Almighty Dad | A stay at home dad blog

The term bed wetting is used for children 4 years and up who have not mastered nighttime bladder control.  Thankfully, neither of my kids have suffered with bed wetting.  But, up to 7 million American kids do suffer with it, and it can be a highly aggravating situation for them as well as for their parents.  The good news is that in 99% of cases it’s self resolving; it goes away by itself without intervention.  At 4 years old 75% of kids are dry at night.  Every year after age 4 another 15% of the remaining cases resolve themselves.  By age 15, only 1% of the population still suffers.  That might seem like reassuring news, but maybe not for the anxious parent who’s worried about their kid or the kid himself who can’t go to sleep without the fear of embarrassment.  I did a little digging and came up with both possible causes for bed wetting and a few solutions. 

Causes: 

According to Steven Parker, M.D, a contributor to WebMD, there are 4 primary theories about what causes primary enuresis (bed-wetting).  You may ask “They don’t know what causes it?” They don’t.  The fact is, according to Dr. Parker, there hasn’t been a lot of research into it because it almost always goes away by itself, and it isn’t life threatening.  It’s a major annoyance for people who have it, but the medical community hasn’t researched it because it’s not quite important enough to get the research dollars.  The 4 possible causes are as follow: 

1. Slow Maturation: Some doctors believe it’s simply a matter of the brain making the connection from the sleeping brain to the bladder.  There’s nothing you can do to speed up the connection making process as it matures with age, and everybody’s different. 

2. Different Sleep: Others believe the problem lies in sleep patterns.  When a kid is asleep, he is so asleep that he doesn’t notice when he needs to pee.  They think it has to do with abnormal sleep stages. 

3. Make More Pee: It’s possible that some kids produce more pee at night because of hormonal factors.  Their bodies may not secrete enough ADH (an anti-diuretic hormone), and thus they make more pee. 

4. Small Bladder Capacity: Not that they actually have small bladders, but that their bladders are wired to tell them to pee before it’s completely full. 

The problem could be some combination of all the above theories or just one.  The point is that until more research is done, we just don’t know. 

Primary vs. Secondary Enuresis: 

Primary Nighttime Enuresis is described as a lack of nighttime bladder control that occurs regularly (less than 6 months between episodes) and is ongoing from youth.  That’s the benign bed wetting that only time can cure.  There is also a condition known as Secondary Nighttime Enuresis.  The term secondary enuresis is used when a person has bladder control for a period of more than 6 months and then loses it again.  Secondary Enuresis is the type of bed wetting that is most concerning to doctors as it is often triggered by an underlying physical condition like a urinary tract infection or the onset of diabetes.  It can also arise from psychological triggers: bullying, anxiety from a divorce, a move, etc… . Dr. Alan Greene recommends a case of secondary enuresis be checked as soon as possible by a doctor who has experience with enuresis. Many doctors don’t treat secondary enuresis with the diagnostic care they should. Thus if a doctor is unresponsive or cavalier about your child’s secondary enuresis, it’s recommended by Dr. Greene to seek a second opinion. 

Solutions: 

Do Not Scold: Nobody wets the bed on purpose.  Scolding, shaming or otherwise getting angry is not effective.  Punishment has only been known to make the problem worse, never better. 

DDAVP (desmopressin acetate): DDAVP has been used for the treatment of primary enuresis since 1989.  DDAVP is a synthetic form of vasopressin, an antidiuretic hormone that is produced naturally in the body.  It regulates water balance and urine production.  Thus, when your body needs more water it produces more vasopressin which, in turn, causes more water to be reabsorbed from the kidneys and less urine to be produced.  DDAVP is something Dr. Greene mentions and is something to talk about with a doctor (obviously). 

Nighttime Underwear: The best reviewed product on Amazon in this catergory are Goodnites Underpants for boys (2/3 of bed wetters are boys) with 4 ½ stars and 26 reviews. 

Mattress Cover: The best reviewed mattress cover designed for bed wetting is the Priva Ultra Plus Waterproof Sheet Protector with 4 ½ stars and 78 reviews. 

Alarm: There are alarms that vibrate or make a beeping sound that are intended to wake someone up if they become wet.  I’m not sold on the idea that alarms work, but there are a lot of people who think they do.  It’s something to try.  One company that makes them says they shouldn’t be used unless the kid wants to use it as it could cause unwanted anxiety if the child isn’t prepared, and that could just make things worse. 

The topic of bed wetting was much more involved than I had expected.  Not having had first had experience with it I was unaware of the stress that it causes so many families.  But, indeed, it’s an issue for millions of people.  It’s not unusual.  It’s not something to be ashamed of.  It’s also not a disease or dangerous.  The vast majority of kids suffer from primary enuresis which, according to doctors, is nothing to worry about from a medical perspective.  To minimize the social awkwardness there are several possible solutions to try on your own, and there’s DDAVP to ask your doctor about.  Enuresis isn’t a laughing matter for kids who have it.  Openness and acceptance are probably the two best things a parent can do for a kid who’s feeling guilty about what he can’t control.

Related posts:

1. Bottled Water: Sure, if you’re an Idiot
2. Four Exercises that will Make you a Better Parent