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Brian A. Roelof, M.D. Bedwetting often becomes a source of conflict in families. Parents will vent their frustration at wet beds by saying all sorts of statements that really don't address the real cause of the problem. "You were dry at grandmas - why can't you be dry at home." "You're just too lazy to get up", or, "We didn't give you hardly any water last night, so why did you have to wet?" Misunderstandings about causes and cures for bedwetting problems also can form tension between parents themselves. One parent may not know how hard the child is trying, and just want to exert more discipline-all to no avail! Years and years often go by with constant daily washing, smelly beds, and extra morning bathing. Nothing seems to work. Books on bedwetting, setting alarm clocks at night, fluid restriction, scolding, pleading, offering rewards, - everything seems to fail for years on end! Parents are understandably frustrated. Children also go through their own form of grief with the bedwetting issue. Children really like to please their parents, and feel immensely disappointed when there is nothing they can do to be "good", - no matter how hard they try. Well intentioned, parents often devise reward programs that actually leave the child with even lower self-esteem, - when none of these attempts ever really work. Caught in an impossible circle of events, children are often left helplessly confused, not knowing what to do. An additional problem that children must go through is teasing by siblings and friends. Sometimes this is so feared that children end up refusing to go to normal childhood functions such as sleepovers, or campouts, for fear of discovery and ridicule. Child psychologists have written much about the devastating effects that can happen to childhood development if that person ever becomes singled out as a "victim" or target of being made fun-of. Unfortunately, children at this age can sometimes be very cruel. It's amazing that despite all this grief, the bedwetting child still will often say, "Naw, - it doesn't bother me that much - it's no big deal." What needs to keep this cycle of frustration from continuing, is to educate parents on what really causes bedwetting, and to recommend the tools that will really solve the problem. Most nighttime accidents simply come from the fact that the child is not able to adequately sense, or control bladder fullness from the sleep-pattern. Once parents understand this, it becomes easier for them to understand why none of their "tactics" have worked in the past. Children simply cannot respond to something they cannot feel or sense. It is doubly important for parents to know the true success rates of different treatments. People have been trying to solve the problem of bedwetting ever since children started sleeping in beds, - and some very odd approaches have been developed. Remember, each year 16 percent of all bed wetters stop wetting, all on their own. Whatever a parent happens to be doing when the child spontaneously stops wetting, is quickly identified as "the cure" - especially if it was recommended by someone in a position of authority. Parent confusion is predictable, given the variety of treatments touted for enuresis. There seem to be a thousand different "remedies", and each carries the endorsement of someone who swears that it cured his or her child. The very first known writings on childhood diseases, written about 1550 B.C., certified that a mixture of one juniper berry and one leaf of cypress in a glass of beer would cure enuresis. In the first century, A.D., Pliny the Elder wrote that bedwetting could be cured by giving the children boiled mice in their food. In America, some Native American groups are said to have had the enuretic child stand naked with his legs spread over the burning nest of a Phoebe bird. Other attempts at cure have included prayer, a diet of ground hedgehogs, and the exorcism of evil spirits. Some "cures" have been cruel or even dangerous. In the nineteenth century, a wide variety of treatments emerged as the sons of British middle class went off to boarding schools where wet sheets were not tolerated. All sorts of wraps and bandages were applied to the penis - until reports of gangrene ended the practice. The most common folk approach is forcing the child to stop drinking after a certain time in the evening. Although this makes intuitive sense, it simply doesn't work. The kidneys must continue to produce urine as they clean the blood. This process does not stop if one skips the bedtime drink. The body is 90% water, and if the child does not drink, the body will draw the needed fluid from its own tissues. Whatever therapy is in current vogue will often be cited as a cure for enuresis. Nutritionally oriented parents have been told that their child will be cured by eating pumpkin seeds or B vitamins. In the 1980's, L-tryptophan an amino acid found in milk, was frequently prescribed by the staff of health food stores. Another herbal remedy, still fairly common, is a pill containing minute amounts of belladonna. Only scientific research, conducted on large groups of children, can identify the truly effective interventions. Virtually any of these treatments listed above might eventually be shown helpful but none of them have been studied scientifically. |
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