That sounds like great news for your son. We recommend that he wear the alarm every night until he has 14 consecutive nights of dryness, then use the alarm every other night until he has an additional 2 weeks of dryness. Have him use the alarm until he achieves the 14 dry nights in a row. If he has a wet night, he should start the 14 night countdown again. By using the alarm long enough now, the chances of relapse after he stops the alarm are much less.

It sounds like you and your son are very motivated to solve his bed wetting. I know he sleeps through the wetting episode and would like to know when he should get up and go to the bathroom. Some children develop this ability quickly, when they are getting day toilet trained. Others, like your son, need some help in getting that brain-bladder connection when they are asleep. Using a tool like a bedwetting alarm will speed up the process of learning how to wake up to a full bladder.

Bedwetting alarms sense wetness, and then sound at precisely the moment that wetting occurs. Initially, you may need to help him wake to the alarm and remind him to get up and walk to the bathroom. Over time, his bladder will stop the urine stream in response to the sound. Then you’ll notice that he has urine left to empty in the toilet. Eventually, he’ll learn to wake up before he wets or hold his urine until morning. The average time to dryness is about 8-12 weeks, so it is important to be patient. However, a few weeks is much better than waiting a few years for him to spontaneously learn how to wake up before wetting.

The best thing about using a bedwetting alarm is that it’s a permanent solution. Once he learns how to wake up if he needs to urinate in the night, he’s just like you and me. A full bladder triggers your body to wake up and walk to the bathroom, not let it out in bed. He can then stay dry, no matter how much or what he has had to drink.

Everyone starts like this. The alarm detects the first drop of urine and immediately sounds. It pinpoints the actual time that the bladder needs to empty, not a few minutes before or a few minutes too late. There is no way to know precisely the time of the wetting until it begins to happen.

Initially, the urine comes flooding out of the bladder, just as it has always done. Even though the alarm sounds at the first drop, your son has not learned to stop the flow yet.

Over time, his bladder and brain will work together to stop the urine quickly so he can get out of bed and walk to the bathroom to empty the rest in the toilet. This is a new conditioned response and takes some time to learn.

Eventually, his brain will begin to recognize what a full bladder feels like and that he must be awake before the urine is released. He’ll learn to get up before the alarm sounds.

The first few weeks are the hardest and the messiest. Using mattress overlays (waterproof pads on top of the sheet) make your job much easier. Put one on top of his sheet before he goes to sleep. When the alarm sounds, have him walk to the bathroom and empty any urine left into the toilet. Simply replace the wet pad with a clean one and he can immediately go back to a dry bed. In the morning, just wash the overlays. The Starter Kit has two overlays in it, as well as the bedwetting alarm and the book.

The missing piece for most children with bed wetting is the ability to independently arouse from sleep to the feeling of a full bladder. Some children can do this from the time they are day toilet trained; others take longer and might need a little assistance. Bedwetting alarms speed up this development and provide a long lasting cure to the bedwetting problem.

Bedwetting alarms sense the wetness and sound to alert you and your son that he needs to wake up and walk to the bathroom. Over an average of 10-12 weeks, he will develop the ability to do this by himself. The first two weeks are the hardest and he may not even respond to the loud alarm. You should go to his room when you hear his alarm, remind him what is happening and assist him to the bathroom. He may have no urine left to empty in the toilet in the beginning. Over time, he will start having smaller wet spots in his bed and urine left to empty out when he uses the toilet. Ultimately, his body will learn to wake up to the feeling of a full bladder or hold the urine until he wakes in the morning,

Providing your son with the right “tool” to permanently stop his bedwetting in a few weeks will be a step in the right direction. Most kids are cooperative and so grateful to have something that will make a difference. The Malem Ultimate alarm, which is a wearable alarm that sounds and vibrates, is popular with boys his age. The Rodger wireless is also a great choice. The sound unit is located across the room, which encourages him to get out of bed to turn it off. You might let him look at the different options, look at the alarm videos and select the color and style he would most like to use.

While bedwetting affects up to 12% of 6 year olds, it becomes less common as kids get older (2% of 14 year olds, 1% of 16 year olds). When your child is the 1 or 2 out of 100 that continues to wet, you can begin to feel very alone and hopeless.

The good news is that bedwetting alarms work as effectively in teens as they do in younger children. It usually takes teens a little longer to get to complete dryness, but a few extra weeks to change a behavior that has been going on for years is quite manageable. I’ve found that the key to success for teens and older children is to use an alarm that is easy to use and acceptable to them.

The wireless alarms (such as the Rodger and Malem Wireless) are my recommendation for teens. A positive feature of wireless alarms is that your son must get out of bed to turn off the alarm. Since the receiver is located in an outlet or on a dresser, it will continue to sound from that location until it is turned off. Many tech savvy teens quickly disconnect the sensor from alarms that are worn on the shoulder, then roll over and go back to sleep. They rarely remember this is the morning and wonder why their alarm is disconnected but their bed is wet and they don’t remember getting up.

Another reason that wireless alarms are recommended is that there are few steps to attach them. The Rodger alarm comes with two pair of specialized briefs. (More can be purchased). Your teenage son simply puts these on when getting ready for bed. The receiver stays plugged in the wall or on the nightstand. This alarm also has a bedshaker option, which is a vibratory cushion that lies on the bed and vibrates when the alarm sounds. The Malem wireless alarm fastens to underwear he already owns (close fitting, not boxers) and can be an advantage if your family doesn’t do laundry very often. If there is no wetting, the underwear go back in the drawer. If wetting occurred, the underwear is laundered with the sheets.

Even with teens, your role is important initially. Listen for the alarm and make sure that your son is getting out of bed and walking to the bathroom as the correct response. The quicker he learns how to respond to the bedwetting alarm, the more quickly he will be on the road to dryness. If your room is far away, either of the wireless alarms can be ordered with two receivers, one for your son’s room and one for your room.

One last point is to make sure the alarm is worn long enough. Having 14 consecutive nights of dryness is important before beginning to use the alarm every other night for 14 nights. Often, my teen patients are so excited to have 4 or 5 dry nights in a row that they stop their alarm use prematurely. Wet nights begin occurring sporadically and further progress is delayed.

Wireless bedwetting alarms can be used for any age child but they are particularly well-suited for teens. Persistence and patience will help insure success.

You are describing most children. Even children who do not have bed wetting exhibit sound sleep patterns and are not easily alerted to sounds. In a study that was done by the fire department, up to 89% of all children tested (non-bed wetting) were not awakened to the sound of a smoke detector of 85 decibels. All of the adults in these households were awakened and the children were finally alerted by their parents’ voices.

This same phenomenon often occurs when using bed wetting alarms initially. Even though most of our bed wetting alarms sound at about 80 decibels, many children will not arouse independently when the alarm sounds. In the beginning, the alarm is for the parents. When you hear your son’s alarm sound, go to his room and remind him what is happening and what he should do. We know that children can be conditioned to respond to familiar sounds and eventually know how to respond to that sound. Over time, your son will understand that the sound he is hearing is important and means that he should stop the flow of urine and get out of bed to go to the bathroom. Of course, if he hears the alarm and knows what to do from the first night on, that makes your job a little easier.

Our wireless alarms, the Rodger and Malem wireless, can both be ordered with dual receivers, one for your son’s room and one for your room. This works well for homes where the bedrooms are far apart. Both of these wireless alarms have a volume control dial on the receiver so the volume can be adjusted to be louder than the shoulder worn models. Another feature unique to the wireless alarms is that your son must get out of bed to turn the alarm off and stop the noise. Wireless alarms are great for those older children who are good at reaching for the alarm on their shoulder, turning it off and rolling over.

The wearable alarms, like the Malem Ultimate or Malem auditory, have a strong constant tone of about 80 decibels. If you cannot hear this alarm from your room, you could use a baby monitor in your son’s room. The Malem Selectable alarm and the wireless alarms all offer a choice of 8 different tones. In some situations, one tone is more likely to alert your son than others. You could experiment with different sounds to see what works best.

