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Bed-Wetting Myths Debunked

What to do and not to do if your child wets the bed.

Don't Blame the Victim continued...

Before resorting to an alarm or medication, try using a "star chart," where you give a child a star for every dry night and a prize for a few dry nights in a row. But "if this doesn't work in two weeks, it won't and continuing it may only discourage the child," Greene says.

Behavioral changes too play a role in achieving dryness, he says. Try decreasing the amount that kids drink before bed. "This will make a difference and may just be enough for some kids," Greene says. Limit fluid intake to 2 ounces in the last two hours before bedtime and cut out caffeine, which is a natural diuretic, he says.

"Kids should not be drinking a lot of soda with caffeine anyway, but a lot of them do," Greene says.

Also consider moving bedtime up by 30 minutes, he says. "In some studies, getting just one half of an hour more sleep at night decreases bed-wetting because kids are less tired and don't sleep as soundly and are able to wake up more easily when their bladder gets full."

Such reassurance can be based on the fact that bed-wetting tends to run in families, Wasserman points out.

"Calm down and reassure your child and do things to help his or her self esteem," he says. "If it's true, you may even say 'daddy used to do this,'" he suggests.

He or she will grow out of it. This is usually true, Greene says.

My son or daughter can never have sleep over at a friend's house!

Not true. Drugs such as DDAVP can be used for special occasions.

"For special situations, medication can be prescribed to make sure the child is dry to participate in social events like sleep-overs," Shubin says. "If a child is afraid to sleep at a friend's for fear he or she will wet the bed, DDAVP works," Shubin says.

The problem with prescribing this medication over the long-term is its expense. "DDAVP can be a great solution for some kids, but the disadvantage is the cost and there may be a long-term need unlike the alarm which usually works in 12 weeks," Greene says.

The other medication that doctors sometimes prescribe for bed-wetting is an older tricyclic antidepressant called imipramine.

"This allows you to have better control of the bladder, affects the bladder musculature and may change sleep patterns, so kids wake up if they have to urinate," Wasserman says. While this drug is cheaper, it does have more side effects including nervousness, intestinal problems, and excessive tiredness during the day. And as with many medications, an overdose can be fatal.

Is It a Medical Illness

For most kids, "bed-wetting is really more an inconvenience then a medical illness," Shubin says. However, "If it's new bed-wetting after he or she has been dry for a reasonable period of time, it may mean something else is going on," Shubin says. In these cases, "children should get a urine test to see if there is a urinary tract infection or possibly, this can be a sign of type 2 diabetes."

"Daytime wetting too raises red flags and you have to assume it's due to conditions such as urinary tract infection or other kidney and bladder conditions or psychological conditions," Wasserman says.

Remember: "It's a problem if it affects a child psychologically and if it affects family dynamic or affects the child's ability to have friends over or sleep out, but you don't want to make a mountain out of a mole hill and focus on an issue that he or she may outgrow." Wasserman says.


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