Episode 1 - moving on from nighttime pull-ups and lifting This is a 14 minute listen. Alina and Bethan talk about how to help a family whose 7 year old is bedwetting. My partner and I are feeling desperate about how to end the bedwetting for our seven year old daughter. We thought she would have grown out of it by now, but it seems to be getting worse, not better. I am fed up with washing all the bed clothes every morning and remaking her bed every evening. Sometimes she wets the bed twice in one night. As she turns seven she announced she would no longer be wearing nappies or pull ups but we went along with that as it was her choice. I didn't mind so much at the time as they're very expensive and were leaking into the bedclothes fairly regularly anyway. Anyway, so far, it's made very little difference. I have tried lifting her out of the bed to go to the loo but only with limited success so far. Sometimes I miss the moment or she's too deeply asleep to actually do a wee even if she's sitting swaying on the loo. Up until now, we've not made a big thing about all this, but she says sorry, when she wets the bed now. And if she notices the bed clothes in the bathroom the next morning. I'm worried it's going to start bothering her now more that she's getting older and her friends are starting to go and sleep overs. What should we be doing now to help our daughter?” Bedwetting is common Yes, it sounds very familiar from the sorts of things that parents will bring up and ask on our helpline and dealing with a child who is wetting the bed can be really distressing, it can be really, really tiring as well. And we know that when the more tired parents get, the more anxious they are about trying to fix things for their child. So there's definitely some really good ways that we can start helping but I think it's important that we try and address some of the questions that they've raised. What about lifting to help tackle bedwetting? The first one I think we're talking about is the lifting. This is something that a lot of families do. Basically taking their child to the toilet, when they're asleep. It's a bit like the dream feeds that some parents do when they've got really, really tiny babies. So you've got a sleeping child that you know, at some point is going to wet the bed. So usually parents do as they're going to bed themselves. They take the child out of bed, sit them on the toilet, and get them to do away and then they pop them back into bed. Some children will then go the rest of the night and not need to do away. But unfortunately, and particularly in the case of this family, where you've got a slightly older child, she's seven now - they're doing the lifting, and, she's still wetting later in the night. So should they be doing this and why is it not actually solving anything? The answer to that is because lifting is just a management of bedwetting, it isn't a cure. What you're doing is you're helping a child to have a dry bed, you're not actually getting that child dry. We wouldn't say on the phone, don't do it because you can have some success with it. And it can be quite a useful thing to never do when you're away on holiday in a staying in a hotel. And you don't want to be having to deal with wet bedclothes because you can't deal with them because you're away from home. But what we will say to parents is just remember when you get back home, it's best to stop doing it at that point, if you are going to do it. And this is where it can get quite tricky. You need to really, really fully make sure that child is awake. How does lifting work? You don't want to disturb their sleep and is quite a difficult thing to do. It goes against your natural instinct, isn't it as a parent don't wanna wake your child once they've gone to sleep. And that is the tricky thing because really in order for lifting to register with that child and for it to help them with their bedwetting, they need to be fully awake because they need to be sitting on the toilet realising that they're now emptying their bladder. Because otherwise all you're doing is lifting a child who's asleep, they stay asleep, they wee in their sleep - they might just as well have been in the bed, you're not actually teaching them anything. And also it is the parents deciding at what point you're going to empty that child's bladder. But what we want to be happening, and what isn't happening, is for bedwetting children to get the signal their bladder is full, for that signal to get through to their brains to wake them up, rather than the parent to decide. So again, that's why ultimately you are not it's not a cure for it. It's just a management. Okay. But it can be quite useful when a child's first stopped wearing nappies at night, you know, younger children, perhaps the under fives. Obviously, you can't lift all children, some are quite heavy and you risk getting a bad back. Try and get them fully awake, just put the light on and chat to them to explain what they're being asked to do. The other negative is that, as we all know, having disturbed sleep even for short period, affects our sleep cycle and can make us really quite grumpy. So you might get a child who is already feeling bad about their bedwetting and this makes them feel really miserable. They don't like being woken up. And also we know that disturbed sleep can have an effect on your vasopressin levels and vasopressin is that hormone that we release more often at night to reduce our nighttime wee production. It's something bedwetting children often lack so if you disturb their sleep, you can also be affecting that hormone. So lots of reasons against but we do we do appreciate you know, this is really tricky issue fair. It's tiring. And sometimes it might work, so we say it's up to the individual parent but those are the reasons we suggest not doing it for this family and others. What about having a potty in the bedroom instead of going to the bathroom? Yes, I mean it can in particular the winter months when it's cold, nobody likes to get out of bed to