself from well-meaning friends or even your own mother. It is still a widely held belief that bedwetting children must be suffering from an emotional disturbance or poor parenting, despite that belief being contradicted by many studies of bedwetting.
Experts suggest trying the following measures if your child is over seven and still bedwetting regularly:

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? Restrict fluid intake for the two hours before bedtime

? Offer rewards such as stickers or special outings for dry nights

? Have the child go to the bathroom before sleeping

? Eliminate or at least limit caffeinated food and drinks

? Use an alarm system. Some of these have a moisture sensor that wakes the child at the first sign of wetness. These systems are widely available and have a high success rate in the older child.

? Make sure your doctor knows about the bedwetting and the failure of these methods

Be patient. You are your child’s best support system and ally in their struggle to overcome bedwetting.

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