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Nevena Lovrinčević • BEDWETTING

B

edwetting is a problem that is tedious, persistent and uncomfortable for both the parents and the child. Moreover, it is unlikely that you will overhear parents talking about it on a park bench or at a playground. This issue is also something that we will rarely discuss outside the immediate family circle. In this book, you will find answers to the most important questions related to bedwetting, ones that are probably occupying your thoughts (causes, frequency, consequences, feelings of children and parents, types of treatment), as well as practical advice on how to – together will your little one – tackle the problem of bedwetting the proper way and when the time is right.


With great support and understanding, I dedicate this book to all the little ones who wake up in soaked pyjamas, and also to their parents


CONTENT Introduction ................................................................................... 5 Bedwetting – facts......................................................................... 9 Definition – what is bedwetting ................................................ 9 Bedwetting causes................................................................... 11 Frequency of bedwetting......................................................... 13 Bedwetting consequences......................................................... 15 When does bedwetting become a problem.............................. 19 How the child feels..................................................................... 25 How the parent feels................................................................... 29 How to talk to your child........................................................... 33 Most common questions and how to answer them................. 35 Types of treatment...................................................................... 39 Dietary changes.......................................................................... 39 Medication.................................................................................. 40 Bedwetting alarm....................................................................... 41 Practical approach and advice.................................................. 45 Conclusion........................................................................................ 49 About the author........................................................................... 51


INTRODUCTION I used to wet the bet until I was eleven. One of my three children used to wet their bed until they turned ten. What’s the point of this short, yet not entirely easy confession? It is quite clear you won’t grab a book titled Bedwetting in a bookshop and casually flip through its pages with curiosity, wishing only to find out how to improve your parenting skills. No. This is a book that you will probably reach for with a feeling of dread – unsure and worried… because your child or a child close to you has a bedwetting problem. This is precisely why it is so important to know, before you even begin reading this book, that I completely understand how horrible it feels to see a child frustrated because of their bedwetting – when they feel bad and insecure, when you see them hiding their soaked pyjamas, when they tearfully say goodbye to their classmates as they go on a school trip they cannot attend (all while pretending that they have an allergy or injured leg)… I also understand how you feel afterwards – when you 5


don’t know how to console them, when you don’t know how to answer the question when bedwetting is going to stop, when you try out various techniques you heard are helpful, when you have to wash the sheets every day, when you can’t find diapers that are big enough so you have to expand the biggest ones you could find using duct tape (and watch your little one be even more embarrassed because of it), when you carry an oilcloth and spare covers when going on a holiday and wash the sheets in the hotel sink… Similarly, I know how awful it feels to wake up in soaked pyjamas and when the first things you feel in the morning are shame, disappointment and discomfort, how hard it is to have all friends go on a school trip but not you, what it feels like to lie in bed at night having your last thoughts be: Please don’t let it happen tonight…, and how worried you are because you don’t know when it will stop, and how uncomfortable medical exams are, and how you constantly wonder: How come there is nothing I can do? Is it my fault?, and how afraid you are of someone finding out about your problem… Therefore, I know about the problem of bedwetting from both the parents’ and child’s point of view. This is what I wanted you to know before you begin reading this book. * When we become parents, it’s almost like we get a membership card for a big brotherhood of parents along with the baby. The 6


interests we had fostered up until that point get knocked down on our priorities list, and everything related to our child suddenly becomes infinitely more important. It’s not unusual for a young mother to notice how she suddenly became much closer with her neighbour who has a child of the same age, and that she would rather spent time with her than her childhood friend who doesn’t have children. It’s almost as if talking about beauty products, sales, types of cars or relationship problems becomes uninteresting overnight, whereas any information about teething, breastfeeding, nutrition, discipline, etc. becomes more intriguing and important. It is this exchange of information and support that parents provide for each other that will offer us so much useful advice and enable us to solve minor and major problems of parenting more efficiently and confidently. Still, even though bedwetting is considered to be an arduous and persistent problem, it is unlikely that you will overhear parents on a park bench or playground talking about it. This problem, which is uncomfortable for both parents and the child, is something not easily admitted and discussed outside of the immediate family. This book will provide you not only with answers to the most important questions related to bedwetting, ones that are probably consuming you, but it will also offer support that will help you face this problem head on – together with your little one – the proper way and when the time is right. In any case, you will deepen your understanding of the bedwetting problem and, in time, successfully solve it.

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BED WETTING – FACTS

DEFINITION – WHAT IS BEDWETTING

The potty training stage, which with most children ends by the time they are four years old, is usually followed by a period when your child will still wet their diaper at night. If nighttime incontinence continues occurring in children older than six or seven, this is what is called bedwetting. Even though international classification of illness and disorders marks the age of five as critical, most experts who deal with the problem of bedwetting do not consider involuntary urination in children younger than six or seven a problem that deserves special approach or treatment. Bedwetting can be primary and secondary. Primary bedwetting means that a child older that six or seven has not expe9


