Brolly Sheets' Helpful Tips for Bedwetting

First of all – you are not alone! There are thousands of us parents out there with children that wet the bed. I like to think of it as another stage they are going through. Like learning to walk, or having dry pants during the day. Of course there are always the people out there that are happy to say “my child has never wet the bed” and one I particularly found annoying was “is that normal for her to still be wetting the bed at 6 – my kids were dry by 4”.

There is no easy answer and the fact is that different things work for different children and no matter what; most children will outgrow it eventually. It's also important to remember there are no miracle cures or overnight successes.

Here are some suggestions

• Be patient and understanding - reassure your child, especially if they are upset.
  
  

• Communicate with and educate your child. With my 6 1/2 year old we talked about her bladder and how it was like a plastic bag in her body that stored her wee. When she went to the toilet she had to imagine squeezing all the wee out of the bag so it was empty.
  
  

• Keeping a record will show progress. Using a reward chart can work for some children, but if motivation isn’t the challenge, and there are reasons beyond the physical control of your child then don’t use this method. It isn’t fair for your child as bed wetting is out of their control. Definitely reinforce a dry night by rewarding your child when it happens. Some experts question the usefulness of this technique as bedwetting is not usually a conscious act. Why reward someone for something they have no control over? Also, the child may get discouraged if frequency of bedwetting is not reduced. It may just be handy for recording how often she wets.
  
  

• A night light can make a huge difference. Your child needs to feel safe getting up in the middle of the night if they need to.
  
  

• Praise and reward your child for staying dry or getting up to toilet
  
  

• Respond gently if your child wets the bed even if you feel angry.
  
  

• Prepare the bed and the child. Take some of the hassle out of bedwetting with a Brolly Sheet.
  
  

• Give the child plenty of fluid during the day. Avoid caffeinated drinks e.g. tea chocolate and fizzy drinks before bedtime. Limiting fluids before bed time. In particular, beverages containing caffeine, such as cola, tea and coffee should not be consumed in the evening. Caffeine is a diuretic, causing an increase in urine production.
  
  

• If you get your child up to wee after being asleep for several hours make sure they are fully awake. The idea is to train the child's unconscious mind to recognize the feeling of "having to go" and use that recognition to clamp down on the sphincter muscle. If a child is sleeping too deeply to wake to go to the bathroom, you will need to wake the child up. Over 10 to 12 weeks, a parent will see a gradual reduction in the amount of fluid a child releases. In other words, the child will still wet the bed throughout treatment, but they will gradually be able to react and use their sphincter muscles before completely letting go of their bladder until they finally reach the point of complete control. It can be like waking up several times a night with a newborn, but, like the time spent with your newborn, the results are certainly worth the sacrifice. Some parents recommend waking the child for a visit to the toilet about two hours after they’ve gone to sleep. If the sheet is already wet, wake them a half hour earlier the next night. Keep reducing the time until you catch the first wee.
  
  

• Shower or bath in the morning before they go to school. The smell of urine may embarrass your child and lead to teasing.
  
  

• Be available to help. Let them know you are there for them if they want help during the night.
  
  

• Bedwetting can be a real challenge for parents: broken sleep, extra washing, worried for their child and so forth. Because of this, it is so important to guard your reactions toward your child. Lack of sleep at 2am in the morning can bring about bad attitudes and it is vitally important that you don’t say what you are feeling at this point. You need to put yourself in your child’s shoes. No one wants to be wet and cold with broken sleep. Your child doesn’t want it either, so punishing them for something out of their control is insensitive and cruel, and can create all sorts of psychological problems. You need to be sensitive to your child’s feelings so as not to add to the problem and create any further stress or anxiety for your child.
  
  

• Make an appointment with the doctor to check that there is no urine infection (UTI) or constipation.
  
  

• Ask your GP for a referral to a bedwetting clinic for an assessment and help to resolve the problem.
  
  

• Drink about 1.5 to 2 litres of water based drinks spaced out through the day (more if very active or if the weather is hot).
  
  

• Keep a diary to take to the doctor that will show the pattern of the problem. Also make a record of daily drink intake to see if any particular drink makes things worse (such as caffeinated or fizzy drinks).
  
  

• Think of ways to manage the problem in the short term, such as wearing washable absorbent pants or pads, or use waterproof bedding protection.
  
  

• If your child doesn't manage a dry bed after three to four weeks of trying, you should give up and try again three to four weeks later.
  
