Bed wetting a secret situation

By Jomay Steen, Journal staff | Wednesday, March 26, 2008

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Family physician Nancy Babbitt of Rapid City compares bed wetting in children to stubbing your toe. It’s involuntary, an accident and no one should be embarrassed or suffer recriminations because of it. “It happens for no good reason,” she said.

According to the American Family Physician Web site at www.aafp.org/afp/20030401, as many as 7 million children in America wet the bed at night. It happens three times more often in boys than in girls. It is a common problem in children.

Another name for bed wetting is nocturnal enuresis. Children are not considered to have this problem unless they are at least 5 years old and still wet the bed at least two times a month.

But for two families, this phase of childhood is recalled as a stressful time for both children and parents.

Virginia Gerbracht of Faith struggled for more than a decade to end bed wetting in one of her three children.

“It was very stressful. I thought it would go away, that it was a phase,” she said.

As the bed wetting continued, Gerbracht said they prevented the child from drinking all liquids after 6 p.m., set an alarm to wake the child up two hours after bedtime and kept the child on a bathroom schedule, but the problem continued.

At age 12, the Gerbrachts took their child to the doctor, who discovered delayed muscle development. A set of muscle-strengthening exercises eventually cleared up the nocturnal enuresis.

“It turned out to be a more serious problem than we realized,” Gerbracht said.

Now a grandmother, she said this isn’t a topic she generally discusses with her family or friends. But she sees the importance of educating the public about this common childhood occurrence.

“I couldn’t imagine what feeling and emotions he was going through,” she said of her child’s experience of shame and lack of control.

“People need to be educated,” she said.

Under pressure from peers, Lou Ann Steen of Faith began training her children to use the bathroom as early as 18 months. In retrospect, she

realizes that she may have forced her three children to begin training much too soon.

“They weren’t ready to be potty trained,” she said.

One child struggled with bed wetting for about four years before the problem righted itself. Steen took one of her children to the doctor at age 3, discovering a medical problem. By age 4, the bed wetting had stopped entirely.

“I never talked about (my children’s bed wetting) with my colleagues,” Steen said.

Any information she received about the problem came from parenting magazines.

“Yes, there is a stigma to this and it feels like it reflects upon you as a mother,” she said.

Babbitt agrees with those observations, saying many of the parents of the children she treats are surprised to find out that the problem is common.

It occurs in 15 to 25 percent of all 5-year-olds, dissipating as a child matures, she said.

“It occurs in 8 percent of all 12-year-olds, but is more prevalent in boys than girls,” Babbitt said.

According to sleep studies, Babbitt said that there is no difference between sleep patterns of children who wet the bed and their siblings who do not. It also is not a behavioral problem on the child’s part. He or she is not acting out; it is an involuntary act, she said.

“There is a genetic disposition of a parent or relatives that were bed wetters as children,” she said.

No one understands the causes of the true nighttime bed wetter, she said. Parents often bring their 5-year-old children to the office, but patients as old as 18 have turned up with the problem. The next time parents will intervene is when their children are at age 7 or 8, when classmates start having sleepovers.

After a physical exam and if the child is healthy, she recommends a bed-wetting alarm. Attached to a sheet, the machine will sound an alarm as the child begins to void his or her bladder, waking the child, and possibly the entire household, from sleep. In 75 percent of the cases, the machine completely trains the child. It has a relapse rate of only 41 percent.

“We’re not sure why the alarm works as well as it does. But it makes a connection between the brain and the bladder,” Babbitt said.

Tips, along with patience, will help

By Jomay Steen, Journal staff

Along with using the bathroom before going to bed and consuming much less fluid during the late afternoon and evening, Dr. Nancy Babbitt of Creekside Family Practice offers some suggestions to new parents who may be going through a child’s bed-wetting experience. She discourages parents from reprimanding or humiliating their children for this involuntary problem. “There’s a stigma attached to nighttime bed wetting, but it’s a common problem,” she said.

* Avoid potty training your child too soon; wait until the child reaches the ages of 2 to 2-1/2 years old for girls and 3 to 3-1/2 years old for boys.

* Talk to family members to discover if parents, siblings, grandparents or any relatives were bed wetters; they may help clear up the matter.

* Realize that this is a common childhood problem.

* At age 5, see a family physician to rule out any allergies or health-related illnesses.

* Chart and give positive rewards such as stickers to the child on the nights he or she is dry.

* Assign age-appropriate chores for the consequences of bed wetting, asking younger children to strip wet linens from the bed, or older children to help do the laundry.

* Try hypnosis, biofeedback or acupuncture

* Schedule night-time awakenings.

* Restrict caffeine.

* Check out and use a bed-wetting alarm system, like those found at pottystore.com.

These remedies may all help, but all it may take is time, Babbitt said.

“Patience is the best cure,” she said.

Contact Jomay Steen at 394-8418 or jomay.steen@rapidcityjournal.com.