In the years that we’ve been doing the show, it just occurred to us the other day that we talk about children’s issues and family issues all the time and we’ve kind of missed a major topic in your child’s development that I can’t remember that we’ve ever talked about. Bedwetting. Well, Dr. Anna Mendenhall is here today with the Children’s Physicians Medical Group to talk to us about that.
Let’s talk – before we quite get into bed wetting, let’s talk about just potty training in general. My son I think was potty trained at a fairly normal age, what between two and three years old. My daughter potty trained herself. She just one day she said I don’t want to wear these diapers anymore and that was the end of it and she did never had an accident – ever, after that. Boys and girls different?
Definitely. Usually girls are much easier and often times I hear this story. They just potty train themselves or had one accident and never again. Boys are a little more difficult sometimes but both of them, you know based on temperament, can be less difficult or more difficult depending.
Okay so when we get to the point of what, past two, three, four years and they’re still having accidents at night, when do we suspect that there might be a challenge, there are something out of the ordinary”? Right, well usually you know, about forty percent of three-year-olds are still wet and we consider it normal until about six. About ten percent of six-year-olds are wet at night and that’s when you start to worry, Oh how long is this going to go on for, things like that.
Now, different parents have different approaches to this. I’ve actually heard of parents, you know punishing, the child and scolding them for wetting the bed – that probably doesn’t solve any problems, does it?
That will make more problems. That will set you back. The best thing to do is respond very gently to wet nights and really praise for that occasional dry night.
And what other help is out there, I mean philosophies, approaches. I mean what what exactly do we do as a parent?
Well, the first thing to do is encourage your child to wake up and go the bathroom in the middle of the night. Don’t focus so much on staying dry all night, focus more on waking up when you feel that full bladder. Getting to the bathroom, making sure the light’s on in the bathroom for the child. If it’s very long to the bathroom, get them a potty chair in their room. And just encourage the awakening. Also you want to limit fluids after dinner. You really want to discourage that.
That seems pretty logical, except you know when a child says you know I’m thirsty I want to drink you know I know the parents going to send off, that set them a little little something there in the sippy cup and then the next thing you know when you’re wet at night. Ok so maybe withhold fluids after, about two hours before bedtime?
Right exactly. Ok. Encourage them to get up at night. But now what if these things aren’t working? At what point do we suspect that there’s actually a problem and is it a is it a psychological problem, is it a physical problem? I mean what do we really know about bedwetting past the age of about six?
Right, well even up until six and beyond oftentimes these kids are the ones that are the really heavy sleepers and they usually have smaller bladders so that’s usually the problem. So that’s not a big deal. Not a big deal, except you know what it causes but less than 1% of bed wetting is actually from a medical cause such as diabetes or you’re an infection, something like that. Kidney or urinary tract abnormalities.
So how would we be tipped off to that though? Things to watch for would be painful urination, foul smelling urine, blood in the urine, weight loss, passing urine during the day, having accidents. When there weren’t daily accidents before or even if you’ve been dry at night for some period and then your child starts bedwetting.
Yeah I was going to ask you about that because that can be indicative of some psychological issues too, can it not? That that’s where we get into a kind of a dark area that we need to address. It’s fairly rare but it can be a sign of some kind of abuse or or stress. It could be stress at home, stress at school, a new baby coming or something like that. It could also be physical or sexual abuse and this is again I want to reiterate this is when they’ve been dry for a period of about six months or longer.
Yeah and then become wet again. Okay that kind of tips you off what is the emotional stress going on. So overall again just to kind of go go back to the beginning – parents really shouldn’t worry too much about this until when? Well you know you really shouldn’t worry too much unless some of the danger signs like we talked about before. I mean it’s never going to be a problem, the child will eventually outgrow it, it’s just kind of hanging in there, supporting the child making them feel there’s no you know no there’s nothing there’s a normal thing they’ll outgrow and things to help you know just set that goal of waking at night rather than trying to stay dry the whole night.
And we put some of the the prevention tips up there, reward them for remaining dry. You suggest maybe like a little star chart or something? Yeah nicem consecutive positive reinforcement. And the other thing on there’s consider diapers or pull ups actually consider not using them because oftentimes the child doesn’t feel wet after they’ve gone in the pull-up. So if you remove them and protect the mattress you may have better results the child has kind of you know they’re a little bit more honestly in touch with what’s going on.
The final final thing I want to touch on is this may be hereditary? We’re not sure why but it’s hereditary. If a parent has had bed wetting, expect one of your children to have it and it’s probably based on a smaller bladder and also deeper sleep and they tend to get over it about the same time as the parent, usually. Very interesting yet all right.
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