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Bedwetting Institute Fact Sheet

Bedwetting, also called nocturnal enuresis, has implications, which are often underestimated by both the community and those advising on its treatment.

It places a huge burden on the whole family, as any parent of a child who wets the bed will testify! Parents often become very distressed and might even suspect that their child is deliberately causing mischief. It is key to believe they are not!

Children can become anxious about their own ability to influence the outcome. Try as they may to help, they feel powerless to stop wetting the bed, and in time their self esteem may even suffer. Sleepovers with friends and school camps can become a source of considerable stress to the child. Many parents become resigned to the fact that they are unable to help their child. Doctors are often dismissive, offering only reassurance that the child will eventually outgrow the problem, when the family requires immediate help. Whilst bedwetting is a very common problem, it is often needlessly tolerated because of a certain stigma and reluctance to discuss what is an awkward and embarrassing subject for many people, yet totally possible to treat.

Don’t just wait for bedwetting to stop!
All children are different.  Just as most of the developmental milestones vary from child to child, so does continence at night. Two thirds of children will have stopped bedwetting completely by five years of age. One third are still wetting at five, with the frequency varying from occasional bedwetting to wetting every night. If your child is five and still wetting then it is time act. The parent must decide when they are ready to do something about the bed wetting rather than waiting for the child to be ready. The first three steps of our program can be used with children as young as four years of age, however, research has shown good results can be achieved with a bed wetting alarm from five years of age. No research has been done on younger children using alarms.

Young children (under 5’s) who are only wetting the bed occasionally are the most likely to outgrow the problem. Five and six year olds wetting most nights and all children seven years and over who are still bed wetting will generally stop bed wetting successfully with treatment. Only about 15% of children outgrow bed wetting naturally over the following 12 months. The older the child the less likely this is to happen. Most children and teenagers need treatment and then have a very good chance of being cured permanently.

Psychological Factors
Bedwetting is often attributed incorrectly to ‘psychological problems’.  In our experience, this is rarely the case. On the contrary, bedwetting, left untreated, may well lead to psychological problems. It may give rise to feelings of shame, guilt, isolation and loss of self–esteem, especially in older children. Following treatment, a child′s emotional health improves, as does self–esteem.

Occasionally when children are under an unusual amount of stress or very tired they may sleep more deeply. This could increase the likelihood of bedwetting but on many occasions children are more likely to wet in the comfort of their familiar bed at home when they are perfectly relaxed.

Physical Abnormalities
It is very unusual for a physical abnormality to be causing the bedwetting. Most children can be cured with the steps on the Bedwetting Cured DVD combined with using a bedwetting alarm.  If results have not been achieved within three months and all the steps on the DVD have been followed, then it is time to seek help from a continence professional or paediatrician.

Causes of bed wetting:

  • Small bladder capacity
    This means the bladder is not large enough to hold all the urine produced overnight; this can be improved with our drinking program.
  • Very deep sleep
    This is very common in children who wet the bed. During the night their bladder sends a message to their brain saying it is full. The child needs to wake up and get up to go the toilet, however, they sleep through this signal. Many children wet early in the night when they are in the deepest sleep.
  • Large volumes of urine produced at night
    Some children produce double the normal amount of urine at night so that even if their bladder capacity is normal it will not be big enough to hold all the urine they produce. Overnight these children often have abnormally low levels of the hormone vasopressin, also called antidiuretic hormone. Vasopressin is a hormone, which helps to concentrate the urine at night i.e. it reduces the volume of urine. These hormone levels can return to normal with treatment.  The drinking program will help the child produce more urine in the daytime and less at night and their hormones will respond to this.
  • Constipation
    This can lead to pressure building up in the area around the bladder reducing the amount of urine the bladder can comfortably hold. It can also lead to tight muscles, which stop the bladder from relaxing and emptying fully when it should whilst using the toilet. A bladder left half full will easily fill up again and soon need to be emptied.

Bed Wetting Treatment
What does a successful bedwetting program involve?
The Bedwetting Cured DVD explains how to treat the main causes of bedwetting with a step by step program.  It includes:

  • a drinking program to improve the connection between the brain and the bladder and to gradually increase bladder capacity;
  • information on foods and drinks which may be interfering with vasopressin, the hormone which concentrates the urine at night;
  • information on the role of constipation;
  • how to get the best results with a bedwetting alarm and
  • information on medication (although medication is rarely needed).

Bed Wetting Enuresis Alarms
The alarm has a sensor which detects any moisture and sounds when urine is released. The Alarm sound helps the “I’m full” message get through from the bladder to the brain.  It is usually necessary to use the alarm for a duration of four to eight weeks in conjunction with the other steps of the program.
It is best to purchase rather than hire an alarm so if there are any relapses they can be treated immediately leading to a final cure.

