How to help children overcome bed-wetting

One of my friends recently told me that I love talking about the things no one wants to talk about. Maybe she is right, but I didn’t think bed-wetting is one of those things until after my previous article. I mentioned some of the causes of bed-wetting past the age where it is considered normal for a child to wet their bed, and when to be worried. You can read the article here.

I found out that we (especially in my country) have some interesting, unconventional methods of dealing with bed-wetting. Unfortunately, most of them are based on superstition and the belief that bed-wetting cannot be a medical condition. Some people believe that it is due to demon possession and associate it with religion. Others believe it is just a habit one develops as a child and finds it hard to stop as they grow up. I honestly didn’t think bed-wetting was such a big deal until I came across some of the solutions people offered online (source NTV Kenya fb).

Here are some of the solutions people offered online;

1. Take uji or bread before you go to bed for two weeks
2. Every time you are about to pee, you definitely don’t know if it is a dream or real, just pinch yourself a little, do all things possible to confirm you are not dreaming.
3. Simple remedy for that problem is those hair-like flowers of the female part of a maize plant, yellow maize or the other one. You just squeeze them and add some water and take three glasses per day for around 2–3 days. It is non-toxic.
4. I used to so when I was 10, but my auntie’s daughter made me lick the urine and smell it almost suffocating and that is how I forgot urinating in bed.
5. Take chapatti. I used to wet my bed always but when there was a chapatti meal it was heaven, but the biggest problem was that we only used to eat chapatti once per year.
6. Climb a tree for about 6 meters from the ground, urinate then jump down when urinating
7. Let go of what is bothering you, mentally and emotionally, and it will cease
8. Tell someone to tie a snake around your waist every night before you go to sleep, and the condition will automatically come to an end.
9. You should find a tortoise during rainy season and carry it on your back like a baby. That problem will disappear completely.
10. Catch a big grasshopper, remove its leg and chew it
11. Look for footprints of a hippopotamus, urinate on it just once, and your problem will end.
12. Lick the body of a lamb or sheep when it is born before it is cleaned out by its mother

This and many more that I could not put down here are some of the practices around bed-wetting. As you can see, bed-wetting past the appropriate age is not considered a medical problem by most of our population.   I’m curious if the lack of nocturnal enuresis cases in my practice is due to parents’ understanding of the condition’s self-limiting nature or their reliance on unconventional remedies that only lead them to seek medical help when all else fails.

When to seek medical attention;

• If your child’s other symptoms fit any of the causes we described in the previous article
• After the age of 7 years
• If your child starts wetting their bed again after 6 months of staying dry at night
• When the bed-wetting affects your child’s emotional, social or academic well-being

How to manage bed-wetting at home;

• Motivational therapy. Encourage and don’t punish your child for something that is natural. Do not spank or shame them. Don’t make a big deal about it. This might affect your child’s self-esteem. Assure your child that they will outgrow it. It is certainly not the child’s fault, and punishing the child makes the situation worse. You can use rewards or positive reinforcements to offer encouragement. Acknowledge and encourage them every time they wake up dry.
• Cut off caffeinated drinks, alcoholic drinks, sweeteners, citrus juices or artificially flavored drinks e.g., sodas. These can act as diuretics or bladder irritants.
• Ensure your child gets a rich fibre diet to prevent constipation, since it is one of the causes of nighttime enuresis.
• Limit fluid intake before bedtime, but remember, it is important to keep your child hydrated during the day to prevent excessive thirst and dehydration.
• Do not use diapers, training pant or pull-up pants at home, especially if your child is older than 8 years. This will encourage them to stay in bed. You can still use them for special occasions like sleep-overs.
• You can also try some bladder exercises to strengthen the muscles and stretch them. Ask the child to hold and squeeze a small ball-the size of a fist-between the thighs, just above the knees.  You can also ask them to hold the urine a few minutes longer when they have the urge to pee; this might help expand the bladder and improve control, as long as they don’t do it to postpone peeing. These exercises are effective when done at least twice a day consistently, so don’t give up after the first day.
• Identify some of the triggers of bed-wetting for your child. This will help you rule out any emotional disturbance that may be the cause. Do not neglect your child emotional well-being.
• Try using bed-wetting alarms. This takes a while to work-about 12 weeks. Therefore, they are only effective if there is enthusiasm for participation from both the child and the parents and if the child is not blamed for bed-wetting. Some commercial bed-wetting alarms are available, but if you don’t want to buy, you can set alarms for your child and wake them up to pee at the same time every night. It is also important to create a nighttime routine for your child. This should include emptying the bladder before going to sleep.  
• Do not use anticholinergics, antibiotics or anti-depressants on your child without a doctor’s prescription. If you are worried that it is a medical issue or if your child is a teenager or young adult, please visit the doctor for further investigations and management.

If you have a friend who is already in their adulthood but still struggles with nighttime incontinence, encourage them to see a doctor, preferably a urologist. Do not shame anyone for what is beyond their control.

True friends won’t judge you for what happens while you sleep; they’ll be there with a clean set of pajamas and a shoulder to cry on.