I have used a moisture sensing alarm for children who need some help putting together the feeling that happens before wetting occurs with the actual wetting episode. No matter how often the parent or teacher checks their pull-up, they inevitably wet the minute they pull the pants back up. The type of alarm that I commonly use is the Malem recordable alarm, because the parent can record a message, such as “You need to go to the bathroom now”, which is triggered by the first sign of wetness. (This alarm also makes 8 different pre-recorded sounds that you can choose from). Initially, you can reward cooperation, that is going to the potty when the alarm sounds. Then you can begin using the reward for “beating the alarm”, going potty before the alarm is triggered. If your son isn’t frightened by sounds, you could also use a less expensive Malem auditory alarm, which just makes one loud sound at the onset of wetting. (You would have to role play what the sound means a few times so he could make that association). I recommend that he wear regular underwear when using the alarm. The small sensor is fastened to the outside of his underwear where you expect the first drops of moisture to appear.

Training of stool continence is often a separate experience, especially in boys. If you train him to sit when urinating, letting go of stool might be easier. Sitting long enough, playing a game or looking at books is important for bowel training. If you see him posturing before having a BM, encourage him to sit on the potty.

An important piece that was identified during taking her history was that she had infrequent bowel movements, 2 or 3 times a week. She was reluctant to go at school. Constipation often goes along with daytime wetting so we worked hard on correcting this. A high fiber diet, increased water intake during the day and Miralax every morning quickly made a huge difference in the frequency and consistency of her bowel movements.

Along with this, we instituted a timed voiding program, using the Vibrowatch set to vibrate at convenient intervals, about every two hours. We made sure the right times were set so that she started PE, lunch and the bus ride to after care all with an empty bladder. A 5:30 pm and 7:30 pm time made sure she voided while her mother was busy preparing dinner and doing evening chores.

Although a little skeptical at first, both parents and daughter were willing to cooperate with the instructions. At two weeks, stools were much improved and her panty liner was no longer soaked. When I described our goal of getting rid of the daytime panty liner, she expressed nervousness about doing that. We implemented a plan of going without a panty liner on weekends first so that she could prove to herself that she could stay dry with the timed voiding program in place. During a follow-up call one month later, mom described her success at staying dry during the day, no panty liner and a huge boost to her self-confidence. She can continue this regimen for the next few months, until her body is able to do the alerting.

Although bedwetting is very common in children, the cause seems to be multi-factorial and not well understood. We do know that bedwetting runs in families and the actual genetic marker has been determined. With both sides of your family affected, more than 70% of offspring are affected. We don’t know exactly what that genetic trigger is, however. For example, do these kids sleep differently, do their bladders contain less, do they pay less attention, etc?

Research has been done to look at risk factors for children with bedwetting. I’d like to share with you some research that was just published online in The Journal of Urology online, Dec 2009. The research was done in Australia using a questionnaire for the parents of 2,856 children. The questionnaire asked about the prevalence of bedwetting among many other general questions about their children. The average age was 7 years and the prevalence of bedwetting was 18%. Bedwetting was defined as any wetting in the previous month, with mild-1-6 nights, moderate-more than 7, severe-every night.

This research did confirm some modifiable risk factors that have been identified in the past years. Encopresis (leaking stool) and daytime wetting were associated with 23% of the kids with bedwetting. I think it is important to note that these two issues should be solved before bedwetting is addressed. In some situations, bedwetting will cease with the cure of the other problems. Males were also more likely to have severe enuresis, when adjusted for age.

Emotional stressors and social concerns were only associated with the moderate bedwetting, not the nightly wetting. This is good news for parents who worry that there is a psychological reason or bad parenting as the cause for their children’s wetting.

AS, if either of your children have encopresis, constipation or daytime wetting, this should be brought to your pediatrician’s attention immediately. As for the other temperamental characteristics that you mentioned, it doesn’t seem that there is a pre-disposition for one type to be more affected than others. I do see all shapes, sizes and personalities of kids in my bedwetting practice but most are just great kids. There is a little higher correlation of ADHD in children with bedwetting, but they can still achieve dryness. From your description, it sounds like both of your children would benefit from treatment using a bedwetting alarm.

ST, I do not recommend this for a couple of reasons. First, how do you know what time your son will need to go to the bathroom? It’s difficult to predict when the bladder needs to empty, which can change from one night to the next. Because you are picking an arbitrary time to alert him, he will not be able to put together the signal of a full bladder and getting up at that precise time. This is also why setting an alarm clock for a specific time each night does not cure bedwetting. Moisture sensing bedwetting alarms are superior, because the alarm does not sound until your son physiologically needs to go to the bathroom.

The second reason is that a 20 second vibration on the wrist is typically not enough stimulation to wake a soundly sleeping child. Because the vibration stops after 20 seconds, most children will sleep through or ignore it and wake up wet and frustrated in the morning. Because you have no idea when the watch is vibrating, you cannot be available to help. With a sound making bedwetting alarm, you can be available to alert him when it sounds. Vibrating watches work great to remind children in the daytime when they should be using the bathroom. Because daytime wetting and nighttime wetting have some different causes, different products are best for each condition.