All bedwetting alarms are battery operated so there is no chance of an electric shock. Alarms have various sounds. Most emit a siren sound or loud noise when triggered. There is an alarm, which has an alarm sound and can be recorded with the parent′s or child’s voice. This is a good option for young children who may be frightened by the alarm sound and may not want to use the alarm again. These alarms also have a flashing light and vibration.
The loudest alarms are the Pad and Bell alarms which are the best option for children who sleep very deeply.

Clip-on Body Worn
Clip-on alarms, attach to the pyjama top near the shoulder. A lead runs from the alarm to the sensor, which is placed between two pairs of underpants or underpants with pull-ups over the top. It will sound as soon as the sensor becomes wet, even with a few drops.

A waterproof mattress pad overlay can go under the child to keep the sheets dry. The overlay is optional and is not connected in any way to the use of the alarm, however, it will save on washing and changing the sheets.

Pad and Bell Alarm
The alarm pad goes on the bed and the alarm box is placed on the bedside table. A lead connects the two. Nothing is attached to the child. The alarm sounds once the wetness has reached the pad. Some of these alarms cost about $2000 making them too expensive for parents to purchase and so are usually rented. However, if a relapse occurs a hired alarm may not be available again for months. To stop the bedwetting in its tracks it is essential to purchase an alarm, keep it in the cupboard after the child has had 21 dry nights and use it the next night if the child has a relapse. We now have a relatively inexpensive Pad and Bell alarm. It is extremely loud and has a music option which is not as loud. The total cost of hiring an alarm is generally more than purchasing one outright.

Why Bedwetting enuresis alarms don’t always work...
Many people have tried alarms previously without success. The common reasons for failure are:

  • Using an alarm alone without following the initial steps of the Bedwetting Cured DVD program.
  • Not getting correct instruction.  It is necessary for the parent to go into the child’s room when the alarm sounds. They must wake the child if the child doesn’t wake independently and then the child must turn off the alarm.
  • Hiring an alarm and having to return it before the child has stopped bedwetting completely. Some programs have time restrictions on keeping an alarm. It is necessary to keep the alarm for about 12 months because it is common for a child to have initial success and then have one or two relapses before remaining completely dry. The alarm must be available to use if the child has a relapse.

Is there any medication that can help? 
Doctors sometimes prescribe medication. The most common medication is a synthetic hormone and has similar actions to the hormone vasopressin, (antidiuretic hormone). It helps to reduce the volume of urine produced at night. This medication may reduce the number of wet nights in some children and even stop the bedwetting completely in a few. The main problem is it’s very common for the bedwetting to return as soon as the medication is stopped. The bedwetting alarm is more likely than medication to result in permanent success.

Does bedwetting run in families?
Yes, there is a tendency for bedwetting to run in families. This does not in any way alter the treatment used to stop bedwetting.

Is bedwetting more common in boys?
Yes, it is more common in boys but is just as much of an inconvenience whether it is happening to a girl or boy. The treatment is the same for both.

Will I need to purchase any equipment?
It may be necessary to purchase an alarm to eradicate bedwetting.   All our alarms come with a bonus Bedwetting Cured DVD

Washable waterproof mattress pads are also available which the child lies on top of to prevent the fitted sheet getting wet

Teenage and adult bedwetting
Our experience has shown treatment can be just as successful with teenagers and adults. Adults need to be aware that alcohol can contribute to bed wetting by suppressing the hormone vasopressin (antidiuretic hormone). This hormone helps to reduces the volume of urine produced at night. Following bedwetting treatment it should be possible to consume alcohol and not wet the bed.

Bedwetting – What not to do

  • We have found measuring and charting urine output and fluid intake in a child is unnecessary, not to mention difficult. It is time consuming and messy and will only tell you what you will find out very quickly when you start the drinking program.
  • Getting children up at night to go to the toilet will not solve bedwetting, even if it leads to a dry bed in the morning. You will still be doing this in a year’s time.
  • We do not recommend asking children to ‘hold on’ as long as possible before going to the toilet (as children tend to leave it until the last possible moment to go anyway) and research has found children may then have difficulty fully emptying their bladder when they do go to the toilet.   It may also discourage them from drinking adequately and may lead to daytime wetting incidents.
  • Reducing fluids in the evening without following a comprehensive drinking program will only lead to a thirsty and disgruntled child, not a dry bed.

Results
Many parents can hardly believe their child could soon be waking to a dry bed every morning, (especially after years of dealing with wet beds) BUT they can!  We strongly recommend starting with one of our bedwetting alarms.  All our alarms now come with a bonus Bedwetting Cured DVD to guide you through the step by step program. 

Parent's comment:  "We found the DVD extremely helpful. The program was easy to stick to and we have had tremendous results. Our son′s confidence has grown and he is a completely different child. We thank you from the bottom of our hearts."

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