Ways to Control Bedwetting

Most kids eventually outgrow bedwetting when they learn to control their bladder. This is great news for many parents, especially if the child is young and bedwetting does not occur every night.

But if the child is older and he frequently urinates at night, parents may turn to the following solutions provided bedwetting is not caused by medical problems:

Reinforcement and responsibility training - this means giving the child responsibilities that suit his or her age. Discuss ways in which the child can help around the house - from clearing the dishes to taking out the garbage.

More importantly, train the child to be in charge whenever he or she urinates at night. You can teach the child how to change wet pajamas and even the bed sheet when he or she is old enough. Reward the child for these efforts. Mark each day on the calendar that he or she stays dry and give the child prizes afterwards. This will encourage him or her to be aware of the need to urinate and teach the child to act in the appropriate manner.

"You must treat your child in a manner that is appropriate for her age. Do not treat her like a baby. Under no circumstances should she be left in diapers and she should sleep in a regular bed. Use waterproof pads under the sheet to protect the mattress. Do not restrict her in any way because she still wets; instead give her extra privileges for taking on the new responsibilities," said Dr. Richard Ferber, director of the Center for Pediatric Sleep Disorders, Boston Children's Hospital, in Solve Your Child Sleep Problems.

"Also, most children should avoid drinking large amounts of fluids after 6 p.m. although this alone will not solve the problem. Severely restricting fluids is harsh and of no value," he added.

Another approach is bladder training that can be accomplished in the following ways:

Do not restrict your child's fluid intake during the day (such restrictions have never proven helpful) although it is reasonable to avoid large amounts of liquid near bedtime.

On the first two days, collect the urine each time your child urinates at home and measure the volume. Note the amount of time between urinations.

"Record the largest volume of urine over the two-day period and use that as the "record to beat.”

If your child urinates more often than every three to four hours, have her try to increase the intervals a half hour each day until she achieves a three-to-four-hour minimum.

Once a day, at the same time each day, have her hold her urine as long as possible, at least to the point of some discomfort. Then when she urinates measure the volume. This will help to gradually increase bladder capacity during the day as she tries to beat her previous "record."

There is no specific volume that will guarantee nighttime continence, but ten to 12 ounces are reasonable goals. Or try for a 50 percent improvement over the initial “record.”

At least once each day have your child practice starting and stopping the stream of urine several times.

When your child has been dry at night for two consecutive weeks, reinforce the success with a program of "over-learning", encourage her to drink more and more fluids during the day and up to two to four glasses at bedtime so that she will get better and better at controlling her bladder.

Some parents rouse their kids in the middle of the night and ask them to urinate before they do so in bed. While this may save you the trouble of changing wet pajamas and bed sheets it won't help your child learn how to recognize the need to urinate nor teach him or her how to wake in the process. "Lifting" - as this practice is called - may work only if the child urinates in bed once each night at a regular schedule. Otherwise, it may hamper your child's progress.

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