Q: My 6-year-old has been wetting his bed for months. What's the most effective way to address this problem?
A: Even after a child is toilet-trained, usually between ages 2 and 4, it's normal for him to wet the bed at night as often as a few times a week. And after that, he may occasionally wet the bed because of stress or other problems within his family, in which case it's important for parents to be sensitive and patient and avoid making their child feel guilty or ashamed.
If a child of at least 5 wets the bed twice a week for three months or more, it's time to seek treatment. And according to a new review of almost 70 studies, urine alarms are the best treatment for bedwetting, says Michael Mellon, Ph.D., pediatric psychologist and director of the Mayo Clinic Enuresis Conditioning Clinic in Rochester, MN.
The alarm, which is either worn on the nightclothes or attached to the sheet, activates when it's moistened, prompting the child to use the bathroom. However, it needs to be used for an average of three months to be effective, and it works best with kids who are 6 or older. "It can be quite demanding," explains Dr. Mellon, who conducted the review. "Once the alarm sounds, the child has to get up, shut it off, use the bathroom, probably change his clothing, reset the alarm, and get back into bed."
For this reason, parents need to be an integral part of the process -- as should a therapist. "Most kids need a lot of support during treatment. After that, most kids have learned how to stay dry, and they're done." Seventy-five percent of children will become dry after using an alarm, with a 15% to 20% chance of relapse.
Alarms usually cost between $75 and $100 and aren't always covered by insurance, a source of frustration for Dr. Mellon. If your child does not respond to alarms, ask your pediatrician about a medication called Desmopressin (known as DDAVP), though Dr. Mellon cautions that most kids continue to wet as soon as they stop taking it.
Copyright © 2001. Reprinted with permission from the December/January 2002 issue of Child magazine.
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