Behavior modification simply means that you train your child or teach your child to wake up in time to go to the bathroom. Behavior modification is considered the most effective way to help a child with bedwetting, as it actually teaches a child to wake up “in time” rather than just treating the symptoms of bedwetting.
Parents should not take “behavior modification” to mean that bedwetting is a behavioral problem that needs rigorous correction to fix. Nothing could be further from the truth. Rather, behavior modification works more by teaching your child the nighttime bladder control that most children learn sooner or later. There are many types of behavior modification tips that have been proven effective in helping children overcome bedwetting:
Discipline Will Not Work
Many years ago, it was thought that children who wet the bed were simply poorly taught, were developmentally delayed (or otherwise “abnormal”) or just needed more discipline. Even though most parents know better today, many still look at bedwetting as a way of “acting out.”
It is important not to discipline your child for wetting the bed. This method not only does not work, but the stress of the discipline may make the problem worse. No child wants to wet the bed after everyone else can stay “dry” for the night. The child who has a hard time not wetting the bed needs sympathy and help, not discipline.
Offer Positive Reinforcement and Praise
When your child makes it through nights without wetting the bed, be sure to offer praise. Not only will this help the child if he or she feels bad when accidents happen, but it will subconsciously motivate your child to continue trying to correct the problem as well. A system as simple as offering gold stars is effective. A week that is dry should be given a slightly larger treat.
You can also use a points system. Have each star or dry night count for a point. When your child reaches three points, allow him or her to have a small treat. Five points can mean a very small gift. Ten points can mean a trip someplace fun, and so on. Keep points posted where they are visible. The excitement generated by this system will encourage your child to keep trying and press on.
Give your child hope that the problem is not forever
If your child seems to be doing better, remind him or her again that most people overcome bedwetting with time and notice that their situation seems to improving itself.
A child who does not believe that the problem will improve will simply have a harder time with the problem and for such a child the problem will seem larger and more dire than it really is. Help your child see that bedwetting will be resolved and your child will be calmer, happier, and so more able to work with you to get help for Enuresis.
Focus on Normal Bladder Control
Most children who wet the bed have trouble at night. However, a small percentage of children have overactive bladders, which means that they frequently have to go to the bathroom and may even have a hard time controlling their bladder during the daytime. If this describes your child, take him or her to a doctor or urologist to see what treatments are available for your child’s overactive bladder.
If your child only has trouble with control over the night, then it may be a good idea to focus on the fact that your child does do well in going to the bathroom during the day. Offer your child encouragement by pointing out that he or she can make it to the bathroom during the day and reassure your child that most people learn to control as well in the night, as well.
Night lifting is a technique that requires the parent to wake up the child in the night. Most children lose control of their bladder at a similar time each night (this is especially true if the child follows the same routine each day). If you can note when each accident occurs, you can set your alarm before this time, wake your child up, and lead them to the bathroom.
You can also try waking yourself and your child up twice a night. In many cases, this helps the child wake dry and encourages the child to keep trying to wake up before they are woken up. However, children may resist waking up in the night, especially if they are tired.
Bladder Control Exercises
Your doctor may prescribe exercises for your child to help him or her control their bladder more effectively. Some patients with Enuresis benefit from holding their urine as long as possible before releasing. The idea is to keep repeating these exercises in order to help the body develop more control.
- Have your child tell you when he or she has to “go” during the day.
- Explain to your child that you are doing an exercise to help him or her stay dry at night. Have the child hold the urine.
- Have your child go to the washroom
- Repeat daily, slowly increasing the amount of time you make your child wait
Urination control exercise
Some doctors find that helping the child control urination helps control the urinary sphincter, or the muscle that holds back or releases urine. This exercise is often used in conjunction with the bladder control exercise and is completely safe.
- When your child urinates, have your child stop urinating “mid-stream” – that is, have your child start urinating and then stop by squeezing the muscles (urinary sphincter) that control the flow of urine.
- Have your child start-stop three times.
- Repeat process during each bathroom visit.
Some parents find the two exercises above useful. The idea is that the child will control the bladder more effectively during the day, causing the control to be present at night, as well.
In general, these exercises work best with children over the age of six years and those who are willing to work hard to control their bladder. Some small improvement should be visible in about two weeks.
