Beating bedwetting

Florida specialist reveals helpful hints for parents


ORLANDO, Fla. – Waking up to wet sheets. It's what happens to up to seven million American kids.

Bedwetting is a normal part of the potty training process, but when it doesn't go away, the worrying begins. Here are some tips to help kids overcome night time incontinence.

There are special concoctions and even alarms to help kids stop wetting the bed.

Pediatric nurse practitioner Penny Noto says, they might work for some kids, and every year another 15 percent outgrow the problem.

"It's absolutely physiologically normal, for a child to wet passed the age of six," said Noto, who's with the Florida Center for Pediatric Urology in Orlando .

But if it continues after age seven, the bedwetting specialist says, there are simple things you can do that could help. First avoid drinks that contain the Horrible C's, such as:

"Things that have caffeine, carbonation, artificial colors, too much citrus or too much calcium. All those things can irritate the bladder and make a child more likely to wet," said Penny Noto.

Replace the Horrible C's with water, cranberry juice, or apple juice. Another ‘C' to look out for is constipation.

"It is hugely undertreated and under recognized," Noto stated.

Noto tells us it's an issue in about 50 percent of her cases. When things get backed up she recommends reducing the amount of dairy, white bread and white rice your kids eat. She says try adding, " things with fiber and nuts and seeds and whole grains."

Noto says her tips won't fix the problem overnight, but they have worked for many of her patients.

Noto runs a special clinic to help kids overcome bedwetting. She says if one of the child's parents was a bed wetter the kid has a 40 percent chance of being one. If both parents wet the bed, their child has an 80 percent chance of inheriting the problem.

Additional Information:

BACKGROUND: Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes. But don't despair. Bed-wetting isn't a sign of toilet training gone bad. It's often just a normal part of a child's development. Bed-wetting is also known as nighttime incontinence or nocturnal enuresis. Generally, bed-wetting before age six or seven isn't cause for concern. At this age the child may still be developing nighttime bladder control. If bed-wetting continues, treat the problem with patience and understanding. (Source: http://www.mayoclinic.com)

CAUSES: No one knows for sure what causes bed-wetting, but various factors may play a role, such as:

  • A small bladder: A child's bladder may not be developed enough to hold urine produced during the night.
  • Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not wake the child — especially if the child is a deep sleeper.
  • A hormone imbalance: During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
  • Stress: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bed-wetting.

(Source: http://www.mayoclinic.com

RISKS FACTORS: Several factors have been associated with an increased risk of bed-wetting, including:

  • Sex: Bed-wetting can affect anyone, but it's twice as common in boys than girls.
  • Family History: If both of a child's parents wet the bed as children, their child has an 80 percent chance of wetting the bed too.
  • Attention-deficit/hyperactivity disorder (ADHD): Bed-wetting is more common in children who have ADHD.

(Source: http://www.mayoclinic.com)


TREATMENT: Doing nothing or punishing the child are both common responses to bedwetting. Neither helps. Parents should reassure the child that bedwetting is common and can be helped. Start by making sure that the child goes to the bathroom at normal times during the day and evening and does not hold urine for long periods of time. Also, bedwetting alarms are another method that can be used along with reward systems. The alarms are small and readily available without a prescription at many stores. The alarm wakes the child or parent when the child starts to urinate, so the child can get up and use the bathroom. Alarm training can take several months to work properly, but bedwetting alarms have a high success rate if used consistently. (SOURCE: http://www.ncbi.nlm.nih.gov)

For more information, you can contact Penny F. Noto, ARNP-BC, DNP, CPNP at the  Florida Center for Pediatric Urology at penny.noto@flhosp.org.