Disclosure :: This post is sponsored by Children’s Hospital New Orleans. We are excited to bring you this content because we know (from our team’s personal experiences) that bed wetting can be a tough issue to deal with as a parent.
Bed Wetting: We’re Potty Trained During the Day… Not So Much at Night
There are few things more demoralizing for a parent than starting off the day washing the urine soaked sheets of your child … again. As parents, we wonder: am I a bad parent? Why can’t I teach him to stay dry at night? Am I feeding him the wrong things? I don’t think hot dogs are related to bedwetting … are they? It can’t be my fault. I never wet my bed as a child, but his father… Oh. I bet he is doing it to get back at us for taking away his binky. Does he sleep too hard? Is he sneaking water at night? Why doesn’t he seem to care? Will my house ever not smell of urine again?!
These questions, frustrations and accusations are experienced by almost every parent (yes, there are a lucky few bladder control overachievers out there). Imagine the frustration when you, the parent, are also the pediatric urologist. Welcome to my world! The frustration is only magnified when you have dedicated over 11 years of training to help others with this very issue.
Hopefully I can share with you some of the basics from my training and add the more practical tools my children have taught me.
Why Don’t You Ever Flush the Toilet?
While flushing should certainly be encouraged, take advantage of this lapse in short-term memory and take a closer look at your bed wetter’s stool. Let’s face it, early childhood has two great parental celebratory moments: sleeping through the night and no more poopy diapers. So why would you subject your senses to it again? Constipation and/or incomplete emptying of the bowels has proven to be one of the most important reasons for poor bladder function. Simply put, if the pelvis is full of poop, the bladder has nowhere to store pee. The ideal excrement should be soft, thin and daily. If not, it is helpful to increase your child’s fiber. While green leafy vegetables and fruits are nutritious, they may not be practical. My son literally gags as if you just fed him a live maggot on a Survivor food challenge if a fruit or vegetable gets near his overly sensitive palate. So instead, go down the fiber aisle and find something your child will eat happily and on a daily basis. There are literally hundreds of high fiber supplements disguised as cookies, granola bars, brownies, juices and my favorite recommendations: fiber gummies and flavored prunes. Give them to your child in the morning with something to drink. Encourage ample fluid intake during the day and watch for changes in their bowel pattern. If nothing happens, give more.
Did You Go To The Bathroom?
The answer to this question is usually an automatic “Yes” or “I don’t need to.” Regardless, either answer is a lie or a lapse of memory. If I don’t see or hear my daughter urinate before bedtime, it most likely didn’t happen. When she says she doesn’t have to, I make her a bet she can, and I have yet to lose. The last time I trusted her automatic answer I was cleaning sheets in the morning. It seems too easy, but I have “cured” many a kid with this simple reminder.
I’m Thirsty Still!
Childhood thirst only seems to occur just prior to bedtime and is directly proportional to how badly the child does not want to go to sleep. If your child is truly thirsty prior to bedtime and not just a master of stall tactics, then he/she is not drinking enough during the day. Kids who play sports in the evenings and don’t drink much during the day come home and drink several liters just before bedtime. Unsurprisingly, they sleep through another accident. Daytime hydration is important for proper bladder and bowel function. An easy sign of hydration: the urine should be clear by lunchtime on. If not, you are probably not drinking enough. Fluids should be stopped at least 2 hours before bedtime with especially no caffeinated or carbonated beverages anytime in the evening.
I Don’t Feel When I Have to Go!
Now this is usually an honest answer and typically justified by the parent as their child “sleeps too heavy.” There is some truth in children not feeling when they have to go, and it is typically not because they have some abnormal sensation or anatomical defect. Proper voiding and storage requires complex neurosensory pathways to mature allowing the bladder and the brain to communicate effectively. Just as my son can ignore me calling him several times from 3 feet away while he is affixed to the cartoon on the TV like a fly attracted to a blue light, he can similarly ignore his bladder about to give up. As far as the “heavy sleeper phenomenon,” I’d buy that for some kids, but even the heaviest sleepers eventually stop wetting the bed despite maintaining their ability to sleep through a fog horn blasted in their room to ready them for school. Some kids just take longer for these neural pathways to mature (i.e. boys) and, yes, it could be Dad’s fault after all, as bedwetting does seem to run in families. Most importantly, your child is not lazy nor wetting the bed to spite your questionable parenting techniques so don’t punish the wet nights – reward the dry nights.
Bottom line … keep your head up! This too shall pass. We all experience this (pay no attention to that braggadocious parent with the bladder overachiever). If you feel you have exhausted all of the above tips and tricks and your child is approaching 6 or 7, certainly talk to your pediatrician and ask about seeing us. We have many more tricks up our sleeve and can provide a fresh look at potential pitfalls, suggest other proven techniques, give you an encouraging pep talk, or even prescribe helpful medications in the right circumstances. While my own house still has a ways to go before it smells normal again, I and my partners would be honored to help you with yours.
**The information contained in this blog post is for networking and informational purposes only, and should not be used to replace the relationship that exists between you and your child’s healthcare provider. Please contact your healthcare provider for specific medical advice and/or treatment recommendations.**
Dr. Aaron Martin
Dr. Aaron Martin is a fellowship-trained pediatric urologist at Children’s Hospital New Orleans Department of Urology with partners Dr. Joseph Ortenberg, Dr. Christopher Roth, and Sherry Langston, NP. He and his wife live in Mandeville, LA with two in diapers (Hannah, 2; Micah, 3 mo), one bed wetter (AJ, 3), and one completely potty-trained (Eden, 6). Children’s Hospital Urology is the largest fellowship-trained pediatric urology group in the state and offers state-of-the-art treatment for all childhood genitourinary issues including reconstructive surgery, cancer surgery, and minimally invasive robotic surgery. For more information, please visit www.chnola.org/urology.