Welcome Back!

User Name
Password
Not Registered?

Tell us a little about yourself.

My child’s birthday is (for newsletter customization):

Enter an email address:

This is where your newsletters will be delivered to and where GreatDad.com will contact you with your new account information.

About Dr. Howard Bennett

Dr. Howard J. Bennett is a practicing pediatrician in Washington, DC and a Clinical Professor of Pediatrics at The George Washington University Medical Center. When he's not sharing humor with patients, Dr. Bennett loves to poke fun at doctors and medicine.

Here are my most recent posts

About the Author – Dr. Howard J. Bennett

Dr. Howard Bennett

 Dr. Howard J. Bennett is a practicing pediatrician in Washington, DC and a Clinical Professor of Pediatrics at The George Washington University Medical Center. When he’s not sharing humor with patients, Dr. Bennett loves to poke fun at doctors and medicine.

 

  



 

Books Authored by Dr. Howard J. Bennett

 

 

 

 

Communication is Key with Bedwetting

 

Every day, 5 million American children wake up not knowing if their bed
will be wet or dry. Many of these children feel embarrassed and ashamed—and some are punished.
Bedwetting is almost as common as asthma, but it is often not discussed, even with doctors,
because of its embarrassing nature.

A recent study showed a significant communication
breakdown between parents and doctors on this issue. While 82% of parents want healthcare
providers to discuss bedwetting, most feel uncomfortable initiating the discussion themselves.
Furthermore, 68% of parents said their children’s doctor has never asked about bedwetting at
routine visits.

Bedwetting is rarely caused by a serious medical disorder. In most cases, it
is due to a maturational delay in the way the brain and bladder communicate with each other at
night. There are three main factors that contribute to the problem:

  • Bladder
    size
    —Children who wet the bed usually have a smaller bladder capacity than their peers. This
    causes them to urinate more frequently during the day and their bladder has less room to “hold”
    urine at night.
  • Nighttime urine production—The brain produces a hormone at night
    that reduces the amount of urine the kidneys make. Some children who wet the bed produce less of
    this hormone and thereby make more urine while they sleep.
  • Difficulty waking up
    For many years, it was thought that children wet the bed in deep states of sleep. However, recent
    research has shown that children wet the bed in all sleep states. These studies have
    demonstrated that children who wet the bed are unable to arouse from sleep when the bladder
    reaches its maximum capacity.

A fourth factor, which is often overlooked by doctors
and parents alike, is constipation. Because the rectum is right behind the bladder, constipation
can interfere with bladder emptying or the way the bladder signals the brain that a child needs to
go. This can lead to both daytime and nighttime wetting episodes.

There is no magic age when
children are ready to work on becoming dry, however, most children show some concern about the
problem by the time they are 6- to 7-years-old. (Bedwetting is so common that most doctors do
not consider it to be a “problem” until children are at least 6 years of age.)

There are five
signs parents can look for to see if their child is ready to work on becoming dry:

  • He
    starts to notice that he is wet in the morning and doesn’t like it.
  • He says he does not
    want to wear pull-ups anymore.
  • He says he wants to be dry at night.
  • He asks if any
    family members wet the bed when they were children.
  • He does not want to go on sleepovers
    because he is wet at night.

Whether or not a child is ready to work on becoming dry,
there are a number of steps parents can take to help children feel better about
themselves.

  • Do not punish or shame children for being wet at night.
  • Remind
    children that bedwetting is no one’s fault.
  • Let children know that lots of kids have the
    same problem.
  • Let children know if anyone in the family wet the bed growing
    up.
  • Maintain a low-key attitude after wetting episodes.
  • Praise children for
    success in any of the following areas: waking up at night to rinate, having smaller wet spots or
    having a dry night.
  • Encourage children to go on sleepovers. (I devote an entire chapter to
    sleepovers in my book; this chapter can be downloaded from my website for
    free.)