(I get this question so frequently that I am re-posting some information from last year).

Yes, I have some great suggestions for this common problem. As you have noticed, urine odor is difficult to remove with typical household cleaners. The key to removing urine, whether it is human or pet, is to use an enzyme based product. The enzyme binds with the protein component of the urine so that it can be removed. Cleaners without this feature simply mask the odor but do not permanently remove it.

We carry two spray-on urine removal products, OdorZyme and the new DP. Lift up as much of the accident or stain as possible by wiping and blotting the affected area. Then saturate the affected area with OdorZyme or DP (de-pee) Stain & Odor Remover. Let it work for 5 to 10 minutes, then wipe away the accident or stain with a clean white cloth. OdorZyme can also be used as a laundry additive if urine smell remains in clothing. Presoaking in Odorzyme before doing regular laundry effectively rids clothing, bedding, and incontinence pads of urine stains and odor.

When using any urine removal product, remember to use as much of the product as the amount of urine that created the stain. If the mattress or carpet is affected, make sure the urine removal product reaches the source of the odor. A thick mattress or carpet with padding requires more product than a hard floor. Older stains may require the product to sit longer. The spray-on products also work well for cleaning vinyl mattress covers on a daily basis. Quickly spray the vinyl surface before remaking the bed with clean sheets.

For older, set-in stains on mattresses or floors, Urine Erase works well. Urine Erase is an enzyme based 2-step cleaner. The first step is to mix the enzyme packet with tepid water and saturate the stain for 8 hours. The second step is to use the special solution that comes in the bottle to saturate the stain and let air dry. The gallon size container can be used for large jobs, such as carpets or floors that pets have urinated on.

Once you get your mattress cleaned, be sure to protect it with a heavy duty 6 Gauge zippered vinyl mattress cover or a breathable Premium Mattress cover. These comfortable covers will protect your mattress from further wetting episodes as well as bed bugs and dust mites.

The components are:
1) The bedwetting alarm of your choice. You can choose a wearable alarm like the Malem Ultimate, or a wireless alarm like the Rodger wireless.
2) Two waterproof washable mattress overlays. These are essential for the children who are transitioning from disposable pants to cloth underwear. (Recommended when you begin using an alarm). Middle of the night clean-up is so much easier when you just remove the soiled pad and quickly replace it with a clean one. Morning laundry is just a pad or two, rather than entire sets of sheets. I recommend the overlays with the tuck in flaps, which stay in place even with a child’s movement.
3) The book “Seven Steps to Nighttime Dryness”. This book guides you with using the alarm, what to expect, what the parents’ role is, and how long things take. Knowing what to expect makes using a bedwetting alarm easier for everyone. “Unrealistic expectations” is the number one reason that families fail to be successful when using an alarm.

Call us (800-214-9605) if you have any questions about the Alarm Starter Kits. If there is an alarm that you want, but it’s not offered in a Starter Kit, call us and we will create a Starter Kit just for you.

“Our daughter was interested in using the potty by herself in the daytime at a young age and she was fully day trained before she was 2. We did not worry about night time dryness, assuming it would sort out spontaneously, but it frustrated her a great deal by the time she was 3 and 4. Her frustration mounted over time, with many morning tantrums over waking up wet. We then tried all of the standard approaches, including setting alarms for us and trying to wake her at assorted times during the night. Basically, she slept so deeply it was impossible to wake her up, and so all failed.

At 5, she informed us that her friends slept dry, and this was not fair. We did some research and talked with her about using an alarm; we explained how they work, and that she would have to decide to listen to her body in the middle of the night, and get up to use the bathroom until her bladder learned to hold all night long. Several weeks later she announced that she would like to have the alarm. I purchased the Rodger wireless alarm, as she often does not like to wear a shirt to sleep in at night, and we did not want to add any additional stress. Based on advice in the other reviews, we also purchased 3 pads and 2 addition sets of alarm underwear (a total of 3 changes all around), the remote alarm for our room, and the vibration alarm for under her pillow since she was such a deep sleeper. We unpacked together, set everything up, let her pick the alarm tone, and practiced several times before bedtime – she pretended to sleep, we set off the alarm artificially, and she had to get up, turn it off herself, and walk to the bathroom with us, sit on the toilet, and at least try to pee.

She was so enthusiastic we were concerned that it might not work, or could take several months, increasing her frustration instead of getting to a solution – so we made sure to talk about how her body might take some time to learn, and she would have to be patient, and tried to set her sights on success in a month or two and not in a few days. The first night, we were up three times, with full floods, and I was very glad of the extra changes for everything – it made getting though possible for all of us. The second night, one flood, and one partial wet. The third night, one partial wet, and one drop, The fourth night, one drop. The fifth night, nothing.

Her ability to wake up changed dramatically as well, the first time the alarm went off, she didn’t budge for several minutes (and believe me, it is LOUD), however, we followed the instructions to the letter, and encouraged her but made sure that she was the one to sit up and turn it off, and walk to the bathroom on her own, etc. By the second night, we were able to encourage her more, because the volume of urine was so clearly so much less, which really resonated with her. By the third night it was clear to all of us it was working, and her enthusiasm for the project, already extremely high, only increased – and the rest is history.

We stayed with the system until she was fully dry for 14 days, as suggested – she did have a few in between lapses, aka she would go totally dry for a week, and then have an alarm for a tiny tiny leak. In all, it was one month from start to finish. It’s now been four months, and not even an accident. I can’t say enough about how well this worked, or recommend it highly enough. Finally, there were no issues with the purchase, everything arrived promptly and in good conditions, and the quality was excellent. Hope this helps anyone on the fence – it was a big investment, but well worth alleviating this incredible frustration for our daughter and empowering her to participate in a solution”.

How Common Is Bed-Wetting in Children

Yes, bedwetting is common in children. As many as 1-in-10 7 year olds continue to wet every night. That means in your child’s second or third grade class, at least 1 or 2 other kids are affected. As children get older, bedwetting does decrease so that only 1 % of teens are affected.

What’s “Normal” When It Comes to Bed-Wetting

There is a wide range of normal and we don’t exactly know why one child continues to wet while another quickly gets dry. It could be due to development and having a bladder that can’t store urine for the entire night. Sometimes the ability to recognize when the bladder is full and get up has not developed. Often a parent or other family member was similarly affected so heredity does play a role. Since the majority of children have achieved dryness by school age, children who are 6 or so and still wetting are considered to have bedwetting. Before this age, nighttime wetness can be a normal pattern.

When Should We Talk to our Health Care Provider about Bed-Wetting

If your child is school age and continues to wet most nights, it should be discussed with your doctor or health care provider. Research has found that many parents of 9 year olds with bedwetting have not mentioned it to anyone. If your doctor does not ask about nighttime wetting, bring it up yourself. Remind your child that this is no different than mentioning other conditions like constipation or diarrhea. Even though it is embarrassing, a confidential office visit is the perfect place to seek help. Many parents assume that there is nothing that can be done or that their child’s wetting has to do with their parenting skills. These assumptions are not true!

Treatment

Most pediatricians and urologists recognize that bedwetting alarms are the most effective and long lasting way for kids to become dry in a few weeks. Although bedwetting alarms take effort from the parents and children in the beginning, the results are worth it. If your health care provider does not recommend any treatment, it may be because they haven’t learned much about bedwetting alarms. Bedwetting alarms sense wetness from the underwear and sound and vibrate to alert the user that wetting is occurring. Over time, the child’s brain begins to recognize when the bladder is full and coordinates the waking and walking to the bathroom. The biggest benefit is that the time to get to dryness can be shortened from a few years to a few weeks.

Each year, 15% of bedwetters spontaneously become dry. The other 85% will continue to wet for another year or until parents do something to speed up the progress. It sounds like your 8 year old is ready for that help to stop her bedwetting. It is frustrating for kids who sleep right through the episode of wetting. In the morning, the bed or pull-up is wet and she doesn’t know when it happened.

