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Most children are dry at night by the time they’re five, but some still have accidents and call for help. Coram Family look at ways of helping a child when they wet the bed
As a parent you tend to assume that once your child bids farewell to nappies, they’ll soon learn to hang on for the loo at night. The truth is that some do and some don’t. If your child is five, six or seven years old and is still struggling to stay dry at night, it’s important to realise that she or he (more likely he) is not alone. Bed-wetting affects about half a million 6-16 year olds in the UK. The specialist support organisation ERIC – The Enuresis Resource and Information Centre reports that surveys conducted in 1998 in the UK, The Netherlands and New Zealand, showed bed-wetting to be a common problem:
- About 1 in 6 five year olds still wet the bed
- 1 in 7 seven year olds
- And 1 in 11 nine year olds are still having trouble
Specialists in this area would not view children as genuine late developers until they were seven or eight years old. So, be confident that, no matter what your friends may say, your five or six year old is not the only one still wetting the bed. Of course, that doesn’t mean that parents can’t find advice and support. At this age, children will be aware that many of their friends manage not to wet the bed, and they may be concerned about staying overnight with friends or relatives.
It’s important to realise that there are two broad problem areas with bed-wetting:
- When children were dry and have now started to wet the bed again
- When children moving towards middle childhood have never managed to become dry at night
The first group of children are almost certainly worried about something. They might be fretting about their schoolwork, upsets with friends or be aware of disruption in your family.
- Listen to your child and encourage him or her to talk. See what you can do together about their troubles.
- Reassure children that helping them is more important that the wet sheets. An older child will not want to go back to nappies, but may welcome a pad inside their pants until this time passes. Be encouraging when the dry beds start to return.
- Explain to children that worries can affect everyone in different ways. For example, another child in your family has bad dreams or you suffer with insomnia when you’re worried.
It’s a different situation when children have never or scarcely ever managed to be dry at night. Then, you all need information and advice that homes in more on the bed-wetting itself. You can talk to your health visitor, G.P. or get useful advice from websites, some of which have an opportunity for parents to discuss their experiences via message boards.
Helping the child who struggles
Most five and six year olds who still wet the bed are having difficulty with night-time bladder control. Only a small minority have an undiagnosed medical problem. Unless there are other symptoms that make you concerned about your child’s health, try some simple strategies, first of all.
- Talk to your child and listen to what she or he has to say. It’s important that children are reassured that they are not bad or dirty. They’re just having a struggle with night-time dryness.
- Let children know that they are definitely not the only five, six, seven or eight year who is facing this problem.
- Do your best to talk about aiming for ‘dry beds’ rather than an emphasis on ‘wet beds’.
A star chart
Children older than five and six years can understand the symbolism of a ‘star chart’ system and be motivated when they see their progress.
- Use a simple wall calendar, on which your child sticks a star (or a smiley face or other friendly sticker), each time there is a dry bed. Decide where to keep the calendar; your child won’t want it displayed for everyone to see.
- Your child must never lose any stars. If the bed is not dry, then that day on the calendar is left blank.
- This approach is not swift. Give it at least a couple of months and allow for three steps forward and one or two back.
- The plus side of a star chart is that children can see their progress and you can be pleased with them. Some families link treats to a certain number of stars, but some children get their satisfaction from the dry beds. You certainly don’t want rewards for stars to be an additional pressure.
The star or sticker chart may also encourage a child who was dry and has slipped back, so long as you also deal with any underlying worries. If things don’t improve, then ask your GP to check for any urinary tract problem. It’s unlikely but worth ruling out at this stage.
Using an alarm
If you and your seven or eight year old have tried lifting, steady encouragement and a star chart, but bed-wetting is still a problem, it may be time to try a buzzer or bell alarm.
Different kinds of alarms can be fixed to pyjamas or go under the bottom sheet. You get proper systems from your GP or ERIC can supply them; this is not a DIY job.
- The night-time alarm goes off as soon as children start to wet. The theory is that the noise wakes them up, they clench their muscles to stop peeing and get up to go to the toilet.
- Children who wet at night don’t seem to be deeper sleepers, but they do have trouble coming to. So, don’t expect the alarm to be an overnight success. It can take two to three months before your child has learned to wake fully enough to get to the toilet.
- In the beginning you may also need to get up when you hear the alarm and go to your child to help him or her to get fully awake.
Most children will manage to achieve dry nights through one of these strategies. While they are trying, they will feel better knowing they’re not the only person with this problem. The Enuresis Resource and Information Centre ERIC has years of experience in offering practical advice, including leaflets written for children as well as their parents. Their website has sections that are accessible for children and teenagers. ERIC can be contacted by the more traditional routes at 34 Old Schoolhouse, Britannia Road, Kingswood, Bristol BS15 8DB and by telephone on 0117 960 3060.
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