Posted in Emotions, For Nurses, Health, Pediatric Nursing, Therapy

Bed Wetting Treatment

Information from Dr. Bettina Shapiro, North Carolina University

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How does a bedwetting alarm work?

A bedwetting (enuresis) alarm is a device that emits an auditory and/or tactile sensation in response to moisture. The alarm is attached to a child’s underwear or pajamas in the area where the first drop of urine would be expelled. When the child wets, the alarm goes off and alerts those in range that wetting is occurring. The child hears or feels the alarm and learns to get out of bed and empty urine into the toilet. Gradually, the child learns to respond to the feeling of a full bladder by waking and going to the bathroom before the alarm goes off. Alarm training is a type of behavioral conditioning.

The average length of treatment is 2-6 months. If the child has VERY deep sleep, it can take LONGER. Requires the purchase of an alarm/sensor system. 

Get an alarm/sensor that goes into the child’s underwear. It is wireless (meaning no cords!). The sensor goes into a pad, then the pad goes inside the underpants. Cost is between $45-$100 online. Some alarms have sounds AND lights. Some only have alarms (the noise).

Treatment must be done EVERY night. This is an ALL or NOTHING treatment. 

Do NOT start treatment until the family is MOTIVATED and READY to start and do it EVERY night. This is a PARENT FOCUSED program. 

Do NOT reward the child for staying dry. Do NOT punish the child for wetting. What you are REWARDING is treatment COMPLIANCE. This means: they are wearing the sensor to bed and they are getting up (with or without parents help) to use the bathroom AS SOON AS the alarm makes noise. Non-compliance would be: “I don’t want to get up.” or “I don’t want to put the sensor back on.”  ***Reward child at the end of the week for COMPLIANCE

Put the alarm by the child’s head.

If the child is in deep sleep, they may not wake up even with the alarm. The parent may need to sleep nearby and immediately take the child to the bathroom when they hear the alarm. Parent must jump up immediately and run the child to the bathroom. 

In the beginning the alarm often rings 3-5 times a night. After a while, the frequency will decrease. 

Keep a record of all this on a chart.

Even with the alarm, continue having the child wear pull-ups so that sheets do not need to be changed. Or, use a rubber bed pad. 

The child must be fully awake when they are taken to the bathroom. If the child is still asleep, it actually continues the bed wetting problem. 

Each night that the child complies with the plan, he gets a sticker. At the end of the week, if he has enough stickers, he gets a reward. 

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Things NOT to do:

  • Fluid restriction. Do not do this. You want the bladder reasonably full, so process will work. Do not stop liquids early in the evening.
  • Do not take the child to the bathroom while the child is still asleep.
  • Do not punish the child for wetting.
  • Do not reward the child for staying dry.

What is considered Treatment Success?

“Success” is 14 consecutive nights of dryness.

Then you can discontinue treatment. 

If there is a relapse, it’s no big deal (this is fairly normal). If child starts to wet the bed again, go back to the treatment process. After 14 days of dryness, keep monitoring for 16 weeks (have the child wear the sensor for 16 weeks). 


List of Products Available

When deciding on a bedwetting alarm, look at how the alarm is placed. Does it fasten to any pair of underwear, or does it come with its own specialized underwear? Some children like using their own briefs while others prefer those with a built-in sensor, where placement is never a problem. A pad type alarm is an option for those who prefer to lie on the sensor rather than to wear it.

Methods of stopping the alarm after triggering can vary. Some alarms require a two-step turn-off in which the sensor is removed from wetness before the reset button is pressed.Wireless alarms require wearers to get out of bed to turn the alarm unit off, which works well for heavy sleepers. Sound comes from a unit clipped to the shoulder in wearable alarms. In wireless and bedside alarms, it comes from a separate unit set away from the sleeper. Most users prefer to have the sound close to the ear, but some like the option of hearing the sound from a distance.

  1. Rodger Wireless Bed Wetting Alarm new-alarm-red-double $129.95 (Dual receiver available – parents can keep one of the receivers in their bedroom)

2. Malem Wireless Bed Wetting Alarm new-malem-wireless_1$139 (Easy Clip on sensor – Dual receiver is an option – Receiver can be placed up to 50 feet from sensor) 

3. Malem Ultimate Bed Wetting Alarm J-M04CN-BI-01.jpg $99.95 (The alarm sounds continuously until the sensor is removed. No mini-pads to buy and attach each night! does NOT offer dual receiver.)

Link to a Chart That Compares Different bedwetting alarm system products: Here

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Source: Cottage Counseling, Lakewood Ranch FL & NeuroPsych Associates, Sarasota FL

Author:

Mother, Pediatric Nurse and a Trail Blazer for Positive Change.

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