Bedwetting alarms are the solution! The moisture sensor detects the wetness and lets you know when the wetting is occurring. The alarm sounds and/or vibrates to alert you to make sure your daughter gets up to walk to the bathroom. Over time, her brain begins to make the connection of the loud sound, a full bladder and walking to the bathroom.

Take time to read a few of the reviews that other parents have written about their experience with the Malem Ultimate or the Rodger wireless or Malem wireless alarms. Many of these parents commented that they wished they had tried the alarm sooner or that they were skeptical, but the alarms worked so well. Bedwetting alarms are an effective type of behavioral conditioning and work well for even the heaviest sleepers. The best part is that this is a permanent solution with a low relapse rate. Once your daughter learns to wake up when she has a full bladder, she can walk herself to the bathroom and be free to accept sleepover invitations whenever she wants.

Since you’re writing to ask this question, I assume that both you and your son are ready to tackle this problem. I will also assume that he wets most nights and now wears disposables or that you do daily laundry. Since invitations to sleepovers with friends will most likely be popping up in the next year or so, this is a great age to help him stop wetting.

The equipment that you need consists of a bedwetting alarm, some waterproof bed protection and some guidance. There are many bedwetting alarms to choose from and they all function to sense moisture and alert your son (and you) that wetting is occurring. Our most popular alarm is the Malem Ultimate, which sounds and vibrates both in response to the wetness. The small sensor fastens to the outside of his underwear and the sensor cord goes under his shirt. The alarm unit fastens to his shoulder and stays put while he moves about in the night. The Malem alarm series also features a wireless model, in which the sound unit sits on a bedside table across the room. This is a great choice for kids who roll over and go back to sleep at the sound of the alarm. The Malem wireless alarm requires that your son walk over to the alarm to turn it off. It can be ordered with an optional receiver for your room as well. If these alarms don’t seem to be the best fit for your son, look at the many others that we carry. Choosing a dependable and comfortable alarm that he will easily and reliably wear each night is important.

The next piece of equipment is waterproof bed protection. When he begins using the alarm, he should transition out of disposable pants and wear regular underwear to bed. You will now be alerted when he wets and you want him to quickly go back to a dry bed after he has walked to the bathroom. My patients love waterproof mattress overlays, which are absorbent waterproof pads that lie on top of the sheet. The ones with the tuck in sides stay in place and protect the sheets from getting wet. In the morning, only the pads need to be laundered. Encasing his mattress in a zippered vinyl cover further protects it from any leaking or wetness.

Lastly, guidance to know that you are doing things correctly is important. Children with bedwetting are all very sound sleepers and many do not hear the alarm by themselves. Your role to wake him when you hear the alarm is important to his success. The first couple weeks can be difficult for parents but knowing what to expect can make it easier. My book, Seven Steps to Nighttime Dryness, describes the process and what to expect at each phase.

The equipment that I’ve described can be purchased individually or bought together, as a Bedwetting Starter Kit. The Starter kit includes my book, and you can decide which alarm and overlays you would like included. This kit saves you money over buying the components individually and includes the bed wetting equipment that your son needs to be successful.

This mother also mentions that she wished she had used this method sooner, a sentiment that I hear frequently. If your child is school age and wetting most nights, I highly recommend trying a bedwetting alarm. Your child should be cooperative and excited to find a solution. If you aren’t seeing that yet, it’s okay to offer helpful suggestions until he or she is ready for a permanent cure. Bedwetting alarms are not scary–they are small, colorful, make lots of cool sounds and help kids make rapid progress toward dry nights. It may be the best money you’ll spend this summer. Solving this problem lets your child have a worry-free summer: going to camp, spending the night with friends and relatives and looking forward to the next school year.

First, if your child is currently using an alarm, we would not expect him or her to take it to camp with them. They can interrupt usage and restart when they come home. If your family is traveling together and using the alarm could be handled discreetly, continuing alarm use while on vacation would be great.

Secondly, a backup plan should be in place, even for children who wet intermittently. Here are a few suggestions:

• Wear disposable pants, with a plan for putting them on discreetly and for disposal in the morning. Disposables come in all sizes, even small through extra large adult sizes. If your child has outgrown traditional children’s pull-ups, there are still many options. Disposable male guards or women’s incontinence pads can be secured to regular underwear to catch a small amount of urine. Disposable underpads that lie on a sheet or in a sleeping bag have tape strips to hold them in place.

• Use washable bedtime pants to preserve dignity. These can be a nice back-up for kids who are dry most nights but want to make sure there is no leakage onto bedding.

• Waterproof sleeping bag liners fit into a regular sleeping bag. They provide a comfortable, waterproof surface for sleeping without raising questions from other campers.

• Mattress overlays can be used on top of a sheet or used inside a sleeping bag. The overlays can be discreetly pulled into place when your child is ready to go to sleep.

• Make arrangements with the camp counselor to have toileting twice before bedtime and to continue a lifting routine if this is used successfully at home. (Lifting is when a caregiver walks the child to the bathroom at a designated time.)

• Medication, such as desmopressin, can be used temporarily to decrease the amount of urine produced that night. The correct dosage should be determined a week or two before camp begins. Only a small amount of liquid (2-4 ounces) should be ingested once this medication is used. It is best dosed shortly before actually going to sleep.

Lastly, make sure that your child knows that they are not alone and most camps are very helpful in discreetly handling any wetting episodes. Fluid of choice after dinner is water. Double voiding before going to sleep is helpful. Staying well hydrated during the day is helpful so the kids are not so thirsty later in the day.

LoveToKnow Kids recently had the pleasure of speaking with Renee Mercer, a Nurse Practitioner with more than 25 years of experience in pediatrics. Her book, Seven Steps to Nighttime Dryness, offers valuable advice for parents who are working with their children in order to achieve nighttime dryness. In conjunction with using a bedwetting alarm, this book provides the tips to have your child waking up dry in 10 to 12 weeks.

LoveToKnow (LTK): What sparked your professional interest in bedwetting?
Renee Mercer (RM): After many years of working in a primary pediatric practice, I saw the frustration that parents and kids felt when they came back for annual check-ups, with bedwetting continuing to be a problem. The response, “Don’t worry, they’ll grow out of it,” wasn’t enough. They wanted solutions. My book, Seven Steps to Nighttime Dryness, was designed to provide solutions, based on experience that I’ve gained working exclusively with bedwetting children.

LTK: Which cases in your pediatric office inspired you to write your book?
RM: Teens who felt that they could not go to camp or on school trips, younger kids who did not see a way out of wearing pullups to bed, and plenty of frustrated parents were individuals that I saw on a regular basis. Many families were embarrassed and felt hopeless that there was no cure for bedwetting.

Bedwetting Basics

LTK: Why do some kids wet the bed?
RM: Bedwetting has several causes: decreased sleep arousal, small bladder capacity, high nighttime urine production, constipation, and heredity all can play a role. Often, a child will have a combination of these things. Children with bedwetting have not developed the ability to wake up when their full bladder needs to be emptied.
Children who still wet the bed are great kids: smart, athletic, great personalities, and no different than other children their age. They do not wet the bed on purpose and usually sleep through the wetting episode.

LTK: What percentage of children wet the bed?
RM: If your child wets the bed, he is certainly not alone! 13 percent of 6 year olds wet the bed, 5 percent of 10 year olds, and 1-2 percent of 18 year olds.

LTK: How long can bedwetting go on?
RM: 15 percent of bedwetting children will become dry each year without intervention while 85 percent will continue to wet the next year. The incidence of bedwetting decreases as kids get older so we believe there is a developmental component that helps with this. Sleeping less soundly, having a larger bladder capacity, and being able to recognize body signals may play a role. Bedwetting can certainly persist into the teen years, however, and there is no guarantee of an age that bedwetting will stop. Treatment can decrease the length of time families have to deal with bedwetting by years.

