Many families have similar concerns.  After adjusting to the new school schedule for six weeks or so, this should be a fine time to begin using an alarm.  Having a regular nighttime routine, as most families do during the school year, is good when beginning alarm use.  You could start the alarm on a Friday night or over a long weekend so you can see what his initial response will be.  Even though his sleep will be interrupted by the alarm when the wetting occurs, most children go back to sleep immediately after getting up to go to the bathroom.  Many have little memory of this in the morning.  Using the waterproof mattress overlays (that come in the Starter Kit or can be purchased separately) on top of his sheet make middle of the night clean-up very easy and quick.  Because the alarm goes off only when his bladder needs to empty, it’s actually less tiring than setting an alarm clock or parents walking their child to the bathroom.

The parents are the ones who may feel a little sleep deprived during this initial phase.  Because your son may need your assistance, you should respond when the alarm sounds.  Insuring that he responds correctly by getting out of bed after turning off the alarm helps him to make faster progress.  Once he can do this independently, you no longer have to respond.  Some parents find that it can be difficult to go back to sleep.  Knowing that the worst will be over in two or three weeks is helpful.  Some parents take turns getting up to the alarm or alternate nights.

Getting to bed on time and being well rested is as important for doing well in school as it is for learning to become dry in the nighttime.  Remind him to double void, about 20-30 minutes apart, before bed and help him to get homework done early so he can have a regular bedtime.  He can be successful in school as well as in conquering bedwetting.

I think the Malem Wireless system would work fine for your daughter. The sensor for the wireless system is exactly the same as the wearable system and I can honestly tell you that we have not had complaints from parents that the alarm is sensing sweat instead of urine. You can experiment with placement of the sensor. If she sweats the most between her legs, you could fasten the sensor a little higher in the front of her underwear. It usually takes an actual drop or two of urine to set off the alarm and I don’t believe that overall moistness would be sensed in the same way.

I think your idea of restarting an alarm is a good one. For some reason, he is now sleeping through the signal that he needs to wake up and walk to the bathroom. Finding an alarm that is acceptable to him is important. Both the wireless models are popular with kids in his age group. The Malem wireless and the Rodger wireless have multiple sounds to choose from. He can pick a tone that he likes (kind of like picking your ring tone for your phone) and that he most easily alerts to. The Malem wireless attaches to his briefs and the Rodger wireless comes with two pair of special briefs with the sensor built in. You might ask him which style he would prefer. Remind him that the sound will be coming from a unit across the room and not from a unit on the shoulder. This will require him to get out of bed to turn it off and he can walk to the bathroom at the same time. This should enable him to re-develop the ability to wake up and walk to the bathroom when he needs to.

Enuresis is the medical term for bedwetting and is defined as the involuntary passage of urine in the night by children older than 5 or 6 who should have developed nighttime dryness. About 90% of children have always had bedwetting, also know as primary enuresis. The other 10% have had at least 6 months of dryness, then resume wetting, which is known as secondary enuresis. We know that bedwetting is inherited and that the chance of a child bedwetting is 44% if one parent had bedwetting, up to 77% if both parents had bedwetting.

There is no single, simple cause for enuresis. Some factors that play a role in bedwetting are:
-Decreased arousal from sleep in response to a full bladder
-Small bladder capacity
-High nighttime urine production
-Constipation
-Other factors, such as evening fluid loading, medications, attention problems, urinary problems, sleep apnea

Since there no single cause, looking at multiple factors is important. Bedwetting alarms address the decreased arousal from sleep by helping your child to develop the ability to wake to a full bladder. Small bladder capacity may change as your child grows older but bladder “stretching” exercises do not seem to speed up this process. High nighttime urine production may be adjusted by drinking earlier in the day. The other factors listed above can be looked at by your health care provider if you have concerns for your child.

The biggest thing to remember is that your child is not wetting on purpose and primary enuresis is seldom due to emotional or psychological issues. Being supportive and offering a solution such as a bedwetting alarm when your child is ready is a good way for parents to help their child stop bedwetting.

When some people ask about a bed wetting mat, they are inquiring about a moisture sensing alarm mat that their child sleeps on. This type of bedwetting mat is plastic or vinyl with a moisture sensor that sounds an alarm when it gets wet. Your daughter probably doesn’t need this type of mat alarm yet. If she is still wetting in a year, using a moisture sensing alarm is a good way to help her achieve complete dryness.

Our most popular moisture alarms (bedwetting alarms) are the wearable models, such as the Malem Ultimate or Malem Wireless. The moisture sensor is attached to the outside of your son’s own underwear. The Rodger Wireless has specialized briefs that sense the moisture. We also carry a couple pad type alarms, although these are a little less sensitive to small amounts of moisture.

Moisture alarms work by sounding and/or vibrating to alert you that the wetting is occurring. The next step is to turn off the alarm and walk to the bathroom. Over time, the brain begins to make the association to stop the flow of urine and get out of bed to urinate. Eventually, your son will be alerted to the feeling of a full bladder and get up before the alarm sounds or hold his urine until morning.

This whole process is quite amazing and it can end bedwetting in a matter of weeks instead of years of waiting for him to “grow out of it”.

