LoveToKnow Kids recently had the pleasure of speaking with Renee Mercer, a Nurse Practitioner with more than 25 years of experience in pediatrics. Her book, Seven Steps to Nighttime Dryness, offers valuable advice for parents who are working with their children in order to achieve nighttime dryness. In conjunction with using a bedwetting alarm, this book provides the tips to have your child waking up dry in 10 to 12 weeks.
Parents & Bedwetting Children
LoveToKnow (LTK): What sparked your professional interest in bedwetting?
Renee Mercer (RM): After many years of working in a primary pediatric practice, I saw the frustration that parents and kids felt when they came back for annual check-ups, with bedwetting continuing to be a problem. The response, "Don't worry, they'll grow out of it," wasn't enough. They wanted solutions. My book, Seven Steps to Nighttime Dryness, was designed to provide solutions, based on experience that I've gained working exclusively with bedwetting children.
LTK: Which cases in your pediatric office inspired you to write your book?
RM: Teens who felt that they could not go to camp or on school trips, younger kids who did not see a way out of wearing pullups to bed, and plenty of frustrated parents were individuals that I saw on a regular basis. Many families were embarrassed and felt hopeless that there was no cure for bedwetting.
LTK: Why do some kids wet the bed?
RM: Bedwetting has several causes: decreased sleep arousal, small bladder capacity, high nighttime urine production, constipation, and heredity all can play a role. Often, a child will have a combination of these things. Children with bedwetting have not developed the ability to wake up when their full bladder needs to be emptied.
Children who still wet the bed are great kids: smart, athletic, great personalities, and no different than other children their age. They do not wet the bed on purpose and usually sleep through the wetting episode.
LTK: What percentage of children wet the bed?
RM: If your child wets the bed, he is certainly not alone! 13 percent of 6 year olds wet the bed, 5 percent of 10 year olds, and 1-2 percent of 18 year olds.
LTK: How long can bedwetting go on?
RM: 15 percent of bedwetting children will become dry each year without intervention while 85 percent will continue to wet the next year. The incidence of bedwetting decreases as kids get older so we believe there is a developmental component that helps with this. Sleeping less soundly, having a larger bladder capacity, and being able to recognize body signals may play a role. Bedwetting can certainly persist into the teen years, however, and there is no guarantee of an age that bedwetting will stop. Treatment can decrease the length of time families have to deal with bedwetting by years.
LTK: What can parents do to help their children?
RM: If your child is over six and wets every night, using a bedwetting alarm can speed up the development of learning to wake up to a full bladder. Using an alarm requires cooperation from child and parents, so choosing a low stress time, without a lot of family obligations, is best.
If your child is younger than five or six and has nightly bedwetting, using disposables to help with the laundry burden is fine. Also, there are other temporary solutions which are appropriate.
Make sure your child is well-hydrated during the day so he isn't so thirsty in the evening. Water should be the preferred beverage after dinner. Urinate twice before bed, about 20-30 minutes apart. Observe that your child has a regular bowel movement most days. If not, increase daily fiber intake because constipation can contribute to wetting.
LTK: How can bedwetting be stopped?
RM: Temporary solutions include wearing disposable Pull-ups, walking the child to the bathroom when parents go to bed, using an alarm clock set at an arbitrary time (there is no way to know exactly when the child needs to go to the bathroom) or using medication. Medication works by decreasing the amount of urine produced during the night. It does not provide a permanent solution because the wetting restarts when the medicine is stopped, unless the child has learned to wake up to a full bladder.
A permanent solution is to use a moisture sensing bedwetting alarm. This sounds at the first drop of urine to alert the user that they should get up. This behavioral conditioning is very effective in helping a child's body begin to make the nighttime brain-bladder connection. The feeling of a full bladder means wake up and walk to the bathroom.
LTK: How long does the training period for achieving dryness with an alarm typically last?
RM: It takes about 10-12 weeks for the average child to achieve dryness while using a bedwetting alarm. Without the use of a teaching tool, such as a moisture sensing bedwetting alarm, it can take years.
LTK: What should parents do when the alarm goes off during the training period?
RM: When the alarm sounds, go to your child's room to ensure that they are responding. They must learn to turn off the alarm, get out of bed and walk to the bathroom.
LTK: Isn't it easiest to just wait until a child grows out of bedwetting?
RM: It might be easiest to ignore wetting but having years of missed sleepover invitations, multiple loads of laundry every day and hundreds of dollars spent on disposables make it beneficial to tackle bedwetting sooner rather than later. Research shows that bedwetting negatively affects children's self-esteem, and stopping bedwetting allows self-esteem to rise. Would you tell your teen with acne not to worry, she'll outgrow it, when there are effective treatments available?
LTK: What is the most important piece of advice you would offer parents whose children occasionally wet the bed?
RM: Observe for factors that may play a role in the wetting. These include: being overly tired, over drinking beverages other than water, being sick, medications, stress, forgetting to urinate before bed, urinary tract infections, among others. Do your best to limit these situations. If wetting occurs, be accepting, help change bedding and know that your child is not wetting on purpose.
If you'd like to give your bedwetting child a boost of confidence, and the freedom to attend sleepaway camp and slumber parties at friends' houses, pick up a copy of Seven Steps to Nighttime Dryness from your local bookstore. Both your child and you will be reaping the benefits in a few short months.