Achieving Dryness

LTK: What can parents do to help their children?
RM: If your child is over six and wets every night, using a bedwetting alarm can speed up the development of learning to wake up to a full bladder. Using an alarm requires cooperation from child and parents, so choosing a low stress time, without a lot of family obligations, is best.
If your child is younger than five or six and has nightly bedwetting, using disposables to help with the laundry burden is fine. Also, there are other temporary solutions which are appropriate.
Make sure your child is well-hydrated during the day so he isn’t so thirsty in the evening. Water should be the preferred beverage after dinner. Urinate twice before bed, about 20-30 minutes apart. Observe that your child has a regular bowel movement most days. If not, increase daily fiber intake because constipation can contribute to wetting.

LTK: How can bedwetting be stopped?
RM: Temporary solutions include wearing disposable Pull-ups, walking the child to the bathroom when parents go to bed, using an alarm clock set at an arbitrary time (there is no way to know exactly when the child needs to go to the bathroom) or using medication. Medication works by decreasing the amount of urine produced during the night. It does not provide a permanent solution because the wetting restarts when the medicine is stopped, unless the child has learned to wake up to a full bladder.

A permanent solution is to use a moisture sensing bedwetting alarm. This sounds at the first drop of urine to alert the user that they should get up. This behavioral conditioning is very effective in helping a child’s body begin to make the nighttime brain-bladder connection. The feeling of a full bladder means wake up and walk to the bathroom.

Nighttime Training

LTK: How long does the training period for achieving dryness with an alarm typically last?
RM: It takes about 10-12 weeks for the average child to achieve dryness while using a bedwetting alarm. Without the use of a teaching tool, such as a moisture sensing bedwetting alarm, it can take years.

LTK: What should parents do when the alarm goes off during the training period?
RM: When the alarm sounds, go to your child’s room to ensure that they are responding. They must learn to turn off the alarm, get out of bed and walk to the bathroom.

LTK: Isn’t it easiest to just wait until a child grows out of bedwetting?
RM: It might be easiest to ignore wetting but having years of missed sleepover invitations, multiple loads of laundry every day and hundreds of dollars spent on disposables make it beneficial to tackle bedwetting sooner rather than later. Research shows that bedwetting negatively affects children’s self-esteem, and stopping bedwetting allows self-esteem to rise. Would you tell your teen with acne not to worry, she’ll outgrow it, when there are effective treatments available?

LTK: What is the most important piece of advice you would offer parents whose children occasionally wet the bed?
RM: Observe for factors that may play a role in the wetting. These include: being overly tired, over drinking beverages other than water, being sick, medications, stress, forgetting to urinate before bed, urinary tract infections, among others. Do your best to limit these situations. If wetting occurs, be accepting, help change bedding and know that your child is not wetting on purpose.

If you’d like to give your bedwetting child a boost of confidence, and the freedom to attend sleepaway camp and slumber parties at friends’ houses, pick up a copy of Seven Steps to Nighttime Dryness from an online bookstore or bedwettingstore.com. Both your child and you will be reaping the benefits in a few short months.
Author: Rachel Hanson

Congratulations to your son on the great progress that he has made! Readiness for sleepovers often depends on the child, the comfort level with the family he’ll be staying with and the child’s confidence. If he wants to give it a try, he’ll probably do just fine. Often the kids are more careful about the fluid intake, double voiding before bed and don’t sleep as long or as deeply as they do at home. (You can gently remind him of those things before he goes). Some kids take their own sleeping bag with a waterproof pad pinned on the inside, or use a waterproof sleeping bag liner, as a back up. Have you ever seen him get up to urinate on his dry nights, before the alarm sounds? Once he can do this regularly, he will be totally dry.
After he is successful at the sleepover, I would still recommend that he wear the alarm until he has 14 consecutive nights of dryness.

The parents of a total of 6147 children aged 6 to 11 years completed a questionnaire about sleep-related symptoms, family and medical history. Those children with a high risk for obstructive sleep apnea (about 400 children), along with a chosen low-risk group (about 200) underwent overnight sleep studies. They found that about 9 kids out of 100 in each group wet the bed. Children without obstructive sleep apnea wet as much as children with sleep apnea. They also observed that about twice as many boys as girls wet their beds.

Sleep apnea is suspected when children have loud snoring, large tonsils, mouth breathing, and excessive daytime sleepiness. Allergies and being overweight are contributing factors. Children suspected of obstructive sleep apnea should be evaluated by a Pediatric ENT specialist and may be tested using a pediatric sleep study. This study confirms the presence of sleep apnea, where breathing stops temporarily during sleep. About 2% of children are affected. Although snoring is a common symptom in children with obstructive sleep apnea, it is important to remember that between 10-20 percent of normal children snore (primary snoring) on a regular or intermittent basis.

So it seems that a combination of snoring and bedwetting is not enough to recommend removing tonsils without further testing to confirm sleep apnea. Treating allergies with nasal steroids and losing weight are conservative treatments for some children with continuous snoring and obstructive sleep apnea. Treating sleep apnea may or may not make any difference in the frequency of bedwetting. Bedwetting alarms continue to be the treatment of choice, even in this group of children.

As you’ve experienced, your son cannot make progress getting to dryness when he is doing the wrong behavior in response to the alarm. He’s not alone; tech savvy kids can pick up on quickly unplugging the cord to turn off the sound (sometimes in their sleep).

I do have some tips to correct this:

1) Review with him that the purpose of the alarm sounding is to remind him to get out of bed and walk to the bathroom. He won’t be successful in staying dry if he doesn’t learn to do this.
2) Make it more difficult to turn the alarm off. Use electrical or masking tape to secure the sensor cord into the alarm box.
3) Have him wear two pair of underwear to bed. The alarm sensor should be attached to the underwear closest to his body. Then put on a second pair of briefs over the top. This makes it more difficult to remove the sensor and causes the alarm to sound a little longer.
4) With the alarm sounding longer, you will have more of an opportunity to hear the alarm and go to his room to remind him of the right response. Use a baby monitor so that you can help him with his response.
5) Know that for the next couple weeks, your job will be important. Enforce the response of your son getting out of bed and walking to the bathroom when the alarm sounds. Be persistent, remind him, “That is your alarm. You have to get up and walk to the bathroom.”
6) Review the proper way to turn the alarm off. First lift the sensor tab that attaches to the underwear, and then push the reset button on the side of the alarm. The phone jack should not be touched.
7) If these tips don’t give you results, you may consider getting a wireless alarm. With the Malem wireless or Rodger wireless alarms, the sound comes from across the room. Your son has to get out of bed to turn of the alarm.

By insuring the right response to his alarm, your son should resume making progress toward having dry nights.

This is a very common concern of parents. The general consensus is that nighttime dryness can follow daytime dryness by months or even years. Here are 8 things that you can do to help with night time potty training:

1) Daytime dryness should be established first. Make sure she is reliably dry in the daytime, knows when she needs to use the bathroom and has soft, regular bowel movements.

2) Encourage drinking and frequent toileting during the daytime. Fluids after dinner should be water, not milk or juice, in a small quantity.

3) Double void before bed. This means making sure she tries to go potty 30 minutes before bedtime, then once more as lights go out.

4) Trial of no pull-ups. Especially if you have noticed that her pull-ups are less wet or dry in the morning, try having her wear underwear to bed. Protect the bed with a waterproof cover and protect her sheets with waterproof, washable overlay pads. The ones with the tuck-in sides are the best. If a couple weeks pass with no sign of progress toward dry nights, restart the pull-ups and know that there will be a better time to try this later on.

5) Don’t allow pull-ups to be worn while she is awake. Put it on last thing before lights out and take it off first thing in the morning. Some children will wet the pull-up as they are waking up in the morning, just because they know it is there.

