When should my child start bedwetting therapy?

When parents consider if and when they should seek treatment for their enuretic child, they should take into consideration some parameters and conditions:

🟦 Child’s age: four years old and up.

🟦 Maturity: Children four to five years old who are mature for their age and able to understand and concentrate on simple tasks.

🟦 Motivation: Children are disturbed by being bedwetters. They are sad when they wake up wet and happy when they are dry. They express their desire to stop bedwetting but sometimes don’t express their distress verbally, and parents shouldn’t assume that they are apathetic to the problem.

🟦 Unstable bedwetting frequency: For some children, bedwetting frequency is inconsistent and changes from time to time. Those are the most difficult cases for treatment due to the instability of the phenomena. It is recommended to start treatment when frequency increases.

🟦 Seasonal bedwetting: Some children are dry or almost dry during summer and wet during winter. It is recommended to begin treatment immediately after autumn.

🟦 Parents’ readiness: Parents have a crucial role in the treatment process and should be ready to invest time and effort. For example: to wake up during the night, to supervise the daily tasks (exercises), positive reinforcements and more. Treatment can fail due to parents’ lack of readiness.

🟦 Causes of bedwetting: Behavioral treatment should not be considered when there is a medical problem related to enuresis, such as permanent urinary tract infections; frequent epileptic seizures; problems related to the spinal cord, such as spina bifida; and more.

🟥 Behavioral treatment should not be considered when the child is suffering from emotional stress or has psychological problems as a result of acute trauma (loss of a close relative; exposure to a threatening event, such as physical or sexual abuse; involvement in a car accident; violence within the family; conflicts between the parents; and more). In these cases, enuresis should not be treated, and treatment should be focused on the causes rather than the enuretic symptom.

Some parents look at bedwetting as a personal failure and are highly motivated to treat the child even if the child is not ready yet and is not troubled by the problem. An attempt to force treatment in such cases might create unnecessary tension between the child and the parents, and the treatment will end in failure.

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