rienced any dry periods, i.e. longer periods during which they didn’t wet the bed at night. Secondary bedwetting means that after a dry period (without bedwetting) that lasted at least six months, a child has begun to wet the bed again. A child can be wetting their bed every night, once or more, but they can also do it several times a week or less frequently than that. When it comes to primary bedwetting, this is a problem that will most likely be resolved with time, even if you don’t do anything about it. The only question is how long it is going to last. Secondary bedwetting can be a sign that your child is experiencing some difficulties: demanding environment in kindergarten or school, jealousy over a younger sibling, parents’ divorce, traumatising event and similar. Problems with urinating during daytime, as well as involuntary defecation, are frequently signs of medical problem that needs to be examined more closely. Medical problems as an underlying cause of bedwetting make up less than 3% of the cases, mostly in regards to secondary bedwetting, and can be one of the following: diabetes, neurological problems, urinary infections, etc. Taking into consideration different causes, the approaches when dealing with primary and secondary bedwetting will vary. With primary bedwetting, you can choose one of the following treatments or opt (if this suits your child first and foremost, then you) to wait for the child to grow out of it. Secondary bedwetting, however, can merely be a symptom 10


for another problem of emotional nature (jealousy, insecurity, burdening situation, unpleasant event) or medical issue. Only when you resolve the underlying issue that is causing secondary bedwetting will you be able to expect the problem of involuntary urination to be fixed. It is important to keep in mind that this book is not intended for parents whose child’s bedwetting is caused by medical issues, i.e. parents whose children are suffering from secondary bedwetting. Some information and support in this book can be useful to them, but the approach in treating this issue is still somewhat different to the one presented in this book. In case bedwetting is a symptom of a medical issue, it is necessary to treat it differently, primarily with a help of a doctor who is in charge of the child’s health.

BEDWETTING CAUSES

The specific cause of bedwetting is unknown, unfortunately. The most commonly mentioned causes of primary bedwetting are one or several of the following: – Genetics. If neither of the parents suffered from bedwetting, there is only 15% chance that their child will suffer 11


from it. If one of the parents used to wet their bed as a child, this probability increases to 45%, and if both parents had that problem, the chances for their child to do same are 77%. The mechanism through which genetics causes this problem to be hereditary is still not precisely determined. -D  evelopment. A slightly slower development of nervous system whose role is to alarm the child to empty their bladder can be the reason for bedwetting; the problem can also be caused by small bladder capacity. - Larger production of urine at night. The production of urine is regulated by a certain hormone. If there is a problem with the activity of this hormone, the body does not reduce urine production at nighttime, causing bedwetting. - Apnea. If a child’s breathing is obstructed at night because they have swollen or infected tonsils, short interruptions in breathing may occur (apnea). This kind of issue can be noticed through other symptoms, such as frequent ear infections, breathing through the nose and snoring. - Structural issues. Problems related to an irregular urinary tract, but also neurological problem a child was born with (for example, spina bifida), can also cause the bedwetting to occur. The most common misconceptions are usually related to the causes of bedwetting. Some parents think their child delib12


erately wets their bed because they are angry (so this is how they want to punish or hurt the parents), but also that bedwetting is a result of lack of attention, laziness or absence of motivation in child. If a parent holds these incorrect beliefs about bedwetting, chances are their reaction to the problem and their child in general will be such that this issue will not be solved. Furthermore, this might significantly strain the relationship between the parent and the child, but also damage the child’s confidence.

FREQUENCY OF BEDWETTING

You can often hear parents discussing their children having allergies or ear infections, whereas you will almost never hear them exchanging stories related to bedwetting. It is this veil of secrecy when it comes to bedwetting that makes both parents and children feel even worse and more alienated. Among children who suffer from bedwetting, around 90% thinks they are alone in this. This implicates not only that they are misinformed, but more importantly, that they feel bad and guilty of their problem. Of course, nothing could be further away from truth!

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The issue of bedwetting is a common one – in fact, more common than the parents and children affected by it might think. Statistics on presence of bedwetting according to age: 5-year-olds

30%

6-year-olds

12%

7-year-olds

10%

8-year-olds

7%

9-year-olds

6%

10-year-olds

5%

11-year-olds

4%

12-year-olds

3%

13-year-olds

2-2.5%

14-year-olds

2%

15-year-olds

1-1.5%

16-year-olds

1%

The development of bladder control happens through the following stages: First eighteen months: child is not aware when the bladder is being emptied or filled up; 18-24 months: child becomes aware of the sensation when bladder is emptied;

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Age two to three: most children develop the ability to consciously stop urinating and are being potty trained; Age three to five: most children have full control over their bladder and are dry during day and night.

BEDWETTING CONSEQUENCES

Bedwetting is a problem that greatly affects not only the little ones, but the entire family, and it can persist for years. This is when the dilemma arises: if that is the case, can this long-lasting, tedious problem leave any permanent consequences on the child? And what kind of consequences are those? Good news for parents is that primary bedwetting leaves no noticeable consequences on the child. The only possible consequences might result from inadequate behaviour on the parents’ part, when they try (perhaps exhausted, discouraged and sometimes irrationally angry) to solve this problem by punishing, humiliating, mocking and pressuring their child. These actions can result in lack of confidence, insecurities, bad mood, hypersensitivity, etc. in children. However, if the parent is stable and offers adequate support and encouragement to their child, and if they are able to

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Nevena Lovrinčević • BEDWETTING

B

edwetting is a problem that is tedious, persistent and uncomfortable for both the parents and the child. Moreover, it is unlikely that you will overhear parents talking about it on a park bench or at a playground. This issue is also something that we will rarely discuss outside the immediate family circle. In this book, you will find answers to the most important questions related to bedwetting, ones that are probably occupying your thoughts (causes, frequency, consequences, feelings of children and parents, types of treatment), as well as practical advice on how to – together will your little one – tackle the problem of bedwetting the proper way and when the time is right.

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