6) Remind your daughter if she wakes up for any reason or if she comes to your room in the night, she should use the bathroom at this time, even if she doesn’t feel she needs to.

7) You can introduce a bedwetting alarm to help her speed up that brain-bladder connection if your daughter gets to 6 and is still having nighttime accidents.

8 ) Walking your daughter to the bathroom before you go to sleep probably does not speed up the development of dry nights but there is one less voiding in the bed.

In most cases, children do not have control over their nighttime wetting and this behavior is not reflective of your parenting skills. There is no need to feel parental guilt; being kind and supportive is much better. Punishment is not warranted and will not speed up the development of dry nights. Be patient and know that each child develops at a different rate.

I’m so glad that you are looking for a bed wetting solution now so he has time to stop bed wetting before summer comes. Since the average child takes about 10-12 weeks to get to dryness using a bed wetting alarm, starting now will most likely enable him to be dry by his summer campout. Bed wetting alarms speed up the ability of the brain and bladder to make their connection in the nighttime. Waiting without doing anything would probably find him still wetting by the time summer comes. As you can read in our product reviews, most families are overjoyed at the success that bed wetting alarms bring to their children and often wish they had used the alarm sooner.

The two most popular alarms for his age group are the Malem Ultimate Selectable alarm in the Camouflage or Royal Blue color or the Malem wireless alarm, if he does not wear a shirt to bed. The Malem Ultimate Selectable alarm unit fastens to his shoulder, where the sound and vigorous vibration come from. This alarm allows him to pick his “ringtone”, which many of the kids enjoy doing. If he gets used to one tone and doesn’t respond as quickly, he can select another of 8 tones. The small Easy-clip sensor securely fastens to the outside of his own underwear.

The Malem wireless alarm is well suited for kids who prefer not to have the alarm unit on their shoulder. The wireless receiver, where the sound comes from, should be placed on his dresser so that he has to get out of bed and walk over to it to turn the sound off. If your son has begun waking to an alarm clock to get ready for school, this might be a good choice. Since his brain has connected the importance of waking to his alarm clock, he should be able to connect the importance of waking to his bed wetting alarm sound. This alarm also allows the choice of one of 8 sounds, so he could choose one similar to his alarm clock. This alarm does not vibrate. Another wireless option that does have an optional vibrating cushion is the Rodger wireless alarm. The vibrating cushion is activated at the same time as the sound and would be placed near his body.

You may want to have him choose which of these alarms he is most likely to use. Any of them will be effective in helping him get to dryness before his summer camp out. The Starter Kit, with any of these alarms included, also features the book “Seven Steps to Nighttime Dryness”, which walks you through what to expect when using an alarm and two waterproof overlays which lie on top of his sheet. Overlays make middle of the night changes quicker and save on laundering sheets every day. The best part is that you save over $20 when you order these essential items together.

Deciding when your family and your child are both ready to work on achieving nighttime dryness is very individual.
6 things to consider are:
• your child’s temperament
• family stressors-pick a low stress time to begin
• your child’s goals and motivators-wanting to work on becoming dry is important
• your child’s age
• whether they have had any dry nights-a 4-5 year old child with many dry nights may continue to get to dryness without much intervention, a 6-7 year old who has never had a dry night might need a little more help
• ability to be reliably dry during the day-day dryness should be achieved before tackling nighttime dryness

Parents know their own children and their own family dynamics better than anyone else. There is not an absolute “right age” for everyone so you will have to be the judge of that. Remember that you do not have to wait for your child “to grow out of it” because there are such effective steps you can take to end bedwetting within a few weeks or months.

You can compare treating bedwetting to treating acne in teenagers. When your teen is bothered by acne, you can intervene and begin some treatment. Products will not be consistently used when they are not motivated or bothered by their complexion. When your teen is concerned about acne, you certainly would not want to say, “Don’t worry, in a few years, this will be over. We don’t need to do anything”. You would provide the most effective products that are available to shorten the years that he or she would have to deal with it. Both children with bedwetting and teens with acne are thankful for parents who help them through these rough phases of growing up.

It sounds like your son is very motivated to get to dryness. You have pinpointed several reasons why setting an alarm clock to sound at an arbitrary time is not an effective method for helping your son get to dryness. Because you are unable to predict exactly when your son will need to urinate, you are unable to set the clock to alert him precisely at the right time.

Because bedwetting alarms sense wetness, they do not sound until the precise time that wetting is occurring. If he doesn’t wet or need to go to the bathroom that night, the alarm won’t sound. If he needs to go twice, the alarm will alert him twice. This precise timing is what allows the brain and bladder to make that important connection. Your son will begin to be alerted when he is wetting and conditioned to wake up to a full bladder.

Parents often ask, “Isn’t it too late to be alerted if the urine is already coming out?” In the beginning, the bladder may completely empty before your son or you can respond. Over the first few weeks, however, the usual response is that the urine flow stops at the sound of the alarm. Instead of a large wet spot on the bed, the spot is reduced to a quarter sized spot on the underwear. Urine remains in the bladder and can be emptied in the toilet. Ultimately, his brain will alert your son to wake up before urination happens.

The children who consumed the largest amount of caffeine did not have the highest incidence of bedwetting but they did sleep fewer hours at night. In the older children, aged 8 to 12, the average amount of caffeine consumed was equivalent to three 12-ounce cans of soda per day. These children slept an average of 8.47 hours per night, which is less than the recommended 9 hours per night for this age group.

So it seems that telling your children that drinking caffeine/sodas will cause them to wet the bed may not be the truth. We do know that caffeinated drinks contribute to less hours of sleep per night, and sodas contribute to obesity and dental caries so it does seem prudent to continue to limit your children’s intake of caffeine for other reasons.

Link to see entire article, http://download.journals.elsevierhealth.com/pdfs/journals/0022-3476/PIIS0022347610009935.pdf

Kids typically are not scared by the sounds the alarms make in the nighttime. Remember that kids are sound sleepers and often are not alerted by sounds that are not important to them. The sound the alarm makes should be loud enough for parents to hear from their room. Parents’ voices are often the best alert for children. When you hear the alarm sound, go to your son’s room and remind him to get up and walk to the bathroom. Over time, he will begin to make the association between the sound, wetting and getting up to walk to the bathroom. Two of our alarms, the Malem wireless and the Rodger wireless alarms can be ordered with 2 receivers, one for your room and one for your son’s room.

Play with the bed wetting alarm when you receive it. Let your son see how it sounds when it comes in contact with wetness. Have him turn it off and review what he will do in the middle of the night. Bedwetting alarms continue to be the most effective tool to help condition children to wake up instead of wetting in their bed.

Your son is exactly the type of child that bedwetting alarms work so well for. You don’t have to wait for years for his brain and bladder to make that connection. The alarm will sense the wetness and alert him and you that the wetting is occurring. Help him get up and walk to the bathroom, even though initially, most of the urine will come out in the bed. (Washable, waterproof overlays that lie on top of the sheet are very helpful at this stage). Over time, his body will begin to stop the flow of urine at the sound of the alarm and he will have urine left to empty in the toilet. Eventually, his body will alert him before the wetting occurs and he will wake up to urinate in the toilet or hold it until morning. Juice may trigger bedwetting in some children. The book, Seven Steps to Nighttime Dryness, that comes with the Starter Kit (along with the alarm and
overlays), has a complete list of foods that may affect the frequency and amount wetting. Temporarily stopping the juice and restarting after a couple of weeks of using the alarm will help you see if it makes any difference in how frequently the alarm sounds.

Parents worry that the bedwetting alarm sound will wake siblings but this usually is not the case. Siblings quickly learn that the alarm is of no concern to them so they roll over and go back to sleep if they do hear it at all. The wearable and wireless alarms all stay attached to your child’s underwear so move as he moves in the nighttime. I would not recommend a pad type alarm because he could roll off of the pad and the urine wouldn’t be detected. I would recommend our Malem Ultimate alarm, with sound and vibration, or the Malem Wireless alarm, if he prefers not to have the sound come from the unit on his shoulder. The sound comes from a receiver that can be placed on his dresser. Both attach to the outside of his own underwear with a durable easy-clip sensor.

