Tips to Help When Kids Wet the Bed Wetting the Bed Or Other Bladder Control up to Several Years—And Then Begins Accidents Are Fairly Common in Children

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Tips to Help When Kids Wet the Bed Wetting the bed or other bladder control up to several years—and then begins accidents are fairly common in children. The wetting again, usually at nighttime. This medical term for this is enuresis. For most type is thought to be linked to the child children, enuresis resolves as they grow and experiencing some kind of medical mature. For other children, however, condition or stressful life event, such as nighttime wetting can continue through a moving, a new sibling, death, or divorce— good part of their elementary school years. to name a few. This tip sheet will provide a basic overview of enuresis, some causes, For children in foster care, and ways that you can help this may include: the children in your care who may have enuresis.  Being removed from their families Overview There are two types of  Adjusting to a new enuresis, primary (with two placement subtypes) and secondary.  Changing or having  Primary enuresis is problems in school when children lack the Secondary enuresis is less ability to control their common, and can be bladder and mostly wet associated with some at night when they’re psychological asleep. For most people, disorders like Attention Deficit Hyperactivity our nerves send a message to our brain Disorder (ADHD) and Oppositional Defiant telling us to go to the bathroom, but for Disorder (ODD). It may be helpful to receive some kids that doesn’t happen. There are feedback from a physician, for either two types of daytime wetting that fall into primary or secondary enuresis, to ensure the primary category: there is not some significant underlying  Kids who have difficulty medical issue occurring. controlling the urge to go. Causes  Kids who put off going to the According to American Family Physician, bathroom to relieve themselves bedwetting may occur more frequently in until it’s (oops!) too late. boys than girls. Possible causes include:  Hormonal problems—not enough anti-  Secondary enuresis is when a child has diuretic hormone (ADH) that slows urine stayed dry for at least six months—even production at night

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 Bladder problems—small bladder or muscle spasms Some Recommendations Following are some recommendations to  Genetics—it runs in families help you and your child deal with enuresis  Medical conditions, such as diabetes and in a positive way. constipation Do  Sleep problems—difficulty waking from sleep  Talk to your doctor.  Psychological problems, such as stress  Stay calm. and trauma  Let your children know if you had a  Slow development in the central nervous bedwetting problem. system—this reduces that child’s ability  Reassure them that there are things to stop the bladder from emptying at that can be done to help. night  Keep your children warm at night.  Urinary tract infections  Gently praise their efforts and successful  Anatomical abnormalities dry nights. (Although, if the bed wetting  Abnormalities in the spinal cord is related to Oppositional Defiant Disorder, praise can sometimes backfire If the child in your care has experienced a and it can become a power and control trauma, such as physical abuse or sexual issue.) abuse, this adds another component to  Help remind them to use the bathroom enuresis. A child may be wetting as a defense before bed. mechanism, or because of anger, or fear.  Help your children wake up when the One foster parent shared that her child had a alarm goes off. wetting problem, but it had stopped for over  Help your child with transitions and a year. When the family found a mouse in stressful events. their house, the wetting returned. After talking with her child, the foster mom found  Get information on treatment options. out that there was a mouse problem in the  Work together with your child as a birth home that scared him. She reassured team. him that they would take care of the mouse Don’t and that she was sorry it scared him, and the  Shame, blame, or punish your wetting stopped again. children. We recommend talking to your doctor before  Give them caffeinated beverages three starting any other treatment option. He or to four hours before bedtime. she may have some ideas that take trauma  Become discouraged. into consideration.

Ways to Deal with Enuresis (such as thinking the child did this on It can be frustrating to deal with a wetting purpose or that she is just lazy) will do little problem. Remember that, very often, it is to improve the situation. Most of the time, equally frustrating and humiliating for the prevention is the best bet and positive child. Becoming angry, punishing the child reinforcement is always the trauma- when he wets the bed, or assigning intent informed approach.

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Following are some tips that other families Alternative Therapies have tried to help their children manage Alternative therapies that have had some enuresis: success include acupuncture and hypnosis.  Decrease or limit fluid intake before Psychotherapy is often helpful for secondary bedtime enuresis in helping your child deal with any  Use an alarm system to wake the child if emotional stress they might be experiencing. they start to wet There are no known ways to prevent  Have the child go to the bathroom at the enuresis, and it can be a very embarrassing start of their bedtime routine and again and shaming experience for your child. He right before bed or she might even avoid sleepovers or overnight camps for fear of having an  Wake the child up at night to use the accident. The good news is that most kids bathroom outgrow this problem, and for those who do  Use vinyl covers to protect mattresses receive treatment, the success rate is high. It  Have a reward system for dry nights might help the kids in your care—even those  Bladder training (have the child practice in the home who might not have a problem holding the urine during the day for with it—to know that no one knows the exact longer and longer periods of time to help cause of bed wetting and remind them that stretch the bladder) it’s okay to get up to use the bathroom at  Talk with the child’s teacher to help your night. child with discretion Working together with the child and your  During the school day, request that the child is allowed to leave at anytime to use doctor to find the right solution for your the bathroom, whether they have time to family can help empower the child and also ask or not. (If there is no safety concern.) reduce any feelings of shame he or she may Also, ensure they know the signal for be feeling. Working together may help get to a resolution faster and, when the child starts using the bathroom if there is one. Ask that they be told to try every two hours, getting through the nights without accidents, and taken to the bathroom at all breaks, everyone will start to feel better. even if they claim they don’t have to go. Feel free to contact us at 800-762-8063 or  Pack extra clothes and underwear for any [email protected] for additional daytime accidents, including keeping an support or resources. extra set at school. Put an outfit in a large Ziploc bag; the child can change if needed and put the wet clothes in the sealed bag to take home.  At home, layer mattress covers and sheets as a great way to quickly get a child back to sleep. Use a waterproof mattress cover and sheet, then another cover and sheet. You can strip the top sheet off while they change and they can get right back to bed.  Use pull-ups underwear

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Resources  Getting Dry: How to Help Your Child Overcome Bedwetting, by Maizels, Rosenbaum and Keating  Enuresis and Encopresis: Ten Years of Progress, by Edwin J. Mikkelsen  Facts for Families Pamphlet #18, Bed-wetting. By the American Academy of Child & Adolescent Psychiatry (AACAP)  Bed-wetting, by the National Kidney Foundation  DryBuddy  GoodNites  Health Communities  Kids Health  Mind Disorders  WebMD  Fostering Perspectives  All About Parenting  Hub Pages