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Published August 19, 2013, 10:00 PM

Bedwetting: Children’s developmental condition a ‘closely guarded secret’ for many parents

FARGO - “Melissa” washes sheets almost every morning. It’s something she’s been going through for years. Melissa, a Fargo-Moorhead mom was asked that her name be changed to protect the privacy of her children, has two teen sons who wet the bed almost nightly.

By: Tracy Frank, INFORUM

FARGO - “Melissa” washes sheets almost every morning. It’s something she’s been going through for years.

Melissa, a Fargo-Moorhead mom was asked that her name be changed to protect the privacy of her children, has two teen sons who wet the bed almost nightly.

Bed wetting is more common than many realize. It’s an issue that millions of families face and is often a natural part of child development, according to kidshealth.org. But it’s also a topic parents rarely talk about, especially in older children.

“It’s like a silent medical condition that no one talks about,” Melissa said. “It’s completely socially unacceptable.”

That’s why she wanted to share her story – to make sure other parents understand that bed wetting isn’t a result of anything they’ve done wrong and it’s nothing the children can control.

“The last thing I would want my boys to feel is worse than they do,” she said. “I don’t share my frustrations with them. I don’t want them to see how desperate I am, my worry for them. It’s really hard for a parent to watch their kids go through it.”

She tells her sons it’s not their fault and they’ll outgrow it. Her unspoken worry is wondering how long it will continue.

As they’ve become teenagers, her sons have outgrown pull-ups and don’t want to wear bladder-control pads, which Melissa said she understands. So either she or they wash sheets almost daily.

Melissa and her boys have tried chiropractors, acupuncture, sleep doctors, two different alarm systems, exercises to enlarge the bladder, waking up at night to use the bathroom, and medication.

The medication was somewhat successful with her younger son. Nothing has helped her oldest, she said.

Her boys don’t talk about it or how it affects them socially and emotionally, but it’s something Melissa worries about constantly.

“It is hard,” she said. “It got to a point where they pretend it’s not happening. They’re so sick of dealing with it that they don’t want to deal with it.”

The boys rarely go to sleepovers, and Melissa brings her own bedding and waterproof mattress pads on family vacations.

Thinking about how it could be affecting her sons’ self-esteem is almost too much to bear, she said.

“Victoria,” of the Detroit Lakes area, who also asked to remain anonymous, is certain her son’s bed-wetting issues have affected his self-esteem.

He started wetting the bed when he was 10 and continued for the next five or six years, she said.

“Your self-esteem, your self-worth is really fragile when you’re at that age in the first place,” Victoria said. “But when combined with bed wetting, it becomes extreme.”

Though his bed-wetting happened years ago, he’s still insecure, she said.

“In the beginning it was really frustrating but then I quickly realized that it was not something he could control,” she said. “We tried very hard to shelter him so he wouldn’t be embarrassed.”

He couldn’t go to sleep overs and he stayed with his parents instead of his friends on athletic trips, Victoria said.

“Nobody knew,” she said. “It was a very closely guarded secret.”

There weren’t as many options when her son was dealing with bed wetting, but they did try waking him at night and an alarm pad, Victoria said.

“My son would go into such a deep sleep that an alarm that woke up everybody in the house wouldn’t wake him up,” she said.

They continued using the alarm pad and her son eventually stopped wetting the bed, Victoria said. She doesn’t know if he stopped on his own or if the alarm conditioned him to wake up.

“It’s the hardest thing in the world when you’re washing sheets all the time and working and raising a family, but it’s no different from any other health problem,” she said. “You just have to be patient.”

Normal development

Dr. David Clutter, an Essentia Health pediatrician, said that for the most part, bed wetting is not a medical or emotional issue. It’s just a developmental process.

Most kids who wet the bed tend to have relatively small bladders and don’t have the storage capacity to make it through the night. But they are also extremely deep sleepers who don’t wake up from sensation of a full bladder, he said.

Dr. Stephanie Hanson, a Sanford Health pediatrician, said bed wetting is a normal developmental occurrence caused by slow development of the nervous system’s control of the bladder.

“It’s not anything that the parents did wrong with potty training,” she said. “It’s not going to be a problem forever in a child that’s otherwise healthy.”

She recommends visiting with a doctor to make sure there are no kidney or spinal cord problems.

Occasionally kids who have been dry and suddenly start wetting the bed may have a medical problem like diabetes or a urinary tract infection, Clutter said.

Both doctors recommend bed wetting alarms and motivational training, like a sticker chart.

“The idea is that eventually the child will wake to the alarms and will subconsciously make the connection between the sensation of being woken to a full bladder,” Clutter said.

It can take anywhere from a few weeks to a few months for the alarm to work, he said.

Common medications used for bed wetting are imipramine, which increases the capacity of the bladder, and DDAVP, which controls the flow of urine. But the medications are not cures and could have side effects, Clutter said. Children will naturally outgrow bed wetting, and it’s hard to tell when that happens if they continually take medication, he said.

For some, a chiropractic treatment resolves bed wetting. Alisha Anderson, a chiropractor at Anderson Family Chiropractic in Fargo has treated multiple children with bed wetting issues.

“The nerves that come out of the spine go to the bladder. With bed wetting, if there’s a spot in the back vertebra that’s not moving properly, that joint will swell up and it puts pressure or irritates the nerves and so the bladder isn’t going to function properly,” she said.

After one adjustment, an 8-year-old girl who wet the bed nightly stayed dry for three nights. After the second adjustment, she was dry for two months. And since her third, she’s been dry for more than a year, Anderson said.

The number of treatments needed varies and chiropractic care won’t help everyone, but it can be a good place to start, Anderson said.

For others, simply waking children on a regular schedule is enough to solve the problem.

Dee Harlow of Manitoba, who used to live in Fargo and was a Southeastern North Dakota Community Action Agency counselor, recommends this method:

About an hour after the child goes to sleep, gently stirring the child without necessarily waking him, steer him or her to the bathroom and quietly tell the child to use the toilet.

“Somehow, this is giving the brain permission to do this without them waking completely,” she said. “This is hard on the parents for a week or two but then it kicks in and it’s wonderful.”

It needs to be done every night the same length of time after the child goes to sleep, Harlow said. It may require a refresher cycle once or twice, but is well worth the effort, she said.

There are cases when nothing works.

Dr. Cutter said children could need counseling if bed wetting continues into their teen years.

“The longer it goes on, the more secretive they get and they start feeling really inadequate about things,” he said.

“Jillian,” who lives in the Fargo-Moorhead area and asked to remain anonymous, said she and her son both went through counseling to deal with his bed wetting.

“There were a lot of tears for both of us,” she said. “I thought that I did something wrong as a parent. I soon understood that this was just the way my child worked, and we worked through it together.”

Bed wetting is also a lonely parenting issue to face. Jillian said it was hard to talk to other parents about it because she didn’t want them to look down on her son for something he couldn’t control.

“You name it, we tried it,” said Jillian, whose son was also between 15 and 16 years old before he stopped wetting the bed. “But I finally realized that I could not do anything but support my son because it was as hard on him as it was on me.”

For other parents going through the same thing, she says: “Be strong. Love your child. Hug them and say you love them even when they are wet and ashamed. Don’t get upset with the child, and someday this bedwetting thing will go away.”

Readers can reach Forum reporter Tracy Frank at (701) 241-5526