All of the bedwetting alarms that we carry work well to detect wetness and then sound and/or vibrate to alert the user that wetting is happening. The way that wetness is sensed varies with the style of alarm. The Malem wearable alarms, the Malem wireless alarm and the WetStop3 alarm have a small sensor that is clipped to the outside of the underwear. The position of the sensor clip is important so that the first drop of urine is detected. If the sensor is placed too high or low, it takes a larger spot of urine before the sensor gets wet. Paying attention when attaching the sensor is easy to do.

The Rodger wireless alarm detects wetness through the built-in sensors in the specialized briefs. The built-in sensor extends from the mid front to the mid back of the underwear so any wetting in this area will quickly be detected.

The pad style alarms, such as the Malem Bedside or WetCall, feature pads that the child lies on to detect the moisture. The more quickly the urine comes in contact with the sensor pad, the more quickly the alarm will sound. A wetting episode when your child is sleeping on his stomach may trigger the alarm more quickly than one in which your child wets while sleeping on his back.

The wearable and wireless alarms detect moisture most quickly but all of the alarms do sound to provide an alert when wetting occurs. Over time, the brain-bladder connection develops so your child can wake up to go to the bathroom or hold it until morning.

In the daytime, she is able to hold in her urine until she gets to the bathroom. She will learn to do this in the nighttime, too. Continue making sure that she gets out of bed and to the bathroom when the alarm sounds. She will eventually learn to get up before the alarm sounds or to hold her urine until morning.

This section of the Post is geared toward the young readers. In his article today, Dr. Bennett makes several great points for kids.
• Millions of kids have bedwetting, it’s just not talked about that much
• Bedwetting is hardly ever caused by a serious medical problem
• Kids who wet just don’t get the signal to wake up when they have to go
• The process of learning to stay dry can be sped up, and there’s no reason to wait
• A small device (bedwetting alarm) wakes you up when you start to pee when you’re asleep
• No one wets the bed on purpose

You might want to share this article with your child. I also encourage you to buy Dr. Bennett’s book. When checking out on bedwettingstore.com, enter the promotion code SVWAK to save $2.00. Expires 11/30/2010.

JL, many kids like your daughter feel frustrated on their wet nights. I assume you have already tried the logical methods of making sure she drinks a lot during the day and little in the evenings, double voiding before bed, making sure she has regular bowel movements and limiting sugary and dairy products before bed. If you haven’t looked at those things, see if those changes make any difference.

In spite of any of these changes, it is often difficult to predict when wetting will occur. In most kids with intermittent wetting, the dry nights occur when her bladder can hold all the urine produced that night. Wet nights occur when her bladder needs to empty. She has not developed the ability to wake up and walk to the bathroom when this occurs. Using a bedwetting alarm (monitor) can help her to develop this ability.

Any alarms will work, but the wireless alarms, such as the Rodger and Malem wireless, are particularly well suited for those with intermittent wetting. Once her underwear becomes wet, a sound is emitted from the receiver unit placed across the room. She must get out of bed and walk over to the unit to silence it. Over time, her body will learn to wake her when her bladder is full before the alarm sounds. Once she can do this, she will be dry 100% of the time.

Taking your son to the toilet every 30 minutes must be a tremendous challenge. The difficult part of this is that it doesn’t pinpoint when he really needs to empty his bladder, which probably is less frequently than this. A moisture sensing alarm can pinpoint exactly when the wetting is occurring so you can help him to the toilet at the right time. When your son wets, the Malem Recordable Alarm (M05R) senses moisture and plays a message that you have recorded. Your message could be something like, “It’s time to go to the bathroom now”. Instead of a loud alarm, your voice or any sound that you choose would be played. This is also more acceptable in a small group or school setting.

The small Easy Clip moisture sensor is fastened to the outside of his underwear where you would expect the first drop of urine. The alarm unit can be clipped or pinned to his waistband, pocket or other convenient location. Once urine is sensed, the message will alert him (and you) that he needs to go to the bathroom. In many cases, the children learn to stop the flow quickly and ultimately head to the bathroom when the feeling is present.

Once your son has achieved daytime dryness, you can use the same alarm to help with nighttime dryness. If the recorded voice isn’t enough to alert him, this alarm also has 8 pre-recorded sounds and vibration that can be used.

It can certainly be frustrating when you’re spending all that money on pull-ups and you still have to do daily laundry.  Since your current product isn’t providing the absorbency that your son needs, let’s talk about some alternatives.

Diaper Booster Pads can double the absorbency of a disposable pull-up or diaper.  The thin disposable pad is worn inside the pull-up.  The polymers in these pads absorb and wick away moisture, just like the disposables do.  Your son’s pull-up will be much thicker in the morning so make sure you allow enough room for the booster pad to expand. The regular booster pad holds almost 11 oz.  A regular pull-up holds around 13 oz. so you can see that this almost doubles the absorbency.

Another option is to look at the sizing of the current pull-up.  If the pull-up fits too snuggly, the urine might leak over the top or from the leg openings.  We carry some disposables in larger sizes, such as the Tranquility All Through the Night in XS Adult or the Prevail Underwear in Youth/Small Adult. These provide more absorbency and many have found that correct sizing helps with the leaking problem.  Protective vinyl pants can also be worn over a pull-up to prevent leaking.  These soft pants feature a layer of vinyl sandwiched between two layers of cotton.  They are machine washable and dryable and add another layer of waterproof protection.

A third option is to use a washable mattress overlay over the top of the sheets.  This would protect your son’s sheets and limit your laundry to a small pad instead of the entire set of sheets. The tuck-in style is particularly popular because it prevents the pad from moving around.  These are very absorbent, holding up to 4 cups of liquid.  Disposable pads can also be useful, especially if traveling.

Until your son is ready for a permanent solution, using some of these products may help you with keeping him clean and dry.

There may be several factors at play here.  The extra sugar and tasty flavor may encourage him to drink more than he would if it was plain water.  In some children, the red and blue coloring agents cause the bladder to be more irritable and need to empty more urgently or frequently.  Also, chances are that his body is more fatigued on the nights that he has sports activities.  It may be more difficult for him to spontaneously wake up when he needs to go to the bathroom.

Sports are important and your son will eventually learn to stay dry every night, in spite of his evening activities or fluid intake.  Until that time comes, rehydrating with water or a clear sports drink is preferable.  Drinking before the practice or game will allow his body to process the fluids as the evening progresses.  If he feels thirsty, allow him to drink after his practices.  Encourage him to void twice before bed, about 20-30 minutes apart, so that he starts the night off with a completely empty bladder.  Being well rested is also helpful.  Having his homework done earlier in the evening should allow him to have a regular bedtime.

Many families have similar concerns.  After adjusting to the new school schedule for six weeks or so, this should be a fine time to begin using an alarm.  Having a regular nighttime routine, as most families do during the school year, is good when beginning alarm use.  You could start the alarm on a Friday night or over a long weekend so you can see what his initial response will be.  Even though his sleep will be interrupted by the alarm when the wetting occurs, most children go back to sleep immediately after getting up to go to the bathroom.  Many have little memory of this in the morning.  Using the waterproof mattress overlays (that come in the Starter Kit or can be purchased separately) on top of his sheet make middle of the night clean-up very easy and quick.  Because the alarm goes off only when his bladder needs to empty, it’s actually less tiring than setting an alarm clock or parents walking their child to the bathroom.

The parents are the ones who may feel a little sleep deprived during this initial phase.  Because your son may need your assistance, you should respond when the alarm sounds.  Insuring that he responds correctly by getting out of bed after turning off the alarm helps him to make faster progress.  Once he can do this independently, you no longer have to respond.  Some parents find that it can be difficult to go back to sleep.  Knowing that the worst will be over in two or three weeks is helpful.  Some parents take turns getting up to the alarm or alternate nights.

