CONTACT PHYSICIAN, SCHOOL NURSE, CHILD CARE CENTRE OR OTHER HEALTHCARE PROFESSIONAL BEFORE TREATMENT
It is important that treatment of bedwetting is initiated after consulting a physician, other health care professional or urologist. Before treatment start a physician should make a medical investigation to exclude any underlying physical conditions, such as urinary tract infection or diabetes.
The so-called "alarm method” is a well-established method where an alarm signals when the child wets the bed. The child thereby learns the reflex to wake up when the bladder needs voiding.
In the beginning of treatment it is important that the parents are available and supportive to ensure that the child wakes up to the alarm and goes to the bathroom. They should not wake the child up before it wets the bed, because then the child won’t learn to react reflexively when the bladder needs voiding.
To achieve a successful result it is important that the alarm treatment continues without interruption, and it usually takes 4-12 weeks.
A few steps to a successful treatment:
- Motivation, the child must be interested in becoming dry and parents must be available to support the child during treatment for a successful result.
- The treatment should be completed without interruption, during weekdays and weekends. It usually takes 4-12 weeks. It is important not to stop too soon.
- Parents must be available and help their child at night the first treatment days.
- The child may drink as usual before going to bed. Children should learn to react to their reflex and not learn a different bedtime behaviour than usual.
- Do not use diapers and protective trousers that makes it too comfortable for the child when wetting the bed. The child should feel a need to go to the bathroom.
- Parents must not set an alarm clock and make the child go to the bathroom before it wets the bed.
It has been shown that 3/4 of all bedwetters are cured by the so-called alarm method. See below for more information about different types of alarms.
A hormone in the body, vasopressin, reduces the normal amount of urine during the night. Drugs that are similar to vasopressin helps reduce the kidneys' production of urine, which could reduce urinary incontinence and alleviate bed-wetting in children. The effect stops when the product is discontinued and therefore the treatment usually doesn’t cure from wetting in the bed. Sometimes parents choose to treat their children temporarily with the drug in connection with for example a camp. During treatment it is important to follow the instructions to take caution with fluid intake in the evening to avoid side effects.
If the bedwetting is associated with overactive bladder function children can sometimes get treatment to calm the bladder.
Urotherapy (bladder training) is given mainly to children with problem voiding during the day because of overactive bladder. Overactive bladder means that the bladder’s muscle contracts one or more times before the bladder is full and the child feels as it needs to go to the bathroom all the time, but does not always get there on time. Bedwetting at night may be caused by an overactive bladder if the child needs to go to the bathroom several times a night.
Sometimes several methods are combined.
DIFFERENT TYPES OF ALARM
Bed mat alarm
A common basic method is the use of a bed mat, so-called detector mat, that is connected to an alarm unit. The alarm unit signals when pee (salty fluid) comes on the mat. The child turns off the alarm. Using a bed mat is a proven method, where the child needs to sleep over a plastic pad, but at the same time no part of the alarm needs to be attached to the child and the child may choose to sleep with or without pyjamas and underwear.
Alternative to the bed mat alarm is the so-called wearable alarms. This functions with a sensor that is attached to the underwear and is connected to an alarm unit that is attached to the pyjamas/ nightdress at the shoulder. When liquid reaches the sensor, the alarm unit at the shoulder signals and wakes up the child. A popular type of alarm that is becoming more common and can be easier to bring for example if a child is sleeping away from home.
A wireless alarm functions the same way as a wearable alarm, but without any wire connected to the alarm unit. A sensor is attached to the underwear together with a transmitter. When liquid reaches the sensor the transmitter sends a wireless signal to the receiving alarm unit placed apart from the bed, that signals and wake up the child. A wireless alarm may be an option for those who want a modern wearable alarm without a wire under the night clothing or who want to sleep without pyjamas/ nightdress.
MATTRESS AND SHEET PROTECTIONS
During treatment with bedwetting alarms the child will wet in the bed until it learns to respond to a full bladder. In order to protect the mattress there are different types of waterproof mattress sheets and pads. In addition to being waterproof a good protection is soft and comfortable to sleep on. They usually consists of cotton. For bedwetting children a protection with good absorbency is recommended.
Common material in the bed protection sheets are cotton terry, but flannelette has also become more common. Both materials consist of cotton and are comfortable to sleep on. Terry generally has a higher absorbency and is slightly lighter and cooler to sleep on, while the flanelette has a softer, slightly denser and warmer material.
Bed protections that covers the entire mattress provides reliable protection for bedwetting. For easy embedding to dry sheets a waterproof pillow and bolster protection can be used. For those who are heavy bed-wetters an extra absorbent protection absoplus can be placed in the bed where the pee is expected to come.
When travelling, it may be easy to use disposable pads and not having to deal with laundry.