The most effective treatment for bedwetting is a product called the
bedwetting alarm. Most bedwetting alarms are small, battery-operated devices that children wear
to bed at night. One part of the alarm attaches to their undershirt or pajama top and the other
part attaches to their underpants. When the child urinates, the alarm goes off, creating a loud
buzzing sound. The sound is designed to wake the child up and teach him what his bladder feels
like when it fills up with urine. As the alarm begins to work, it teaches children to wake up
before they wet the bed. Over time, most kids stop waking up at night to urinate. This happens
because the bladder learns to hold all of its urine until morning.

There are a few medications
available to treat bedwetting. The one that’s prescribed most often is called desmopressin (brand
name: DDAVP). This drug works by reducing the amount of urine a child makes during the night.
The effects are not long lasting, however, and most children relapse when the medication is
stopped. Consequently, doctors generally recommend it for short-term use such as sleepovers,
vacations or as an adjunct to other behavioral measures.

So why is it that parents and
doctors are not talking to each other about bedwetting? Parents aren’t asking about bedwetting
because they’re either embarrassed about the problem or they aren’t sure the doctor can help.
Doctors aren’t asking about bedwetting because they assume parents would bring it up if it were a
concern. For every child who gives the doctor an indication that something is bothering him, there
are many more who would never say a word. The prescription for this situation is simple: Doctors
need to ask about bedwetting at routine checkups, and parents need to be more proactive by asking
for help if they have a child who is wet at night.

 

 

Dr. Bennett is pediatrician in Washington, DC. He is the author of a self-help guide
written for children and parents entitled, Waking Up Dry: A Guide to Help Children Overcome
Bedwetting. On his website, www.wakingupdry.com, he posts bedwetting-related information.

 

 

 

 – Dr. Howard Bennett

Help Your Child Cope With Doctor’s Visits

Despite the friendly atmosphere, doctors’ visits can be unsettling for
children. Children may not understand why they are being examined and
they typically have little say in the matter. To top this off, the visit
often ends with blood tests or shots.



How You Can Help

Children are sensitive to their parent’s emotional state, so a calm and
reassuring tone on your part helps tremendously. Let your child know she
is seeing the doctor before you leave for the appointment. This will
give her a chance to ask questions about what to expect. If your child
appears anxious, discuss a previous visit, emphasizing what she liked
about the doctor or the office.

The most important thing to do at a doctor’s visit is to tell your child
the truth. Above all, avoid the temptation to say something won’t hurt.
The reason for this is because “the truth” varies from person to person.
For example, even though throat cultures don’t bother most adults, they
can be distressing to children. It’s better to say a procedure may hurt,
but add that it will be over quickly and you’ll be there to help.



Plan Your Trip

Getting through a doctor’s appointment can be trying, so it’s helpful if
you plan your day carefully.

  • If possible, do not schedule a visit during your child’s naptime.
  • Bring a bottle or snack to the office in case your child gets hungry.
  • Take a favorite book or toy for your child to play with.
  • Bring as few children to the office as possible.
  • Don’t plan another activity right after the appointment in case it lasts
    longer than expected.



Help Your Child Interact With the Doctor

Although pediatricians love children, the opposite is not always true.
That said, there are a number of things you can do to make the visit go
more smoothly.

  • If you are new to an area, make a brief “get acquainted” visit with the
    doctor. This lets your child can meet the doctor in an informal way that
    does not involve an examination.
  • If your child is nervous before the appointment, read a book about
    doctor’s visits.
  • Bring a lovey to the appointment—they are not only comforting, but they
    foster communication between doctor and child.
  • Bring a toy doctor’s kit so your child can “examine” the doctor.



What To Say About Shots

Parents often ask if they should tell children about shots before the
visit. If your child has a specific appointment for a shot, you should
tell him before you leave home. Although this may make your child
anxious, it gives him a chance to prepare for the procedure. If your
child is having a routine checkup, the best approach is to say you don’t
know if he’s getting a shot. The reason for this is because it’s hard to
know for sure if a shot will be part of the visit—immunization schedules
change and doctors sometimes run out of vaccines that are given at
certain ages.