Getting to bed on time and being well rested is as important for doing well in school as it is for learning to become dry in the nighttime.  Remind him to double void, about 20-30 minutes apart, before bed and help him to get homework done early so he can have a regular bedtime.  He can be successful in school as well as in conquering bedwetting.

Enuresis is the medical term for bedwetting and is defined as the involuntary passage of urine in the night by children older than 5 or 6 who should have developed nighttime dryness. About 90% of children have always had bedwetting, also know as primary enuresis. The other 10% have had at least 6 months of dryness, then resume wetting, which is known as secondary enuresis. We know that bedwetting is inherited and that the chance of a child bedwetting is 44% if one parent had bedwetting, up to 77% if both parents had bedwetting.

There is no single, simple cause for enuresis. Some factors that play a role in bedwetting are:
-Decreased arousal from sleep in response to a full bladder
-Small bladder capacity
-High nighttime urine production
-Constipation
-Other factors, such as evening fluid loading, medications, attention problems, urinary problems, sleep apnea

Since there no single cause, looking at multiple factors is important. Bedwetting alarms address the decreased arousal from sleep by helping your child to develop the ability to wake to a full bladder. Small bladder capacity may change as your child grows older but bladder “stretching” exercises do not seem to speed up this process. High nighttime urine production may be adjusted by drinking earlier in the day. The other factors listed above can be looked at by your health care provider if you have concerns for your child.

The biggest thing to remember is that your child is not wetting on purpose and primary enuresis is seldom due to emotional or psychological issues. Being supportive and offering a solution such as a bedwetting alarm when your child is ready is a good way for parents to help their child stop bedwetting.

When some people ask about a bed wetting mat, they are inquiring about a moisture sensing alarm mat that their child sleeps on. This type of bedwetting mat is plastic or vinyl with a moisture sensor that sounds an alarm when it gets wet. Your daughter probably doesn’t need this type of mat alarm yet. If she is still wetting in a year, using a moisture sensing alarm is a good way to help her achieve complete dryness.

Our most popular moisture alarms (bedwetting alarms) are the wearable models, such as the Malem Ultimate or Malem Wireless. The moisture sensor is attached to the outside of your son’s own underwear. The Rodger Wireless has specialized briefs that sense the moisture. We also carry a couple pad type alarms, although these are a little less sensitive to small amounts of moisture.

Moisture alarms work by sounding and/or vibrating to alert you that the wetting is occurring. The next step is to turn off the alarm and walk to the bathroom. Over time, the brain begins to make the association to stop the flow of urine and get out of bed to urinate. Eventually, your son will be alerted to the feeling of a full bladder and get up before the alarm sounds or hold his urine until morning.

This whole process is quite amazing and it can end bedwetting in a matter of weeks instead of years of waiting for him to “grow out of it”.

SJ writes, “My 9 year old needs help! I even offered to buy him a favorite Lego set if he didn’t wet for 7 nights. He stayed dry one night but has wet every night since then. I don’t know what other motivation he needs”.

Offering a reward for something your son has no control over can be counterproductive and very frustrating. I’m sure your son would love the new toys but he doesn’t know what steps he can take to get there. Even if he cooperates with limiting evening fluids and empties his bladder before going to bed, he does not have a method for getting up if he needs to in the nighttime.

Introducing a tool, such as a bedwetting alarm, to help him to make a change is very effective. Instead of sleeping through the wetting episode, now both your son and you will be alerted that wetting is occurring.

Initially, I recommend rewarding cooperation, something that he does have control over. By cooperation, I mean hooking up the alarm before bed, getting up as a response to the alarm (it is ok if mom and dad help him with this part) and double voiding before bed. Double voiding means urinating twice, about 20-30 minutes apart, before going to sleep-even though he doesn’t feel the need to urinate again. Your son can easily accomplish all of these things and earn a sticker or token as a reward for his cooperation. The important thing is that all of these things are necessary steps on the road to dryness and you’re helping to condition him to do these things. Dry nights will follow. Initially, he does not have control over whether or not that night will be a dry one. Once he does begin to have dry nights, if you want to add two stickers or tokens for dry, that’s fine. If a certain number of tokens equals a new toy, he does have the ability to earn that just by cooperating and trying to do his best.

This is a common question this time of year. I am re-posting some suggestions that I wrote last year about this time. Parents wonder what to do??

First, if your child is currently using an alarm, we would not expect him or her to take it to camp with them. They can interrupt usage and restart when they come home.

Secondly, a back up plan should be in place, even for kids who wet intermittently. There are a few choices:

• Wear disposable pants, with a plan for putting them on discreetly and disposal in the morning. Disposables come in all sizes, even small through extra large adult sizes. If your child has outgrown traditional children’s pull-ups, there are still many options. Disposable male guards or women’s incontinence pads can be secured to regular underwear to catch a small amount of urine. Disposable underpads that lie on a sheet or in a sleeping bag have tape strips to hold them in place.

• Use washable bedtime pants to preserve dignity. These can be a nice back-up for kids who are dry most nights but want to make sure there is no leakage onto bedding.

• Waterproof sleeping bag liners fit into a regular sleeping bag. They provide a comfortable, waterproof surface for sleeping without raising questions from other campers.

• Mattress overlays can be used on top of a sheet or used inside a sleeping bag. The overlays can be discreetly pulled into place when your child is ready to go to sleep. The new blue cloud overlays are colorful and look like a regular piece of bedding.

• Make arrangements with the camp counselor to have toileting twice before bedtime and to continue a lifting routine if this is used successfully at home. (Lifting is when a caregiver walks the child to the bathroom at a designated time.)

• Medication, such as desmopressin, can be used temporarily to decrease the amount of urine produced that night. The correct dosage should be determined a week or two before camp begins. Only a small amount of liquid (2-4 ounces) should be ingested once this medication is used. It is best dosed shortly before actually going to sleep.

Lastly, make sure that your child knows that they are not alone and most camps are very helpful in discreetly handling any wetting episodes. Fluid of choice after dinner is water. Double voiding before going to sleep is helpful. Staying well hydrated during the day is helpful so the kids are not so thirsty later in the day.

Taking calls from the listening audience was interesting because you didn’t know what question would come in next. Although many of the questions centered on toilet training, one concerned parent of an 8 year old daughter with nightly wetting called in. To listen to the broadcast, simply click here.

I highly recommend listening to 98.1 KISS-FM, in the San Francisco Bay Area on Sundays from 7-8 am or you can listen to any of the past shows by going to the website, http://www.childhoodmatters.org/index.html.

What you are describing is perfectly normal in the beginning. In the first night or two, the alarm is new and your son may not have been sleeping as soundly. It’s quite common for the kids to sleep through the alarm and have no memory of what happened when morning comes. You should go to his room when you hear the alarm sound and make sure he is turning it off, then walking to the bathroom, even though it looks like all the urine has been wet out in the bed. If you can’t hear the alarm from your room, put a baby monitor in his room. After a couple of weeks of consistently doing the right response, his brain and bladder begin to make that association and work more independently. Making it more difficult to turn off in his sleep, by doubling up on the underwear or the shirts is also a good strategy for right now.

Secondly, the alarms are all designed to be used to detect a small amount of wetness from cloth. Most of you know how quickly disposable pants wick moisture away from the skin. Alarms sense the moisture more quickly and your daughter will become more aware of the feeling of wetting if disposables are not used in conjunction with the alarm.

In special situations, such as lack of laundry facilities or working with a special needs child, using a disposable pull-up with the alarm may be the only option. The Malem alarm company does make a Standard Sensor that can sense moisture from a disposable product. A small slit is cut in the pull-up and the flat sensor is slid into the pull-up at the spot where you expect the first drop of moisture. This sensor can be purchased as an accessory with any of the Malem alarms. Another option is to use a pull-up over the Rodger underwear that come with the Rodger wireless alarm. The pull-up should not cover the transmitter that is attached on the waistband. The underwear would still need to be laundered once it becomes wet.