SJ writes, “My 9 year old needs help! I even offered to buy him a favorite Lego set if he didn’t wet for 7 nights. He stayed dry one night but has wet every night since then. I don’t know what other motivation he needs”.

Offering a reward for something your son has no control over can be counterproductive and very frustrating. I’m sure your son would love the new toys but he doesn’t know what steps he can take to get there. Even if he cooperates with limiting evening fluids and empties his bladder before going to bed, he does not have a method for getting up if he needs to in the nighttime.

Introducing a tool, such as a bedwetting alarm, to help him to make a change is very effective. Instead of sleeping through the wetting episode, now both your son and you will be alerted that wetting is occurring.

Initially, I recommend rewarding cooperation, something that he does have control over. By cooperation, I mean hooking up the alarm before bed, getting up as a response to the alarm (it is ok if mom and dad help him with this part) and double voiding before bed. Double voiding means urinating twice, about 20-30 minutes apart, before going to sleep-even though he doesn’t feel the need to urinate again. Your son can easily accomplish all of these things and earn a sticker or token as a reward for his cooperation. The important thing is that all of these things are necessary steps on the road to dryness and you’re helping to condition him to do these things. Dry nights will follow. Initially, he does not have control over whether or not that night will be a dry one. Once he does begin to have dry nights, if you want to add two stickers or tokens for dry, that’s fine. If a certain number of tokens equals a new toy, he does have the ability to earn that just by cooperating and trying to do his best.

You’re not alone with this situation. Other parents also report that they sleep soundly, with their door closed or a distance from their child. We’re happy to have a NEW solution. The Malem Wireless Alarm System is now available with two receivers, one for your son’s room and one for your room.

Once the sensor, which is fastened to his underwear, detects moisture, it transmits wirelessly to both receivers (up to 50 feet). Both are programmed to receive the same frequency. You can turn your receiver off while getting out of bed to make sure your son is waking up and walking to the bathroom. It is important that one of the receivers be in your son’s room. He has to begin to make the association that the sound happens when his bladder is full and he needs to get up to use the bathroom. This is sometimes a subconscious response. Once he no longer needs your help, you can stop turning the second receiver on. It’s important to turn the receivers off when you’re not using them to preserve the battery life.

The Rodger wireless alarm can also be ordered with two receivers, one for the child’s room and one for the parent’s room. This alarm comes with two pair of specialized briefs, with built in moisture sensors. The two receivers use the same frequency so both sound at the same time and can transmit up to 50 feet. When the wetness is detected on the special underwear, both the parent and child are alerted.

Other solutions are to use a baby monitor in your child’s room or to temporarily have your son sleep closer to your room. As you begin to see his response to his bedwetting alarm, you can decide when to move him back to his own room.

This is a common question this time of year. I am re-posting some suggestions that I wrote last year about this time. Parents wonder what to do??

First, if your child is currently using an alarm, we would not expect him or her to take it to camp with them. They can interrupt usage and restart when they come home.

Secondly, a back up plan should be in place, even for kids who wet intermittently. There are a few choices:

• Wear disposable pants, with a plan for putting them on discreetly and disposal in the morning. Disposables come in all sizes, even small through extra large adult sizes. If your child has outgrown traditional children’s pull-ups, there are still many options. Disposable male guards or women’s incontinence pads can be secured to regular underwear to catch a small amount of urine. Disposable underpads that lie on a sheet or in a sleeping bag have tape strips to hold them in place.

• Use washable bedtime pants to preserve dignity. These can be a nice back-up for kids who are dry most nights but want to make sure there is no leakage onto bedding.

• Waterproof sleeping bag liners fit into a regular sleeping bag. They provide a comfortable, waterproof surface for sleeping without raising questions from other campers.

• Mattress overlays can be used on top of a sheet or used inside a sleeping bag. The overlays can be discreetly pulled into place when your child is ready to go to sleep. The new blue cloud overlays are colorful and look like a regular piece of bedding.

• Make arrangements with the camp counselor to have toileting twice before bedtime and to continue a lifting routine if this is used successfully at home. (Lifting is when a caregiver walks the child to the bathroom at a designated time.)

• Medication, such as desmopressin, can be used temporarily to decrease the amount of urine produced that night. The correct dosage should be determined a week or two before camp begins. Only a small amount of liquid (2-4 ounces) should be ingested once this medication is used. It is best dosed shortly before actually going to sleep.

Lastly, make sure that your child knows that they are not alone and most camps are very helpful in discreetly handling any wetting episodes. Fluid of choice after dinner is water. Double voiding before going to sleep is helpful. Staying well hydrated during the day is helpful so the kids are not so thirsty later in the day.

Taking calls from the listening audience was interesting because you didn’t know what question would come in next. Although many of the questions centered on toilet training, one concerned parent of an 8 year old daughter with nightly wetting called in. To listen to the broadcast, simply click here.

I highly recommend listening to 98.1 KISS-FM, in the San Francisco Bay Area on Sundays from 7-8 am or you can listen to any of the past shows by going to the website, http://www.childhoodmatters.org/index.html.