Parents of children who wet at night must understand that they are not alone. Millions of children have the same problem. Your child is most likely not a bed wetter because of bad parenting or because of abnormal anatomy. Before starting a treatment plan, please remember that your child does not intend to wet the bed and under no circumstances should she be scolded or punished for doing so.
 

You should do everything in your power to comfort and support your child during this difficult time. If you do not, the problem may only get worse.
 

Many parents and physicians do not focus on bedwetting until the child is older and it becomes a social issue. This approach may be okay, but if you feel that your child is going to have problems later you may want to start treating the problem now.
 

Since we do not know why children wet at night, we have not been very successful in curing or alleviating bedwetting. Like many other problems in medicine, bedwetting is a “medical” condition that may require a lifestyle change. Be prepared to make these changes and educate yourself about all of the possible causes of bedwetting, so you can tailor your treatment to achieve the best results.

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.

These are the steps to overcome bedwetting:

1. 1. Decide if it is a “problem”
2. 2. Discuss the options for treatment
3. 3. Build up dialogue and support within the family
4. Simplify bedding, PJs, and laundry tasks
5. Improve daytime bladder and bowel habits
6. Keep a diary or calendar for weeks/months
7. Limit nighttime fluid intake
8. Be patient for results/Monitor progress
9. Add a bedwetting alarm
10. Use the alarm every night for weeks
11. Track progress
12. Stay motivated and be patient for results
13. Possibly add a medication
14. Consider counseling if no improvement
15. Consult with a physician, or a specialist along the way

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.

Listed below are some of the more common items one may want to consider when attempting to improve their child’s potty habits.

Voiding and bowel diaries are useful when the parents are trying to monitor how often a child is peeing and pooping. Many times, the parents are not completely aware of what their child is doing while at school and away from home. By keeping a diary, one can see if a child tends to have more problems during specific times of the day, or at particular places or during several days.

Reward systems are helpful especially for the younger children. As stated previously, praise from everyone is important. The child needs to know that good potty behavior is rewarded with praise and satisfaction. Stickers, small items, toys and even candy are commonly used. The best rewards are those that require a “build up” and are not achieved with each successful event.

Bathroom timers can give children visual or audible feedback about how long they should stay in the restroom. Timers that have the children stay on the potty for about 3 minutes can be very valuable, since they will learn to take their time without the parents standing over them.

Alarm and Vibrating Watches are excellent tools to remind children during the day to go to the bathroom often. Depending on a child’s schedule, they should be set to alarm or vibrate at least every 1½-2 hours. The watch should have a special feature that causes the watch to automatically alarm without resetting. Older children may be embarrassed by an alarm and desire a watch that vibrates.

Urine collection devices can be obtained from a medical supply company or a physician. These open containers fit into the commode and collect the urine. A child and parent can then measure and see how much urine is produced with each trip to the potty.

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.

If your child has any daytime bladder or bowel “issues” then the daytime program for nighttime dryness should be considered.

1. 1. Children should use the bathroom the moment they wake up and at least every 1½-2 hours during the day until they go to bed. Children that go often also have episodes when they do not go frequently. These kids will hold it at times and will need to be told to use the potty. Avoid using statements like “wait till we get home” or “try to hold it longer.” Do not ask your child if they need to go potty or if they can go. Just simply say it is time to go potty.
2. Children should be told to relax and take their time in the restroom. They must not strain, push or be in a hurry. If they are straining or trying too hard tell them to stop and relax. Close the bathroom door and tell them to sit (even the boys) deep into the potty with their legs apart. Younger kids should place their feet on a step stool. Closing their eyes and taking deep breaths is very helpful. Do not send them with a book, game, or toy. This will only distract them from understanding the subtle sensations of normal emptying of their bladder and bowel. Pit stops are not allowed, and they should stay on the potty for 3 minutes.
3. Children with abnormal potty habits should avoid stimulants that cause them to be hyperactive and less likely to relax. This becomes especially important when a child has ADD, ADHD, or has a classic anal-retentive personality (type-A personality). They should also avoid drinks and foods that are potentially irritating to the bladder. There are many items one could list, but the biggest offenders are caffeine drinks, chocolates, and
   
   sugar/carbonated drinks.

4. A bowel program is essential. Painful, difficult and long bowel movements will discourage a child from using the potty. Remember, even if a child does not have obvious constipation, they may need to have frequent bowel movements to urinate better. There are no medications or procedures that will make a child urinate better. But if they have frequent bowel movements (goal=2 mushy poops a day), they will have to sit, take their time, and usually pee well when they poop.

   We can safely manipulate the bowel movements with diets and mild laxatives. Fiber, fruits, vegetables and increasing fluid intake can help with constipation. Laxatives are usually required to get the results that are needed. Common examples include Miralax (glycolax), Senokot, lactulose, mineral oil, and milk of magnesia. Consult your child’s doctor if you have any concerns or questions about laxative use.

Many times additional help is needed from devices and products that assure your child will follow the program and achieve success.

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.

Children who do not completely empty their bladder during the day probably do not empty their bladder prior to going to bed. If they go to bed with a partially full bladder they are more likely to wet. If the bladder is trying throughout the day to empty, and the child postpones going by holding, then the bladder becomes thicker and it is more likely to contract and empty at night. This is commonly referred to as a bladder spasm. Usually a child can hold urine during the day by squatting, wiggling and tightening their bottom muscles. At night the child is not able to squat and tighten their bottom muscles because they are sleeping and unaware of the bladder’s need to empty. If a child has excellent daytime potty habits, his bladder is more likely to be completely empty when he urinates prior to going to bed.

Daytime urine and stool patterns significantly influence a child’s tendency to wet at night. Personality traits and lifestyles that lend themselves to abnormal daytime potty habits are also more likely to contribute to bedwetting. Current medical literature supports a strong correlation between constipation and daytime accidents and bedwetting. Yet most physicians have not yet recognized this connection.

Pediatric urologists often care for children who have failed all other bedwetting treatments and still wet at night. Yet it is still not commonplace for them to recommend improving all of the daytime potty habits to see if the bedwetting stops. Even if the bedwetting child does not have any obvious daytime problems, it is reasonable to make the child pee and poop regularly during the day to see if it helps the nighttime wetting.

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.