Treatments for Bed Wetting

Here are some of the treatment options and therapies that your child's pediatrician may recommend. There are two main types of therapy:

  • conditional
  • behavioral

The goal of all the therapies is teach the child to wake up when the bladder if full and/or to decrease the need for nighttime urination.

Conditional Therapy

Moisture alarms or Bed Wetting Alarms are the most common form of conditional therapy are considered to be safe and effective. The alarms are built to sense moisture and make a very loud noise, which should wake up the child, so that they get out of bed and go to the bathroom to finish urinating.

The alarms can be effective if they awaken the child. Using the alarm along with a behavioral therapy like guided imagery can help the child to awaken.

The parent can also try to awaken the child and help walk the child to the bathroom to finish urinating. After about 4 to 6 weeks of being awakened and guided into the bathroom, the child's body and mind will be getting used to it and usually within 6-12 weeks, the child will master night time control and will not need to use an alarm.

The research I did suggested that alarm use can be discontinued after 3-4 weeks without wetting; however, to reduce the chance of relapse, the alarms should be used for 3 to 5 months.

Most children can be helped with a moisture alarm if it is used consistently and most kids will stay dry permanently; relapses after alarm therapy are uncommon.

(Read our article on How to train your child to use a bed wetting alarm. )

Behavioral Therapies

There are a number of different behavioral therapies such as motivation programs with star charts, guided imagery and hypnosis.

Behavioral treatment is often more effective and certainly is safer than medical treatment (see bed wetting medications). While behavioral treatment may take somewhat longer to show results, the improvement usually continues indefinitely. There are several methods that may be helpful:

Motivation programs are based on the concept that children wake up easier when the day holds promise and excitement; i.e. it is easier to get out of bed on Christmas morning, or on a day of a major event, especially when compared to a "normal" day. So, this anticipation and excitement is created with a Star Chart - where the child receives a star for each dry night and then after 3,5 or 7 nights, the child is given a smaller reward and then after 3 weeks, the child gets the big prize which is something they really want.

The prize has to be something that will keep the child's excitement and anticipation going for 3 weeks, because it takes that long to break an old habit and form a new one!!

These star charts can be used alone or in conjunction with a bed wetting alarm. This motivational program is enough for some children to help them and their bodies learn to be responsive to a full bladder. Always consult your child's pediatrician before starting any therapy program. The program should be modified (i.e. add / remove therapies and tools) if no results are seen in 2 weeks. We offer a number of free potty training charts that could be adopted for use as a star chart with stars or stickers.

Visit Potty Training in One Day to print out fun and motivation star chart / calendars.

Guided imagery can be done by a trained professional, but a parent can also try this with their child. It basically involves creating a detailed image in your child's mind about how urine is made and how it is eliminated. Dr. Alan Greene recommends the following imagery:

Have your child relax, close his eyes, and listen to what you say. Tell him that his kidneys are a pee factory, making urine day and night. His bladder is a storage tank where the pee is kept until he is ready to put it in the toilet. There is a gate or muscle that holds the pee in the bladder until he is ready. During the day, he is in control of the gate, but at night some of the pee has been sneaking out. When he sleeps, he is going to begin taking control. When the bladder starts to fill up, he will control the gate when he is asleep, just like when he is awake. He will pee in the toilet when he is ready.

Having a detailed image like this one in your child mind helps the brain to be ready to receive the signal of a full bladder and to awaken the child.

Hypnotherapy should be considered only with a full trained therapist.

Hypnosis: Hypnosis has been found to be a very effective form of treatment for bed wetting. By repeated listening to a hypnosis tape, the brain is re-programmed so that the child will be able to respond to a full bladder while asleep the same way he or she does while awake.

Retention Control Training: The child is asked to control urinating during the day by postponing it, first by a few minutes and then by gradually increased amounts of time. This exercise can extent the capacity of the bladder and strengthen the muscle that holds back urination. Parents should always check with a doctor before asking their child to practice retention control:

Night-lifting: This procedure involves waking your child periodically throughout the night, walking your child to the bathroom to urinate, and then returning your child to bed. By teaching your child to awaken and to empty his or her bladder many times during the night, it is hoped that he or she will eventually stay dry.

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