In some children, especially those who have been toilet-trained and have had dry nights for at least six months, instances of bedwetting may begin after a change or stressor, even a minor disruption, such as a family vacation, a new babysitter, or a short parental business trip.
Even events that the parents and/or child perceive as exciting, such as a move to a nicer home or an eagerly anticipated start of a new grade, can be stressful in that they are sources of change. A new baby is often a trigger for a regression in different developmental areas, such as bladder control. Serious, though less common sources of stress, such as a death in the family, severe family conflict, and in a very small minority of cases, sexual molestation, can also be associated with bedwetting.
Stress may indirectly cause bedwetting to get worse, as children who are stressed may have a change in routine, which can disrupt sleep patterns, causing children to go into deeper sleep to make up for sleep deprivation. A change in routine can also cause children to forget to refrain from drinking liquid late at night or cause them to go to bed without using the bathroom. Stressed children (or those with stressed parents) may also eat poorly, such as snacking on salty foods that can cause water retention.
No matter what the cause, the experience of wetting the bed, along with the worrying and shame that can often accompany it, can cause further stress on the child. Some ideas for reducing stress in children who wet the bed include:
Don't Make It Worse
Do everything you can not to add to an already stressful situation. Handle the incident calmly and quietly, without getting angry or showing frustration. Let your child know that you understand that accidents happen to everyone, and you will help her figure out how to stop wetting the bed. Make sure that the family is a safe place for children who wet the bed, and do not allow teasing of any kind around this issue.
Find Out Why
Try to discover the source of the stress that may be associated with the bedwetting. If you can do so, talk to your child about it. Let him know that everyone gets worried or scared about changes in life, and our bodies react in different ways; some kids’ bodies might show worry or fear by wetting the bed. Tell him that learning how to get used to or handle the change may help with wetting the bed. Talk about ways to do so, and have your child pick one or two ideas to try.
Feeling control over one’s body and one’s life can go a long way towards reducing stress. Help your child feel in control of her body by having her practice exercises to strengthen bladder muscles, such as starting and stopping while she is urinating. Consult your doctor first to make sure that the exercises are appropriate for your child. Once you know that she understands how to do the bladder exercises, let her practice on her own, without your interference.
Stock the Bedroom
Help your child feel control over the situation of bedwetting by ensuring that he can prevent damage to his clothes and bed with items such as disposable underwear and mattress pads. Layer mattress pads, towels, and sheets on the bed so that the child can take off a wet layer by himself during the night, if necessary. Assist him in setting up his bedroom that he can clean up after himself, with a drawer of clean pajamas, sheets, towels, and plastic bags. Let him set up a bedtime routine that helps him feel relaxed. Offer suggestions, such as playing soft music, rubbing his back, taking deep breaths, or tensing and releasing muscle groups. If fear of the dark is an issue, turn on nightlights or provide a nearby flashlight as part of the nighttime routine.
Feeling safe and in control during the daytime, not just at bedtime, can also reduce stress. One important way to help children feel safe and in control is to establish daily routines. When children’s days are predictable, they are more able to relax, and they gain confidence in themselves, as well as those around them, so stick to a routine as much as possible, and let your child know when changes will occur. Routines also help children practice self-control because they learn that they must wait until a particular time for each activity. Lastly, routines can help ensure that your child is getting enough sleep at night, which in itself, can cut down on bedwetting.
Take It Easy
Children pick up on the stress of adults around them. As difficult as it may be, try to figure out ways to manage stress in your own life so that you can be a good example for your child. Try to do activities together that will relax you both, even if it is just a short walk around the block or watching a silly movie that makes you laugh. Try to reframe your understanding of the bedwetting (e.g. there are much worse problems your child could have; he will eventually grow out of it; it’s not that big of a deal to do an extra load of laundry here and there) so that the bedwetting itself is not an added stressor for you. If you think your child can handle it, and you are sure that you are not being sarcastic or mean, try to use a little light humor to remind yourself and your child that bedwetting is not the end of the world.