Tinkle Tinkle Little Star… What to do about bedwetting

Amongst the many things I didn’t like about summer camp, being on the bottom bunk below a bed-wetter compromised even the would-be refuge of sleep.  Yet despite fearing that it would leak through the half-inch of a sorry mattress and rain on me, I still felt compassion for the poor fellow-eight-year-old treading up the hill with his soiled sheets every summer morning for the long two months.  I also admired that kid for being willing to go to summer camp with enuresis (although it’s possible that he didn’t want to go any more than I did).

Enuresis (doctor-speak for peeing in bed) is generally considered an issue after five or six years old if the bedwetting happens more than a couple of times per month.  While the experts do not suggest doing nothing at all about it, enuresis almost always takes care of itself over time.

My key voice here is not to advise but to encourage, to give info and provoke thoughtfulness so that parents will trust their own instincts, and also find pleasure and a sense of right-path through whatever is on their plates.

Parenting demands that we connect with our kids, it nourishes us by getting us to engage; talking and thinking about parenting is a way for parents and non-“parents” alike to connect, to discover a shifting and widening sense of respectful and interconnected community.  Even if we don’t have kids, or if our kids don’t pee in their beds, we can still realize that in reading these words we subtly link with those who do care about this issue today, sending compassion and deepening connections that may not be obvious or tangible.  And in being compassionate about those who can’t hold their urine all night, we might heal around the things we have trouble holding, be it anxiety, sadness, loneliness or anger.

As I see it, the main concerns with bedwetting have to do with kids feeling badly about themselves and about parents getting over-concerned or frustrated.  While there can be an emotional aspect to bedwetting, particularly if it is secondary enuresis, meaning a relapse to wetting the bed after six months or more of dry nights, most bedwetting is about normal development taking its own wise time.

Some of the primary causes of enuresis include heredity, which would relate to the whole concept of late blooming in general, co-mingled with having a bladder that is still too small to make it all night, and also being such a deep sleeper that a child is hard to wake, and thus has trouble waking up to pee at night.

If your kid is struggling with bedwetting, a consult with the pediatrician is an important first step just to rule out a urinary infection or other physical problems.  Secondly, it’s important to keep in mind that kids who pee in bed at night are not lazy or deliberately acting out, they cannot help it.  It is a drag to have to wash urine-soaked sheets morning after morning, but we want to avoid shaming children about anything, particularly about an inability to develop faster than their bodies are ready and able to achieve.

As parents we need to particularly guard against interpreting bedwetting as some sort of insult toward us (kids are not like dogs marking their territory, and bedwetting is pretty much not about us parents).  From the yoga point of view, we might dedicate the washing of sheets and the learning of non-judgment and patience to our children’s well-being.  If you are in a wet-sheet patch take it from parents further down the childcare trail, this will pass soon and you’ll hardly remember it was ever front and center.

The pediatrician can guide you toward intervention options; the key standard treatments are medicines (to help reduce peeing during sleep) and an alarm that is triggered by wetness.  The problem with alarms is that they may well wake the parents before they wake the kid (so think about if messed up sleep is more of an issue than extra laundry).  Used together, very good results can be had with alarms and meds, but sometimes it is also okay to be patient and let things take care of themselves.

In addition to parent laundry responsibilities, other chief downsides of enuresis are the inhibition from sleepovers, and also embarrassment and downward pressure potentially on self-esteem.  It is important to normalize bedwetting, and also to attune to your child’s level of distress (or notice that they may not be particularly distressed).

It’s good practice to limit drinking liquids after dinner (but not being draconian about it) and to be sure children pee right before sleep.  Something I think is worth a try is to talk to your kid before bed, crafting visualizations where your child imagines either waking up when they need to pee, and/or holding it through the night.

Using playful imagination, perhaps you could suggest that your child imagine that he or she is a camel, walking across a desert—going a long way while holding onto water in its hump.  Encourage your child to visualize waking up dry, like a camel that made it across the vast dry journey.  Mix it up; use your child’s favorite animals and/or characters to make up scenarios of success (either waking up to pee in the night, or staying asleep all night while holding it).

Tactically, you might consider tallying dry nights and rewarding your kid with a toy or treat they earn for some predetermined number of successes.  Also, you don’t want to make a big deal about wetting the bed—and you can very matter of factly teach your child to just strip the sheets and take them near the laundry; in this way they have mild motivation not to wet the bed (and thus deal with the chore), but also feel that they are pitching in around the house in partially looking after their own selves and their messes.

Finally, if you do have reason to suspect that your child’s bedwetting could be an emotional regression, and/or symptom of anxiety or hurt of some kind, you want to invite your child to talk about whatever might be on their minds—seeking help on their behalf with a counselor of your own, or sending the child to a therapist more directly if you feel it could be useful.  If there is a hurt or threat, it is the conscious parent who must face this and find the courage to do what’s needed to protect a child.  If you can’t tell if things are your fault or not, talking to a therapist can be a profound way to help your child.

So, let’s dedicate today to compassion and patience—for ourselves and our children, around anything from enuresis to older kids who may have dry nights and yet still seem to be chronically pissed off about something, to ourselves who may be that same way—working toward insight, inter-connection and organically natural development in the service of all our collective children.

Namaste, Bruce


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