“The problem with bedwetting is not that the kidneys produce too much urine. The issue is: is the brain waking up in response to the full bladder and the urge to go to the bathroom when the bladder is full?” explains CHOC Pediatric Urologist Dr. Tony Khoury. “In a child with a bedwetting issue, the communication between brain and bladder is incomplete and inefficient. You need the brain and bladder talking to each other so that the child can awaken in response to that stimulus.”
Training the brain to respond to the need to urinate is the goal, so one treatment option is the use of an alarm. An alarm with sensors is placed on the child’s underwear and when wetness is detected by the sensors, a buzzer goes off and wakes the child.
“If the child isn’t ready, wait and when the child is ready, that will be the time to start talking to them about the alarm. It has to be used properly,” says Dr. Khoury.
Dr. Khoury suggests that parents not push their child to stop wetting the bed or use the alarm unless the child is ready and motivated to stop. To help motivate your child to work on staying dry and to work with the alarm, parents can try taking off the potty training pants and put the child in regular underwear. Parents also can have their child help do his laundry and change the sheets to get him more motivated, Dr. Khoury says.
In cases where the child isn’t ready or motivated and still wets the bed despite using the alarm, it’s not the alarm that is failing to work.
“The alarm requires them to wake up. The alarm is doing its job and buzzing when the urine is coming out but the child is not responding,” Dr. Khoury says. If this is the case, Dr. Khoury says, “Have a parent or older sibling sleep with the child the first few nights of using the alarm and the parent or sibling can make sure he is waking up. If the child fights this, then there isn’t enough motivation so wait a few months and try again. The problem is, families give up. Wait until the child is ready. The child has to want it. If he is ready to be dry, he will work very hard with the alarm.”
The success rate of wetness alarms is excellent – provided the child wakes up to the alarm. In fact, 75 percent of children in three weeks manage to respond to the alarm and wake up as they are wetting or right before they wet, and then they sleep through the night.
“They begin to wake up on their own to go to the bathroom,” says Dr. Khoury. “I tell parents to keep putting the alarm on for six months past the child’s last wet night.”
Parents can tell their child is motivated to stay dry if he starts to notice that he is wet in the morning and doesn’t like it, if he says he doesn’t want to wear potty training pants anymore, and if he avoids sleepovers he wants to attend.
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CHOC Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2023-24 Best Children’s Hospitals rankings and ranked in the urology specialty.