Visualization is a behavior modification tool that has proven effective in helping people accomplish many things, from waking up without an alarm to quitting smoking. You can use the same technique to help your child overcome bedwetting:
- To begin, have your child relax and close their eyes. You should be in a quiet and comfortable room that has few distractions. Your child should be sitting down or lying down. Have your child breathe deeply and relax.
- Now, have your child imagine sleeping in their regular bed and in their regular sleep wear.
- Next, have then imagine having to go to the washroom. Your child should really imagine the pressure of having to urinate. Ask your child to imagine what it feels like to have to “go” during the day and have your child imagine that same feeling as vividly as possible in their imagining of the sleep.
- Now, have your child imagine waking up and going to the washroom.
Have your child imagine this several times over a period of time. People who use visualization sometimes practice seeing a goal several times a day for weeks. Experts think that visualization works by having the body imagine how things are to be done so precisely and intensely that the body actually accepts the mind’s visual clues as reality.
The body actually believes what has been visualized is real. If your child imagines waking up in time to go to the bathroom, then, he or she will have set a sort or emotional and mental precedent for doing so in reality. Visualization is especially effective with older children and can be used with other behavior modification techniques. It is very safe and will generally show results in about two weeks.
Avoid lots of fluids before bed
It is important to keep your child hydrated. Drinking enough water helps the body function properly and helps keep the kidneys healthy. However, encouraging your child to drink most of his or her water intake earlier in the day so that less water is drunk in the hour or two before bedtime can help ensure that the body does not produce lots of urine at night.
Remember, though: Encourage your child to drink more fluids, not less, even if it does mean some wet nights. Drinking fluids helps the bladder and kidney function well, which will help ensure dry nights in the long run. Dehydration and lack of fluids will not solve anything, and may make the problem worse as people with smaller bladder retention have a harder time staying dry at night.
Watch what fluids your child drinks
Some fluids cause more problems that others. While your child is trying to overcome bedwetting, it is often best to stick with water. Colas, dark teas, and coffee all contain caffeine that irritates the bladder and also may increase the urgency to urinate more frequently. If your child is older, alcohol may also affect bedwetting by ensuring that motor controls (needed to wake up) are affected while the need to urinate is increased.
Apple juice also seems to cause increased urine in some children, thanks to the two substances, patulin and gallic acid, that it contains. Encourage your child to eat apples during the day, but do not serve apple juice or applesauce in the evenings.
Watch what your child consumes
Some parents have also found that sugary foods, carbonated drinks, milk, yellow cheese and other products containing these foods. Try cutting specific foods from your child’s diet for a while to see whether these foods have any effect on bedwetting. Monitor what your child eats before bedtime closely and eliminate any foods that seem to contribute to bedwetting, or at least limit these foods to morning.
Remember: When limiting specific foods, take great care to ensure that you child eats a balanced diet that still includes plenty of foods from each food group. Bedwetting is a minor problem compared to vitamin deficiency.
Night trips to the bathroom.
Encourage your child to go to the bathroom before sleep. You can even wake him or her up when you go to sleep so that he or she can urinate again. This gets rid of the urine in the bladder, reducing the chances that the bladder will be left with enough urine to vacate in the night again. Even if your child wets the bed, the amount of wetness will be reduced. Some parents also find that this technique alone is enough to help bedwetting. Even if it is not, it is a safe method that can be used with other remedies.
Wake up alarm
For many children who wet the bed, the problem comes from the fact that the bladder simply does not communicate well with the body. For most of us, when we have to urinate during sleep, our body wakes us up and we can head to the bathroom before returning to bed. For children with Enuresis, this system does not work. In addition, many children who wet the bed are also very heavy sleepers. Basically, the bladder empties itself since the body does not wake up to allow the child to go to the bathroom. In some cases, the child might not even notice the problem until they wake up the next morning.
There are a number of alarms on the market that your child can wear. These emit a noise when moisture is detected. They will wake your child up, allowing him or her to go to the bathroom. Even if your child is a very heavy sleeper and will not wake up, the alarm can wake up the rest of the household, so that you can wake your child up. The idea behind this device is that the child will eventually learn to wake him or herself after being woken up by the alarm several times. Some improvement will usually be seen in about two weeks.