shiver down a corridor and get to toilet some children don’t like getting up when it's dark. So a little nightlight or torch in the room and a decent size potty depending on the age of the child. Because you know the older children get, the less likely they are to sit on the potty. Anything that's going to make it easier for you and them. You can get those pee bottles, particularly useful for boys the kind of things you take camping. And what about nighttime pull-ups? It's such a common thing that we get asked about. It's really natural that a child reaches a certain age. And they're aware that they get become more aware that nappies are for babies, and they're not a baby anymore. But actually, if you've got a child doing an awful lot of wee in bed each night, there is some really good bedding protection that you can get. But these nighttime nappies will hold the way and keep them dry so they can keep sleeping. So it's a bit of a no brainer really for the child and the parent that they they're a really good solution to that problem of not having an uncomfortable child. But you know, something that children will feel is that they've grown out of wearing them but unfortunately haven't grown out of the bedwetting yet. So what we would say is it's a really positive sign in this family's case there's two girl is keen not to wear them because it shows that she's got an awareness of the bedwetting and she is trying to think of ways to help and stop bedwetting. I think it's really important that families encourage that. But do it as a sort of negotiation of why don't we try it for a week and see what happens. What you don't want to do is make that child feel that if they have their weeks trial and it makes no difference which is very it probably isn't going to make a lot of difference because if you imagine bedwetting happens when a child is asleep, so it's happening outside of their conscious control. So whether they have or haven't got a nappy on, for a lot of children makes absolutely no difference and that it can feel really, really demotivating and miserable for them. Obviously, nighttime nappies and pull ups they're really good. They're very absorbent. But if the child isn't feeling the sensation of getting wet during the night, does that play into the whole kind of awareness issue? If you if you allow your child the opportunity, to feel that sensation of getting wet, that might start to help the process of raising their own awareness levels?, And also going to bed knowing that you haven't got a nappy on is a bit like when children occasionally go and stay with grandparents, and their parents were amazed that for the week, they were with the grandparents, they don't wet the bed. But as soon as they come back home, they do. Bedwetting is very complex and we think that it does affect their subconscious. They know they're in a different bed. And somehow they're able to stay dry a little bit like when you've got a very early flight to catch, and you're going on holiday, and you we can wake up just before the alarm goes off. That's because we've gone to bed knowing in our subconscious that we've got a plane to catch. So going back to the nappies, again, a little bit like the lifting, there is a place for it to have that trial , maybe a week, you might want to try two weeks. Make sure you get the bed really well protected. Make sure the child knows exactly why you're trying this and that it doesn't matter. Be really encouraging of them. Put all the reward not on not having the nappies, but things like the drinking while they're doing their ways before bed, all those kind of things. So they've still got nice positive achievements that they can make and contribute to. But just be prepared that it's probably going to make it might not make very much difference. There are a few children that will never be dry whilst they're in nappies. And there are also those particularly younger ones, when they're just on the cusp of getting dry at night. And when they wake up early in the morning and they're wearing their nappy, it's very convenient to just wee in the nappy. I won't go into that now, because we want to keep focusing on this little girl and being eight. And of course, you know, she's, she's thinking about sleepovers and things. So yeah, have your trial but it's fine if you need to get back into them. There's still plenty of other things you can do to try and help her get dry. Just really try and avoid getting in and out of those nighttime nappies. It's better to just have a consistent approach to have your child and then go back into them rather than one week in nappies, the next week off because that can just be really confusing. And give them quite a mixed message for a child when they're really trying their best to try and get dry. Visit the GP to check for any underlying reasons In terms of next steps for this family it's very important that children who are bedwetting get checked for any underlying reasons for the wetting and that they have an assessment by a doctor or nurse to look into the reasons why it might be happening and then decide the next course of treatment. Its from age 5 that children can be seen by a doctor or nurse. So what I would recommend doing is taking a look at our website, that's www.eric.org.uk where we have a whole section on nighttime wetting.. There's also really good bedwetting checklist tool on a website called www.Stopbedwetting.org. And that takes you through all the things that you need to think about before you see a doctor. So there's advice there on checking that your child is drinking enough, what are they drinking, particularly around bedtime, making sure they're not having screen time close to bedtime and looking out for things like constipation and daytime accidents as well. So, some brilliant resources out there. And I think it's just a case of doing some homework and then making that appointment and not feeling that you're failing his parents or that there's nothing you can do because there's lots of things that you can do.