Urologists around the country agree that this can be a common and frustrating problem that is best handled by frequent urination on a regular basis. Emptying the bladder regularly eliminates the urgent messages that sometimes result in urine leakage. The difficulty arises when children get busy with other activities and lose track of time. Telling a child to go potty every 2 or 3 hours is a hard concept to grasp. Even remembering to go to the bathroom before lunch or recess can be difficult. A discreet vibrating wrist watch is a reliable tool for providing a reminder to go to the bathroom.

We carry several vibrating wrist watches that are perfect for this purpose. Our top selling watch is the Vibrowatch. Up to 12 specific times can be programmed to coordinate with your daughter’s schedule. The watch vibrates for about 20 seconds and is difficult to ignore. It comes in several different colors and has a durable plastic band. Vibrating watches are generally a little larger than time telling watches to accommodate the larger battery.

Starting the new school year off with a reminder watch is likely to eliminate many of the embarrassing accidents she had last year. You can consult her teacher about the best toileting times and make sure she has free access to the bathroom when her watch reminds her to go.

In feedback from our customers, we were asked for a “green” washable alternative to nighttime disposable pants. Over years, the amount of money that families were spending on disposables was adding up. The new Bedtime Pants fit this need. Designed to resemble longer length boxer briefs, these are completely waterproof and washable. An absorbent sewn-in pad extends from the front to back waistband. An absorbent disposable pad can be used over this to double the absorbency in those children who produce large amounts of urine. The best fit is one in which the absorbent pad fits close to the body. These pants can be machine washed and dried and used again the next night. They are European sizes and tend to run a little small. Children need to know that these are bulkier than the disposables they are used to using. In order for cloth to be absorbent, there must be more layers and padding. Even though they are bulkier than regular underwear, they are more discreet than disposable pants for children who are doing a sleepover or camp.

We were also asked for daytime alternatives to wearing pull-ups to school. This communication was often from families whose children had developmental difficulties, urologic problems or daytime accidents. They wanted these to be easy access for kids to handle independently. We offer two selections in this category-daytime absorbent briefs and easy-open absorbent briefs. Designed to look like regular cloth underwear, the padded area between the legs catches any leakage. The outside of this area of the underwear is waterproof, so prevents any embarrassing spots on the outside clothing. The original daytime briefs pull on just like regular underwear. The easy-open absorbent briefs have Velcro sides. These are ideal for children who need to do self-catheterizations or who find it difficult to stand to pull underwear up and down. These underwear are designed to be used in the upright position and are not completely waterproof. For this reason, they are not to be used for nighttime wetting.

Lastly, families asked for an alternative to the old-fashioned “rubber pants” to prevent leaking, either from disposables or from absorbent underwear or diapers. In the new protective vinyl pants, the vinyl barrier is sandwiched between two layers of cotton cloth. They come in pretty colors of light blue or navy and appear to be no different from regular underwear. These pull up and down and stand up to repeated washings. It’s best to dry on low heat. These pants do not provide absorbency so should be used in conjunction with an absorbent product or as a backup to prevent a few drops of wetness from leaking through to clothing.

We’re pleased to now carry this full line of washable, reusable and comfortable underwear to meet all of your needs. It’s important to choose the right product, with the right fit. Measure your child’s waist before ordering. Call us if you need help in selecting any waterproof product. 800-214-9605

Making sure that the urine/urinary tract is normal is always prudent when noticing this behavior. You can consult with your pediatrician about this. Also, constipation and infrequent stools can contribute to daytime wetting problems. Address these factors first. If neither of these things is found to be contributory, you can move on to some behavioral techniques.

It seems that when these children’s bladders become overly full, they sent a very urgent message to the brain and begin contracting before the child has a chance to get to the bathroom. Parents describe this as “waiting until the last minute” or being so interested in play that they “ignore needing to go to the bathroom”. You and I receive messages from our bladder well in advance of actually needing to use the bathroom. We have time to finish what we’re doing and leisurely make our way to the toilet. Children with daytime wetting often don’t have this luxury.

We know that “timed voiding”, which is emptying the bladder on a schedule, rather than waiting for internal messages, is very effective in preventing overfull bladders from sending urgent messages. It’s almost impossible for a child, who has little comprehension of time, to remember to “Go to the bathroom every 2 hours”. A discreet, independent reminder can make all the difference.

Using a vibratory wristwatch is a great way of fostering the independent behavior of going to the bathroom on a regular schedule. Usually around every 2 hours is a good amount of time to begin with. For school age children, I prefer watches in which you can set specific times. That way, you can coordinate with the teacher the times that would be less disruptive but allow him/her to start p.e., recess or lunch with an empty bladder. Voiding at the end of the school day allows your child to begin the trip to home with an empty bladder, eliminating accidents on the bus or running to the bathroom when entering the house.

The Vibrowatch offers 12 independent times and vibrates about 20 seconds, making it difficult to ignore. The Medose and WobL watch each offer 6 independent alarms, and vibrate for 20 and 5 seconds, respectively. You can watch these videos to get a better idea of how these watches work. Most of my patients are amazed at how well their children do once they’re given a simple tool to help.