Mental health articles

Solutions for Bedwetting Older Children Many families become very anxious about bed-wetting. Reassure them and explain that bedwetting is common, that it is not a sign of mental retardation and that it is treatable. Parents
should not blame the child for the bed-wetting. It is not the result of the child misbehaving.
If there is a urinary infection, treat with an antibiotic and advise the child to drink enough water. Remember to be sure that it is an infection before you give this advice because the same advice can make a child’s problem worse if there is no infection!
Solutions for Bedwetting Older Children For bed-wetting (i.e. night-time wetting), the parents should be told to try the following:
• Make sure that the child passes urine in the toilet just before bedtime.
• Give praise for nights when the child does not wet the bed, but do not get angry on nights that he does. Simply say that you are happy that he tried and that it will be better the next night. Use a star chart (see below).
• If bed-wetting persists, wake the child in the middle of the night to make him to go to the toilet.
• Encourage the child to learn how to ‘hold’ his urine in the daytime by increasing the amount of time spent between trips to the toilet.

• Another exercise that can help the control over urine is making the child stop urinating before he has finished, then hold the urine for a few seconds, and start urinating again until he finishes. The more he can stop–start his urinating in this manner, the more control he will gain.
• Special ‘buzzer’ alarms are available in some places that can be attached to the bed sheets and make a loud noise the instant the bed is wet. This wakes the child before he completes urinating and the parent can then take the child to the toilet.
• If none of the advice above works, then you can try using imipramine in a dose
of 25–50 mg two hours before bedtime. This medicine will help many children but the problem often comes back when the medicine is stopped. Thus, its real advantage is that by helping control the problem, it will boost the child’s confidence. The medicine must be combined with all the other advice above. It can be used for up to six months.
• If there are any worries or stresses in the home, try to correct them.
Solutions for Bedwetting Older Children For daytime wetting, parents should be advised as follows:
• Reward the child with praise or other rewards for each day that goes off without wetting. An easy way to reward children is using a star chart. This is a sheet of paper which is stuck on the wall of the child’s bedroom. Every day or night the child goes without wetting, she earns one star, which is stuck on the sheet. By prior agreement, after a certain number of stars are achieved, the child gets a reward (such as a toy or a special food).
• Get the child to go to the toilet regularly, say every two hours. This way, the bladder is always empty. Once this controls daytime wetting, gradually increase the time between trips to the toilet. If the child is in school, it helps to involve the teacher in this plan.
Review the child and parents until the problem is completely under control.

When to refer Solutions for Bedwetting Older Children
Refer to a child specialist if:
• there is a physical cause such as diabetes or a neurological problem;
• there is severe family disturbance, especially if you suspect abuse;
• the problem persists despite your suggestions;
• the child has the problem beyond the age of 10 years.

 

Related articles

• why bed wet
• Potty training before age 2 linked to increased risk of later wetting problems

Tags: bedwetting, children