  

• Have realistic expectations. Expect just the occasional dry night at the first few attempts.
  
  

• Praise your child very warmly when they manage a dry bed but don't expect this to be every night at first.
  
  

• If your child has an accident, praise them for telling you and still take them to the toilet to see if they can do a bit more.
  
  

• Teaching the child to change his/her own sheets after an accident. The child helps take responsibility for the event and parents get an uninterrupted sleep, but frequency of bedwetting is not necessarily affected. Brolly Sheets can help make this a bit easier.
  
  

• Installing a nocturnal alarm. This is a small battery-powered device which contains a moisture sensor. When the child starts to urinate, a signal is sent to a control panel and the alarm sounds (and/or vibrates) to wake the child. Alarms are effective in about 70% of cases, but 10-15% of successes return to bedwetting. The key is patience; the system can take up to 12 weeks to make a difference.
  
  

• Bladder training during the day. Because some cases are due to a small or immature bladder, some experts suggest encouraging the child to increase the time between urinating during the day. This helps to stretch the bladder so it can hold more at night. See Bladder training
  
  

• Usually, medical intervention doesn’t happen until the child is at least seven years old, and only if behavioural treatment has been unsuccessful. For girls under five and boys under six; occasional bedwetting is absolutely normal and they will grow out of it. If the problem persists or increases in frequency, a visit to the doctor might be in order, particularly if the child is distressed. There is wide variation in the age at which night time bladder control is achieved. Physical problems are rare; the more serious concern with older bedwetters is the psychological impact.
  
  

• Never punish or humiliate a child who has wet the bed and try to ensure there is no teasing from siblings.
  
  

What next?

There are a number of known physical causes and interventions which include:

• The bladder fills but the signal to wake doesn't get through, causing the bladder to empty during sleep. A bedwetting alarm can be very effective in strengthening the signal to wake - the alarm sounds as the bladder starts to empty and the child learns to react to the alarm by waking and holding on. Gradually they learn to wake to the signal that the bladder is full.

• The lack of a hormone called vasopressin causes the kidneys to make a lot of urine at night. A medicine (desmopressin) can be prescribed which mimics the hormone and reduces the amount of urine made.

• A bladder muscle that is overactive contracts and empties before it is full. Medication can be prescribed to relax an overactive bladder.

• An inherited genetic tendency.

• Stress, anxiety and tiredness can sometimes make bedwetting worse, or trigger it off.

• It is important to note that these treatments don't always work in every case. Your doctor may need to try more than one.

• Do not allow your child to get constipated, as this can affect bladder function.

• Encourage your child to drink enough during the day (six to eight glasses) - but not fizzy or caffeine rich drinks. Restricting day time fluids may cause the bladder to be less efficient.

• If you are still giving a bedtime bottle, now is the time to drop it. If your child is hydrated during the day, a big drink at bedtime or during the night is not necessary.

What should you do?

1. Don't attempt night-time training too soon. Regardless of her age, if she's wet every night, she's not ready, so stick with nappies or pull-ups.

2. Make sure she can get to the toilet easily – if she's in a bunk bed, put her in the bottom bunk, and leave a nightlight on.

3. Encourage her to have six to eight glasses of water-based drinks a day – cutting back on fluids can reduce her bladder capacity. Avoid fizzy drinks, as these can trigger wetting.

4. Praise your child for dry nights, but try not to show that you're angry or disappointed if she does wet – if she's stressed, the problem may become worse. Reward charts may also help.

5. Talk to her to find out if anything is troubling her and causing her to wet.

6. If your child is still bedwetting at seven, she may benefit from medication or an alarm to rouse her as she starts to urinate. Before seven, she's unlikely to be offered medical help, but talk to your GP – they may be able to suggest different strategies.

When staying dry at night is difficult the following may help

1. Remember that it might take years for your child to reliably master night-time dryness. Don’t stress about it or compare your child’s efforts with other children who are apparently dry at night.

2. If your child is scared of the dark, going to the toilet at night is an enormous challenge. Consider putting nightlights in the hallway. Think about leaving their door open for easy access. You could even put a potty in the bedroom.

3. Make sure your child feels that it’s okay to wake you up in the night when they need to go to the toilet.

4. If your child is becoming anxious or frustrated, take the pressure off. Forget about night-time toilet training for a while.

Our thanks to Brolly Sheets for this useful information.