Potty Training the Older Child (part 2)

I had the privilege of writing for the e-book Parenting Responsively along with 11 other ACPI parent and family coaches.  Over the next few weeks I will be reprinting my chapter.  I hope you will enjoy it.  If you would like to order the entire book you may do so on my website for $9.99 - Strong Roots Family Coaching.  Enjoy

(View the previous post on Potty Training without the Power Struggle)

                There is a certain amount of bedwetting and accidents that will occur during the months after successfully potty training your child.  It is common and even normal for occasional nighttime accidents to occur several years after your child is fully potty trained.  Accidents may happen because of a change in diet or consuming large amounts of liquid before bed.   They can even happen as a result of a bad dream or stressful experience.  Most every child has at least a few nighttime accidents after being completely trained.

                Consistent bedwetting, however, is a different story. In fact, consistent bedwetting is a problem for more children than you may think. According to Medline Plus1 about 15% of children regularly wet the bed after the age of five.  By the age of 10 it is more like 5%. Bed-wetting is more common in boys than it is in girls, and it also tends to run in families. With most children, chronic bed wetting usually stops during puberty.  Bed-wetting is usually not a sign of underlying emotional issues.  In fact, it is usually just a sign of underdeveloped bladder control.   If you suspect this is your child's case, limit large amounts of liquid two hours before bedtime and encourage your child to go to the bathroom before he goes to sleep.  Praise your child on days he wakes up dry and do not punish him for having a bed wetting experience.  If all else fails, try waking him in the middle of the night to use the toilet. 

                However, if your child has been dry at night for many months or years but suddenly begins having regular, routine, nightly accidents, this is a good indication that he is dealing with underlying emotional issues. 

                When a child is faced with overwhelming issues, bed-wetting can be one of their bodies’ ways of dealing with stress or anxiety. In these situations, bed-wetting is not a conscious act, but an involuntary response to how the body and mind deal with stressful events. It is very difficult for us as adults to see the world from our child’s perspective, but it is important for us to make an effort to do so, especially when our child experiences major nighttime setbacks.

                If your child is having issues with bed wetting well past being trained, you will want to make sure that there is not a physical problem, like a bladder or kidney infection or a sleep disorder.  Once you have established there is not a physical problem, try to find out what underlying issues he may be facing.  Talk to your child about what might be causing him stress.  Don’t ask him why he is wetting the bed, he won’t know. Remember bedwetting can be an unconscious event that leaves him unable to make any mind/body connection.

                It is also important to keep in mind that if your child is bedwetting, he likely is already embarrassed.  Making him feel bad or ashamed may make things worse.  If your child is wetting the bed, do your best to make a more stable and predictable environment for him.  Consider your child’s school experiences and the current state of his relationships with teachers, family members and friends.  Help your child identify any problems and help him find and work through appropriate solutions.  While it may be tempting for you to jump in and fix a problem for your child, doing so may be the wrong approach, especially if the problem involves an issue is with his peers.  As a parent, the best thing you can do is be there for him, love him and help him come up with solutions that he can implement.  When you do, you'll likely see his overnight dryness pattern return.

                If you are unable to help your child identify the cause of his emotional bedwetting, there are some treatments you can discuss with his doctor.  These include behavioral conditioning devices like a pad or buzzer that will wake him when he starts to urinate.  There are also a few medications that could be prescribed like anti-diuretics, hormone nasal spray and anti-depressants.   In rare instances when a problem can't be resolved by parents and doctors, talking to a child psychiatrist may prove beneficial as there could be underlying emotional problems that are causing the bedwetting.  A child psychiatrist will work with you and your child to resolve any underlying issues.

                While potty training may be often portrayed as a long, messy and frustrating process, it does not need to be.  It is possible to empower your child to take on this challenge, to keep his dignity intact and truly have a positive potty training experience.  By letting him make the choices for his body and by being at his side with the right words and tools, you give him the respect he needs to meet this challenge and the many others he will face on his road ahead.