It sounds like your daughter will be very motivated to do what it takes to get to dryness. You can give her the tools necessary to make the transition from sleeping through the wetting episode to alerting and getting up to go to the bathroom. It is so frustrating for the kids to sleep through and have no idea when the wetting is occurring. Moisture sensing bedwetting alarms provide a way for your daughter and you to be notified when the wetting occurs. Initially, she may have little urine left to empty in the toilet. Over time, her brain will begin to make the association that the sound of the alarm means to stop the flow of urine in the bed and walk to the bathroom to empty urine in the toilet. This will eventually enable her to wake up and get to the bathroom when the urge to urinate occurs.

I often use the small and comfortable Pink or Purple Malem Ultimate alarm or the Malem Wireless alarm for girls her age. She can look at and listen to the different alarms on-line and choose which she would be most likely to use. Once she begins using the alarm, she can get out of pull-ups and wear regular panties to bed. The Starter Kit, with the alarm, two mattress overlays (which help with middle of the night clean-up), and my book, Seven Steps to Nighttime Dryness, is your best buy.

Giving her some control over her wetting is sure to help with her feelings of frustration and eliminate her tears at bedtime.

According to the article, Sarah wet the bed until she was in high school. One reason that I am so happy to see her story being published is that the more we can openly discuss bedwetting, its embarrassing implications and its resolution, the more families will feel comfortable seeking help. Getting the word out that bedwetters can grow into pretty wonderful people is important. At the Bedwetting Store, we try to offer concrete suggestions, matter-of-fact phone discussions and product reviews that are actual stories from families of bedwetting children.

As a nurse practitioner, I speak with families of bedwetting teens on a weekly, if not daily, basis. These teens often feel hopeless, helpless and that they are destined to be denied sleepovers, camp and college dorm living for the rest of their lives. Developmentally, the incidence of bedwetting decreases as kids get older so that only about 1% of 18 year olds continue to struggle with bedwetting.

That said, it’s also important to know that there are effective steps that can be taken to speed up the whole developmental process. Bedwetting alarms continue to be an effective strategy for teens with bedwetting to learn the behavior of getting up to urinate when their bladder is full. Some teens have half-heartedly tried using a bedwetting alarm at some point in time, perhaps when they were 7 or 8. Because they did not achieve dryness at that time, they assume that this method will not be effective for them. I have had success in my practice with using the wireless alarms for older kids. Both the Rodger wireless and Malem wireless alarms allow the teen to select a sound to alert them when wetting occurs. Picking a tone that is similar to their cell phone ringtone may be helpful. Achieving dryness and getting up as a response to a full bladder is a permanent behavior that can take time to learn, but having a tool to help speed up this whole process is a welcome relief for most teens.

Although I have not seen research that directly connects seasonal allergies to an increase in bedwetting, there are some factors that may coincide to increase your son’s wetting episodes. First, does he take any medications during this time? Antihistamines, even non-sedating ones, may change his sleep patterns. You could experiment with dosing times to see if the time of day the medication is given makes a difference. Some allergy medications increase thirst so your son could be drinking more than usual. Increasing fluids during the day so he isn’t so thirsty in the evening is important.

With spring, more outdoor play and sports activities are also common. A later bedtime and going to bed exhausted can contribute to bedwetting. Trying to maintain a schedule where he gets an adequate amount of sleep each night can be helpful.

Other than seasonal allergies, some children’s bladders may be “allergic” to certain foods. Some foods have been reported to make the bladder more irritable (contracts more easily) or increase the production of urine. These foods include citrus (lemonade or orange juice), artificial food colors, carbonation, foods with added Vit C ( or megadoses of Vit C), candy and foods with high sugar content. Milk and milk products produce some natural sedative effects so in some cases cause the kids to sleep more soundly. Having milk products earlier in the day is best. Experimenting with eliminating most of these things allows you to see the impact, if any, on the wetting episodes. Then gradually restart and keep tract of your son’s response. If you do the elimination diet while he is using a bedwetting alarm, it is very easy to know when and how often the wetting occurs. You can see for yourselves if allergy medication, diet, milk, fatigue, or any other springtime event makes a difference.

I think you have identified an important piece in getting to dryness–wanting to do so. At some point in time, your son will indicate that he is ready to tackle getting to dryness. You can wait until he is ready without any untoward effects. As far as your daughter goes, I certainly do have families where one sib has used an alarm and now a younger sib really wants to use it, too. You know your children better than anyone
else. If your daughter wants to try the alarm for a few weeks, you should begin to see progress by then. If it becomes a source of frustration for her, you can delay it a little longer. I will tell you that in families where a younger sib becomes dry, the older ones take note and do what they can to get to dryness as well.

Results: The number of wet nights decreased with DDAVP treatment. Delta power, distribution of sleep stages, number of arousals, arousal index and the effect of arousals on sleep stages did not differ significantly between the two groups. Bed-wetting occurred within each sleep stage and did not follow any particular pattern. In most cases, it was preceded by an arousal reaction, but no awakening occurred.

Conclusion: DDAVP has no effect on the sleep architecture of children with bedwetting.

This study concluded that DDAVP did not affect the sleep patterns of children who take it. Since its mechanism of action is to work locally on the kidneys to produce more concentrated urine, the results are exactly what I expected.

The reason that this study was so interesting to me; however, was that these sleep studies indicated that bedwetting occurs during every sleep stage and does not follow a particular pattern. This is exactly what I see clinically in the families that I work with each day. There are some organizations that talk about bedwetting as a sleep disorder and how bedwetting children stay in the deep sleep phase longer and wet during this phase. This is based on research that was done in Canada in 1968. In the more recent research report that I just read, bedwetting did not occur only in the deep sleep stage but throughout the entire sleep cycle, with no pattern. Families report that the bedwetting alarm goes off at different times each night, anywhere from 30 minutes after bedtime to 30 minutes before wakening in the morning. The child cannot be in deep sleep all of these times.

Anyway, it would have been nice to have a larger sample size but this is good information.

Medication often has immediate results, but when you stop it, the relapse rate is high-about 80 percent. DDAVP allows about half the children who use it to sleep dry that night, which makes it particularly useful for sleepovers and camps. DDAVP is available in two forms: a nasal spray and tablet. The tablet is now preferred because it delivers a more consistent and convenient dose. The nasal spray has a Black Box Warning because of some reported cases of seizures and death because of water intoxication. Also, children with allergic congestion can get erratic results with the nasal spray.

Dosage of DDAVP must be individualized, with one to three tablets (0.2 mg.) each night before bed as the recommended dose. The greatest number of dry nights is achieved by 0.4 to 0.6 mg. nightly. If your child is taking the medication for a situation outside of his home, such as sleepover camp, start it ahead of time to establish the appropriate dose. Your child’s doctor or nurse practitioner is responsible for determining your child’s dosage, but the general recommendation is as follows:
• If your child wets when taking one tablet, increase it to two.
• If wetting occurs with two tablets, his dosage should be three tablets.
• Three tablets is the maximum amount recommended for any age group.

DDAVP is generally safe with few side effects. Reported side effects include headache, stomach ache or water intoxication if a large amount of water is ingested after taking it. The manufacturer provides fluid guidelines, recommending no more than four ounces of water before bedtime. This medication can be safely used for three- to six-month intervals with a one week break. If wetting persists, it can be used for another interval. DDAVP is expensive, as much as $3-4 per tablet. The cost should be taken into account when considering long-term use.

DDAVP does not stop wetting in every child. Increasing the length of time taken will not make it work. The expected results should be seen in a week or two. Parents should realize that this medication does not provide long-lasting effects, but it does provide short-term dryness for many children. For long lasting results, getting to dryness by using a bedwetting alarm has a more permanent response.