what to do if your child wets the bed

by Diane K. Newman, RNC, MSN, CRNP, FAAN

The problems of bedwetting and daytime urinary incontinence in a child cause severe disruptions to the family routine. Most of the parents' frustration is over their inability to help their child and the daily chores associated with changing and washing clothes and bed linens. In desperation, many parents leave the child in diapers well past the age when they are appropriate.

Children should be taken out of diapers by the time they are four or five and their bed protected with layered under-pads. Many mothers have told me that the Kimberly Clark Pull-ups® have been lifesavers since they provide protection and are acceptable to the child.

Never punish a child for wetting his bed or clothes. He or she cannot control the bedwetting or urinary incontinence and punishment usually makes the problem worse. In many cases, punishment increases the child's shame and embarrassment. Instead, use positive reinforcement for any success at staying dry by marking a calendar when the child has a dry day and/or night and celebrating the child's success with stars and stickers. This is very effective at decreasing the incidence of bedwetting. Identifying achievable goals, staying dry one night a week, for example, can be helpful.

Try to make it easy for your child to spend the night at a friend's house. Hiding a pull-up in the bottom of an overnight bag will allow the child to discretely slip it on. Let the friend's parents know about the problem -- they are usually very understanding about a child's incontinence.

Children who have dysfunctional voiding may need intermittent catheterization as an additional treatment. When introducing self-catheterization in children with normal perineal sensation, be patient and take time for the child to overcome the fear of pain.

References

1. Berry, AK. Helping Children with Nocturnal Enuresis. AJN. 2006;106(8):58-65.

Posted August 2006
Updated August 2009

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