Learning a new behavior

When I began working exclusively with bedwetting children, I soon realized that the characteristic that all these children have in common is that they have not developed the ability to wake to a full bladder. The behaviors of drinking too much in the evening, sleeping very soundly, or forgetting to urinate before bed do not result in a wetting episode for most children. The difference seems to lie in the ability to sense the urge to urinate, get up and walk to the bathroom.

How do you “teach” your child how to get up when they need to in the nighttime? The challenge of learning daytime toileting often comes between two and three years, with nighttime toileting as a logical next step. Some children establish nighttime dryness simultaneously with day dryness. The majority of these children are able to sleep dry all night without getting up to use the bathroom. Some children progress gradually over months to a year to nighttime dryness with fewer wet pull-ups and occasionally just getting up on their own to use the bathroom. This group is completely dry by 5 or 6 years. The group of children that I work with continues to wet most nights through the age of 5-6 and for years after that.

Research demonstrates that 15% of bedwetting children will spontaneously stop each year. That leaves 85% that will be wetting the next year. The frustrating thing for a parent is “not knowing” which group your child will be in. If you knew for certain that the bedwetting would stop at a certain age, most families would patiently wait for that time to come.

Is there a way to stack the odds so that your child will be one of the dry ones next year? How can you speed up the development of nighttime dryness? I have found that the best method of speeding up this process is through the use of a bedwetting alarm.

Bedwetting alarms serve as an alert so that the brain and bladder can begin to make this connection. Without an alert, most bedwetting children sleep through the wetting episode, with no knowledge of when or how the wetting occurred. A bedwetting alarm sounds when it senses moisture so that the brain can begin to make that association between the feeling of a full bladder and what happens next. The conditioned response begins to be one of stopping the flow of urine rather than letting it flood into the bed. Over time, the ability to get up to a full bladder or to hold it later in the sleep cycle is developed.

The biggest mistake that families make when using a bedwetting alarm is having unrealistic expectations. Most children do not respond the first night by jumping out of bed and running to the bathroom. I’ve talked to hundreds of families who “give up” after a week, saying the alarm isn’t working for them because their child sleeps through it. What they’re describing to me is perfectly normal-exactly what I expect to hear. Initially, the most important piece is for the parents to hear the alarm and wake their child while the alarm is sounding. It takes time for a child to begin to process this sound with what to do next. Knowing that the first few weeks are the hardest helps many families hang in there until they begin to see results.

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