If your daytime-dry kid soaks his sheets at night, it takes patience to remember he's not doing it on purpose -- and to wait while he outgrows it. Which almost every bed-wetting kid (or "monosymptomatic enuretic") will do, eventually. While 5 million to 7 million U.S. kids are dry by day but wet by night, all but 1 to 2 percent stop wetting by age 15.
Most enuretics are boys. For many, it's hereditary. If there's no discomfort while urinating and no daytime wetting or poop problem, you needn't worry: Your child's body simply hasn't yet developed the sleep-time ability to recognize that the flow is imminent.
While most experts don't recommend even considering treatment until age 7 or later, some families want to speed things along. According to Saul Greenfield, director of pediatric urology at Children's Hospital of Buffalo, options include a behavior-modification alarm that attaches to pajamas and sounds at the first trickle. At $50 to $100, alarms work in about 75 percent of cases, with most kids remaining dry after they stop using the alarm.
Medications are cheaper (usually covered by insurance; some have generic versions) and easier to use but less effective, working in only about half of the kids who take them, and many kids resume wetting once drugs are discontinued. Desmopressin, a hormone available in tablet and nasal spray form, makes the kidneys produce less urine; it has no notable side effects. Imipramine helps the nervous system suppress bladder contractions. Imipramine is an antidepressant, so must be used with care.
Some parents use meds to tide their child over until his body matures; some save drugs for occasions like sleepovers.
While pull-ups neither enhance nor retard progress toward nighttime dryness, they might ease frustration among parents and kids weary of midnight sheet swaps. But older kids may shun them -- if they can even squeeze into them. Restricting fluids won't solve the underlying problem, Greenfield says, but this approach can make life easier till the bed-wetting solves itself. Waking the child to use the bathroom doesn't teach the body to change its ways; the child often ends up wetting despite that groggy trip to the toilet, leaving him not just wet but exhausted.
Whatever you do, don't badger, berate or tease your bed-wetter. If he could fix the problem, he would.
-- Jennifer Huget
The columns KidLife and MidLife, devoted to healthy handling of children and adulthood, will appear in alternating weeks in this space. Send comments, suggestions and questions to firstname.lastname@example.org. For U.S. Mail, see address below. No calls, please.