(Do you need the Spring Ahead printout? Here it is: Spring Ahead printout.)
I have felt almost FRANTIC to talk to you lately. Nearly every day for what feels like FOREVER there’s been SOMETHING that makes it difficult or impossible. One thing is that I had a burst of anxiety-fueled bravery and made a bunch of appointments that needed to be made (nothing interesting: things like Rob’s wisdom tooth evaluation and Edward’s vision exam), so it seems I am always sitting in one waiting room or another. Another thing is that the kids, one after another, got sick—a mild illness, but with a fever so they couldn’t go to school. (They rejoiced. That is the BEST kind of illness: when you’re sick enough to stay home, but not too sick to play video games.) (Now I’m having a flashback to a Peanuts comic strip that said the same thing, but about being not too sick to watch television. A child, probably Charlie Brown, was in bed with the television on his stomach, which bothered me a little as a child. Seemed uncomfortable/impractical.)
Anyway, with all that pent-up talking to do, it may be a little surprising that today’s topic is bed-wetting. Specifically, bed-wetting that happens in late childhood, or into adolescence.
I am going to talk very GENERALLY about this topic. I wasn’t sure I could discuss it at all, but it seems to me it falls into that category of Parenting Topics that Get Sorely and Sadly Neglected Online. If I want empathy and ideas about potty-training a toddler, I can find ENDLESS discussion on ENDLESS blogs. If I’m worried and frustrated about a early elementary-school-aged child who is still wetting the bed at night, I can find plenty of companionship and know I’m not the only one handling it. But when kids get older, we get understandably squirrelly about discussing their personal and potentially embarrassing issues. Which leaves us all stranded, feeling like we’re the only ones going through all these things. That’s not good either.
So here is the thing. I have access to some information on a topic that I think falls into that category of topics that parents shouldn’t need to feel stranded about. Who even knows WHY I have this information? It could be because I’m parenting a kid with this issue; it could be because it was something I personally dealt with as a child; it could be that a friend is going through it with her kid; it could be that I have been trying to get out and about more and so I attended an informational talk at the library; it could be that a book on the topic caught my eye; it could be that I have a friend who works in an office that deals with this issue. Whatever the reason, I have some information, from a doctor who treats this issue. And here it is:
1. Later bed-wetting is much more common than you’d think. (Unless you already knew it was this common. In which case it’s as common as you’d think.) This is another of the downfalls of not talking about it: it feels RARE, when actually it is not at all rare. Kids who have it tend not to discuss it. They tend not to go to camps or other places where it would be discovered, especially when they’re too big to wear pull-ups. Their parents tend not to discuss it.
2. It doesn’t have anything to do with potty-training. That is, many parents think they screwed up the potty-training and that’s why the child is still wet at night. Maybe they should have been stricter, tried harder, been less laid-back about it, started earlier/later, used a different training philosophy. But no, that is not why it happened.
3. It isn’t yet certain why it DOES happen. There seems to be a large genetic component: if one parent has some family history of later-childhood bed-wetting, the children have a 40% chance of having that issue; if both parents have some family history, the chance goes to 80%. But because of the aforementioned “not talking about it” thing (an even bigger issue in families than in blogging), people may not know they have a family history. It’s understandable if no one told you your cousin or grandpa or uncle wet the bed until age 16.
4. Another likely contributor is the thingie that makes the hormone that stops people from peeing in their sleep. It’s supposed to kick in during the potty-training years, but it doesn’t always, or doesn’t always make enough of the hormone. If it doesn’t, that is a SIGNIFICANT LIKELY CONTRIBUTING FACTOR, as you might guess.
5. Another possible contributor is constipation. The doctor said about 50% of his patients have it, and about 95% think they don’t have it; it’s not always obvious, if it’s not causing discomfort. The bowel presses on the bladder and also causes muscle contractions; during the day, it’s not an issue, but at night it is.
6. Many people think a contributor is deep sleep, and almost all parents report that the child is a deep sleeper and has trouble waking up. But it’s not a likely factor: in a room of sleeping children, half bed-wetters and half not, attempting to wake them up wouldn’t give you information about which of them were the bed-wetters. However, there DOES seem to be a correlation between a certain KIND of sleep and bed-wetting: the same kind of sleep that leads people to sleepwalk, talk in their sleep, turn off their alarms in their sleep, etc. That kind of sleep activity indicates that the “You are asleep, so don’t move or do anything” situation is inadequate covered.
7. MOST cases resolve in adolescence: a big batch at around 11-12, and another big batch at around 16. Something about puberty seems to reset the brain for most people. If adolescence doesn’t do it, college usually does. It’s possible that the change in schedule/circumstances contributes. Or maybe it’s just that some people have a little more adolescencing to do, and this is when it happens, and then the brain gets reset and everything’s okay.
8. Almost never is anything WRONG. That is, if you are worried that the kidneys are deformed or there’s something wrong with the bladder or whatever, that’s generally not a concern if the accidental wetting is only at night and if the daytime peeing seems normal in other ways. If it’s only at night (and has ALWAYS been that way—that is, it’s not that the child was night-trained but then started wetting again), it’s usually that hormone thing, or constipation, or an unknown-but-self-resolving delay.
9. Almost never does it Not Go Away by adulthood. It DOES go away. Like teething and colic and everything else that seems like it’ll never go away.
10. Suggested treatment is going to vary depending on the person/situation/doctor. The doctor I encountered is not keen on medication in general, but approves of desmopressin for situations where he thinks the likely cause is lack-of-hormone as opposed to constipation or some other unknown delay; it can be used even long-term, and then discontinued when no longer needed. (If he thinks the likely cause is constipation, he instead begins by treating that.) Other possible tools are hypnotism and guided thinking (“Imagine an alarm clock attached to your bladder”), acupuncture, bladder-stretching exercises (drinking more water and waiting longer to pee); there are also more medications to try.
11. It’s not anyone’s fault. It just happens to some people for some reason, and there are things that can be done to improve the situation.