Treating Bedwetting in an Older Child

Do you have an older child who is not yet dry at night? If so, Connecticut Children’s Sleep Center may be able to help!

Bedwetting is considered normal until about age 6. But if your older child is still not dry at night, he or she may be a very deep sleeper who may not be able to wake in time to go to the bathroom. About 5% of 12-year-old boys, for example, still struggle with this issue.

Unfortunately, only about one third of families with this problem seek treatment. There is a treatment available that has a success rate of 80% and this treatment is called a bedwetting alarm. A bedwetting alarm is very likely to help your child learn to be dry at night and it is not at all difficult or uncomfortable to use.

First choose and purchase a bedwetting alarm. These are readily available online for $30-50 and Connecticut Children’s has “loaners” that families can borrow as well. Each family who borrows an alarm will receive a brand new moisture sensor that has not been used by any other child.

Next, purchase some mattress pads. Saddle-style mattress pads are easy to find online and are highly recommended. They are very simple to remove and replace and they hold up to six cups of liquid. They are tucked under each side of the mattress, as in the picture below.

Begin familiarizing yourself with the steps below and rehearse these steps a few times with your child in the daytime. You may wish to begin the actual process on a weekend since everyone’s sleep will be interrupted initially.

On the night you’ve chosen, rehearse once more what you and your child will do at night and then clip the small moisture sensor into your child’s underwear in a spot where the first few drops of urine would come in contact with the sensor. Your child can wear a pull up over his or her underwear, too, if desired. Place a small flashlight near the bed, if needed, so that you can both find your way safely to the bathroom during the night.

During the night, the alarm will begin sounding when these first drops begin to flow. You, the parent, are completely responsible for listening for the alarm to sound (either by having a baby-style monitor in your room or by sleeping nearby). Remember that your child is not dry at night yet because he or she is a very deep sleeper. You must be the one to listen for the alarm each and every night until your child begins to hear it.

When you hear the alarm sounding, come quickly to your child’s room, and say “That’s your alarm. Please stand up and walk to the bathroom now.” Repeat this sentence while helping your child do those two things.

After reaching the bathroom, your child can finish urinating, if need be. You can then help your child to:

• put on dry underwear and a new pull up
• clip the sensor back on
• remove the wet mattress pad
• replace it with a dry one.

This pattern would be repeated each and every night, every time the alarm sounds.

When your child awakens the next morning, have him or her write on a calendar what happened. Your child can write:

• DRY (slept through the night without wetting)
• ALARM (got up after the alarm went off) or
• BATHROOM (woke up and went to the bathroom without the alarm)

Rewards are often VERY helpful!

Clean-up chores can be given to the child (for example, changing the pad, putting the wet pads into the washing machine, and so on) but these should never be presented as any type of punishment but rather as a step toward independence.

After a few weeks, your child will either be dry all night or will have learned to wake up and go to the bathroom independently.

Everyone wants to see dry nights immediately but this does not usually happen! Learning to be dry at night is a conditioning process and takes time. The average child takes 6-12 weeks to become permanently dry at night.

Watch for signs of progress. Perhaps the pad is less wet or the alarm is sounding fewer times each week. Once your child has 2-3 dry nights, these will come more often. Don’t stop using the alarm nightly until your child has been dry for a full four weeks. If your child is wet again after two dry weeks, for example, simply restart the four-week countdown.

Once your child is dry for 4 weeks, you can also try a technique called “over-learning” and this can help ensure your child’s long-term success. To use this technique, have your child drink six ounces of fluid at bedtime. Make sure to keep using the alarm nightly until your child is dry for another 4 weeks.

You can also help your child to learn this skill more quickly by encouraging your child to practice starting and stopping the stream when they are urinating during the day as often as they can.

Your child is likely to feel much more self-confident once he or she is dry every night. Your child is also likely to be much more willing to participate in typical childhood activities like sleep-away camps, sleepovers with friends, overnight school trips, weekend visits to the homes of other relatives and so on.

This confidence carries over into the daytime, too!

If you would like to find out more about this program, please call the Sleep Center at 860.837.6643. We’d love to help your child learn to be dry all night!

Dr. Schneeberg is the director of the Behavioral Sleep Program at Connecticut Children’s Sleep Center.