Frequently Asked Questions
These are common questions that have been asked by concerned parents. Although we have provided thorough answers, we must remember that each child is unique and may require personal assessment and coaching to assist with their toileting issues.
Q: Why is my child wet in the morning even though we wake him up in the middle of the night and take him to the toilet and he wees?
Studies have shown that you can get a child up out of bed, make them walk, talk and wee on the toilet while still in the deepest part of sleep. Often these children do not remember getting up with their parents at night. The child can be taken to the toilet and told to do a wee. Once the wee begins he has been taught to wee in his sleep! This is exactly what you are trying to prevent him from doing.
Q: My seven year old son has always wet the bed. A friend once told me the cause is psychological and emotional. My son appears very confident, happy and comes from a loving family. Could this still be the case, or could there be another reason?
A: It certainly appears to be a common misunderstanding that bedwetting is caused by psychological problems. This misconception, along with the fact that it relates to a bodily function contributes to the notion of bedwetting being a socially taboo topic and associated with shame and embarrassment. In actual fact, bedwetting can become a causal factor of basic psychological disturbance if left untreated. Studies on self-esteem in enuretic children reveal that it is lowered in enuretic children and that as most people know self-esteem is an important psychological variable associated with mental health. Therefore, low self-esteem can be an indicator for present and possible later psychological dysfunction. Bedwetting is an inherited condition with a child having a 40% chance of bedwetting if one bedwetting parent and this doubles to 80% if both parents wet the bed as children. So generally children have their parents to blame in terms of genetics. This of course can be reassuring to many children, knowing that dad wet the bed when he was a child and he turned out ok and doesn’t have any bedwetting issues now!
Q: Why do children wet the bed?
A: There can be a number of reasons why children wet the bed. One of the most common reasons appears to be that it is inherited. If one parent wet the bed then a child has a 40% chance of wetting and if both parents wet it is as high as 80%. Other reasons include having a small bladder which means the child needs to urinate more frequently, having a weak bladder muscle, a urinary tract infection and not yet having a good brain-bladder connection.
Q: At what age should I be worried about my child’s bedwetting?
A: By the age of 4 70% of children are generally dry at night most of the time, at 5yrs only 15% still wet the bed, by 10yrs 7% of children wet the bed and at 15yrs only 1% still wet. Children over the age of 5 should be offered techniques for stopping wetting.
Q: Does limiting fluid intake in the afternoon and evening help to stop bedwetting?
A: No, limiting fluids may actually increase wetting, as the bladder remains small and inflexible which decreases the amount of time a child can go without urinating.
Q: How do I reward my child for being dry at night?
A: Using small rewards such as a sticker is a good way of rewarding a child for having a dry night, especially when a certain number of accumulated stickers (or dry nights) leads to a special reward such as a family outing. However, be aware that rewards only work if the child can actually have a dry night; it is very frustrating and upsetting for the child if they feel that the goal is unattainable.
Q: Should I get my child up in the night to toilet?
A: No, waking your child to toilet during the night will not allow her or him to recognise the sensation of their full bladder. It may seem to work temporarily in helping them to be dry, but generally as soon as parents tire (and that happens pretty quickly) from waking them, the child resumes wetting again. Also, it quite often results in a grumpy child and frustrated and tired parent.
Q: What is the most effective method for stopping bedwetting?
A: Bell and Pad Alarms are generally the most effective method of stopping bed wetting (the Boss of the Bladder program has a 90% success rate), provided that they are used under the supervision of a psychologist or consultant. The psychologist can assist with the implementation of supportive methods such as coaching and bladder training. Coaching refers to having a support team that rallies around the child and encourages them to stay dry with self-esteem strategies and rewards. Bladder training teaches children how to increase the size of their bladder so that they can “hold on” and avoid accidents.
Q: How old should my child be, before we begin treatment for bedwetting?
A: The minimum age usually for undergoing our program is 5, however this does of course depend on the individual child; maturity, motivation etc.
Q: When is the best time to begin a program like The Boss of The Bladder Program?
A: The best time to begin our program would be when there is relative stability in the household (i.e. no huge changes like a new school, new house, going on holidays etc).
Q: My child feels they have been bad when they wet the bed, how do I stop this?
A: Naturally it is important to encourage them when they are dry, but not by referring to being dry as “good”, so that the child does not automatically assume that it is “bad” to be wet. Offering incentives such as reward charts can be useful to improve motivation, BUT only if they are able to have some dry nights.
Obviously it is very important to NOT make a dramatic issue out of the wet nights.
Q: How much does a program like Boss of the Bladder cost?
A: The costs involved are subject to individual circumstances, but generally the main cost is for the rental of pad and alarm (for 6 weeks). The other cost involved is for the initial consultation, approximately 1 hour with a registered psychologist.
This also includes all weekly phone contact from the child and parent and follow up consultation at the end of the program, usually between 6 – 8 weeks. The child is considered dry when they have had 14 consecutive dry nights.
As of the 1st November 2006, in Australia, Enuresis (day wetting and night wetting) is eligible for a Medicare rebate, with a General Practitioner’s referral under a Mental Health Care Plan. If you choose to go through Medicare, your child is entitled to up to 12 sessions in which you will receive $80.40 back on each session.
Some children will benefit from just the basic program whereby they become dry.
Other children who may have lost confidence or have low self-esteem because of the bedwetting may benefit from a longer series of consultations.
Any questions: Phone Dr Janet Hall and Associates on 03 9419 3010