Techniques To Use Before and During the Shot

As mentioned previously, a calm and direct approach works best. It also
helps to give children some choices. Your child can pick which arm gets
the shot, which bandage to use, and whether you should rub the arm fast
or slow when the injection is over.

Here are some additional tips that you can use to help reduce shot
stress:

  • Young infants: maintain eye contact, smile and talk to the baby, sing
    songs
  • Older infants and toddlers: distract the child with toys, songs, a
    story, car keys, blowing bubbles, or looking at interesting objects in
    the room
  • Preschoolers and school-aged children: same as toddlers plus look at
    family pictures, use electronic devices like a cell phone or Game Boy,
    talk to the child, watch a video on a portable DVD player

 

Techniques To Use After the Shot

Some children will cry despite your attempts to ease their pain—I always
tell children that it’s okay to cry, but we need them to try and hold
still. Once the shot is over you can tell your child that he did a good
job getting through the procedure. Other things that help include hugs
and kisses, rubbing the child’s arm, and stickers. Finally, it may help
if your child knows he can do something special after the visit—a trip
to the park, extra TV or computer time or even going out for a treat.

 

 

Dr. Howard Bennett is a pediatrician in Washington, DC. He is the author of two
picture books for children, Lions Aren’t Scared of Shots and It Hurts
When I Poop.

 

 

 

Does Your Toddler Have A Problem With Stuttering?

As children learn to speak, pauses and repetitions of syllables or words are normal. Parents typically notice episodes of stuttering interspersed with periods of normal speech. The stuttering that is seen in this age group is developmental in nature due to the acquisition of new language. In essence, the child can think of words faster than he can say them. Developmental stuttering occurs in children from 18 months to four years of age. It usually resolves in three to six months. It is different from true stuttering, which is seen in older children and adults.

 

Toddlers who stutter demonstrate some or all of the following symptoms:

  • Repetition of the first sound of a word such as “d-d-d-dog,” “ca-ca-ca-cat,” or “I-I-I-want.”
  • Repetition of a phrase within a sentence such as “I want-I want-I want to go.”
  • Open their mouth to speak and make a throaty sound, but fail to say anything.
  • Express frustration at not being able to get the words out.

If you notice any of these symptoms, consider discussing them with your child’s doctor. The approach that is usually recommended includes the following:

  • Speak slowly and clearly to your child at all times.
  • Do not interrupt or correct your child and do not finish sentences for him.
  • Remain calm while your child is speaking as though you had all the time in the world for him to finish.
  • Do not say anything about the stuttering. If your child expresses frustration about the problem, calmly reassure him that everyone has trouble getting their words out from time to time.

 – Dr. Howard Bennett

What to Do If Your Child Has Hiccups

Hiccups are caused by a sudden contraction of the diaphragm, which draws air rapidly into the esophagus. The characteristic squeak occurs because the epiglottis closes rapidly shutting off the influx of air.

Young babies frequently get hiccups after a feeding. In most cases, hiccups do not bother babies and require no treatment. They will resolve in 5 to 10 minutes. Because hiccups bother adults, it can be hard to do nothing while you wait for them to go away. However, this is one of those situations where patience is clearly a virtue!

If hiccups occur during a feeding, they may bother your baby. In that case, change his position or hold him upright and see if a burp will make him feel better. If this doesn’t work, give your baby an ounce or two of sugar water (1/4 tsp sugar to 4 ounces of water). Hold him upright for a few minutes, and try feeding him again if he seems hungry.

Hiccups bother children more than babies. They usually occur after rapid eating, overeating or the ingestion of carbonated beverages. If hiccups last more that 5 minutes, give your child a teaspoon of granulated sugar. Have him swallow the sugar in one gulp. Repeat this two or three times over 10 minutes if necessary. If the hiccups last more than two hours or your child is very uncomfortable, call your doctor.

 – Howard J. Bennett, M.D.