Dr. Sagie’s Bedwetting Blog

“My son, age 11, has bedwetting issues. He really wants to go to summer camp with his friends for 2 weeks and is begging me to let him. His friends don’t know about his problem. I can only imagine the implications when he will have accidents in camp and the boys in his bunk will find out about it; he will be so miserable.  How can I expect him to stay home when his friends are having so much fun? I’m at a loss. Please help.”

This request is just one of the many that I routinely receive on my bedwetting forums and my website from desperate and perplexed parents worldwide. Their questions cover all aspects of bedwetting: causes, parents’ mistakes, treatment, and more, but questions regarding sleeping away from home are quite frequent. As children get older, this issue becomes more unmanageable and unbearable. To avoid revealing his bedwetting issue, the child is forced to lie to his friends about why he can’t sleep over, and doing this certainly affects his social life and self-esteem.

One of my ex-patients, a 9-year-old girl, slept over at her best friend’s house and wet the bed. A few months later, the two girls got into a fight, and the friend told her classmates that the other girl wets the bed. In no time, every child in her school knew about her bedwetting issue, and they made fun of her and mocked her. She was so miserable and upset that her parents were forced to move her to another school far away.

Another ex-patient, a 16-year-old boy, was a Scouts group leader. He and his troop had to participate in an outdoor camping trip that required using a sleeping bag for three nights in the field. As a group leader, he obviously couldn’t excuse himself from this sleepover. Unfortunately, he had an accident in the sleeping bag. To conceal it, he poured a bottle of water over it to make it seem like that was a source of the wetness.

Bedwetting affects a child’s quality of life in a great many ways. The child is very disturbed by being unable to control his body while he is asleep. He is afraid that his friends will find out about it and make fun of him. It affects his self-esteem and self-confidence, but the primary problem of being a bedwetter is the difficulty he faces when he wants to sleep at a friend’s house, go to summer camp, or even sleep at a hotel. During adolescence and adulthood, this problem makes it difficult for the bedwetter to develop a relationship with a partner.

The simplest, obvious, and most logical solution to this problem will be to treat bedwetting, which will make this matter a nonissue.  Millions of children suffer from the problems caused by bedwetting and need help.

How To Help?

When parents are thinking of allowing their bedwetting child to sleep away, the following points have to be considered: the child’s age, how often the child has accidents (provided the parents do not wake the child at night and take them to the bathroom and that no fluid restriction is applied before bedtime), how long the sleepover will be, the sleep venue, and the parents’ presence there. All these points are significant.

Based on these parameters, the parents have a few options:

Forbid the child to sleep over: Parents are in a difficult situation here; on the one hand, they do not want to disrupt their child’s social life, but on the other hand, they want to avoid a very unpleasant situation should bedwetting occur. Parents should consider the chances of a wet night based on the above points and past experience.

Waking the child and taking them to the bathroom: This solution can be considered when the parent is present or if another adult can be asked to do so. This solution will reduce the chances of bedwetting but can’t ensure that accidents will not happen, especially when the initial bedwetting frequency is very high. It is advised to send a plastic sheet cover and even extra linen when the child sleeps away. This solution is not suitable, though, for adolescents. In this case, the parents should be told about the bedwetting issue and asked for their consent.

Using medication: In most cases, using medications to treat bedwetting doesn’t cure the problem. One very common medication, DDAVP (Minirin), is able to reduce urine production during sleep and consequently lessens the chance of bedwetting. This solution, though, does not ensure complete dryness. Some children respond positively to Minirin, but before this solution is used, they should try the drug in order to assess their response and determine the appropriate dosage. You should always consult your doctor before using Minirin. A friend of mine who is a camp director in Los Angeles told me that the fridge in the camp’s clinic was always full with bottles of DDAVP (at that time, Minirin was administrated by nasal spray that had to be kept in a fridge). When Minirin is stopped, the relapse rate ranges from 60 to 90 percent. Parents should also be aware of the possible side effects of the drug. The child should be restricted from fluid consumption before bedtime; otherwise, he might develop water intoxication because the amount of salt in the body has been reduced.

Using pull-ups: Under normal circumstances, I’m totally against using pull-ups. It is OK when they are used with children ages four and five, but it is a big mistake to use them with older children. It suppresses any motivation to become dry; the message delivered by the parents is that they anticipate their child will wet the bed, and that they do not expect their child will be able to handle the problem. Instead of coping with bedwetting, they perpetuate it. There is no learning process. As their child grows older, it might lead to low self-esteem, low self-confidence, and additional emotional problems that could be avoided.  Having said that, when a sleepover is being considered, it is the best solution. The child is able to hide his problem, and it gives him peace of mind. Pull-ups are the only 100% insurance policy solution. All other solutions can reduce bedwetting but can’t ensure 100% dryness. Using pull-ups will certainly not prevent bedwetting, but it can be concealed if it should happen.

Some children, particularly teenagers, have low and unstable bedwetting frequency, but even if they wet once a month, they still rightly fear sleeping over should it happen to them on that particular night.

For two reasons, the chance that they will wet the bed is very slim, since the depth of sleep is affected and becomes shallower when we sleep away:

  1. We sleep best in our own bed.
  2. The fear of a wet night causes us to be alerted during sleep.

Some of my patients have told me that during the three nights of sleep away at a camp, they manage to be dry, but they wet the bed at home the first night after they return.

To sum up, all the tools mentioned above can help children ease their situation, but they are certainly not a solution, and parents should seek professional treatment.

When my patients outgrow bedwetting and then sleep over, for them, it’s a “practical test” that shows they have overcome the problem. It makes them feel confident about being able to stay dry.

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