Washington – To help a 7- year-old overcome bed-wetting, Dr. Howard Bennett reaches for red water balloons and a superhero named Bladderman.
Bed-wetting is a problem for more than 5 million U.S. children age 6 or older. Alarms and medicines are available, but understanding how their bodies work for many kids is key to staying dry – instruction that’s a challenge to work into the typical rushed visit to the doctor.
Enter Bladderman, Bennett’s creation and hero of the first book published by the American Academy of Pediatrics aimed directly at children, not just their parents.
The goal: To demystify bed- wetting so that children understand accidents aren’t their fault – it’s not a matter of willpower but of biology – and to outline research-backed steps they can take to help stay dry.
Bed-wetting “is common. You can ask for help,” says Bennett, author of “Waking Up Dry” and a Washington pediatrician who specializes in treating what doctors call nocturnal enuresis.
Bed-wetting is hard on youngsters’ self-esteem. They may decline sleepovers or dread camp, or devise elaborate schemes, such as doing their own laundry, to hide the problem.
Children usually get nighttime bladder control between ages 3 and 5. The brain and bladder must learn to work together: First, the bladder signals the brain that it’s filling. The brain then either signals back for the bladder to relax and hold more urine overnight, or signals the child to awaken.
Occasionally, medical problems such as diabetes or anatomical abnormalities cause bed-wetting. But 85 percent of the time, it’s because the brain-bladder maturation isn’t finished.
Three main reasons:
While people’s bladders are all about the same size, some sense that it’s full sooner than it really is. Bennett calls this a “small functional bladder.”
Some kids don’t produce enough of a hormone called vasopressin that signals the kidneys to make less urine at night.
Some children are difficult to arouse at night and sleep through the sensations of a full bladder.
Boys are twice as likely as girls to experience delays in nighttime bladder control, and bed- wetting tends to run in families; whatever age mom or dad became dry usually is the age their own children will.
The good news – 15 percent of bed-wetters become dry each year without any intervention.
For children who don’t want to wait it out, Bennet has a number of suggestions: Exercise the urine sphincter by squeezing it several times a day.
Limit liquid near bedtime, but drink two extra glasses of water earlier in the day to exercise your bladder. “We think if you pay attention to your bladder in the daytime, you’ll pay more attention at night,” he explains.
Kids should chart on a calendar how often they wet. Once they’re dry for 14 consecutive nights, bed-wetting probably is over.
Tell kids it takes practice to achieve bladder control, just like sports stars practice their jobs daily and offer small weekly rewards for the effort whether they stay dry or not, advice that mothers of two of Bennett’s patients called key to maintaining children’s enthusiasm.
Humor, Bennett says, also eases kids’ anxiety so they can learn: He regularly gets splashed as he uses water balloons to show his patients how the bladder’s door, the sphincter muscle, controls urination.
