Bedwetting treatment starts with open communication

 “He was 8 years old and still wearing diapers. We knew he had a problem.” – Mother of a boy with a bedwetting issue

It really wasn’t difficult to talk about her wetting as she knew something was wrong. We concentrated on making her comfortable and assuring her all would be fine.” – Mother of a young girl with a wetting problem

Urinary incontinence, otherwise known as “enuresis” or “wetting,” is fairly common, often embarrassing and sometimes difficult to talk about it. Of children 6 to 7, about 20 percent of boys and 17 percent of girls have some problem with daytime or nighttime wetting. Still, many kids are reluctant to talk about wetting with parents, friends and teachers. Parents themselves often have a hard time confronting the issue.

The Voiding Improvement Program (VIP) at Boston Children’s Hospital uses noninvasive methods to help children overcome incontinence and other urinary issues, such as urinary tract infections. Treatments can include biofeedback training, Reiki therapy, behavioral therapy and referral for acupuncture. The program’s director, Carlos Estrada, MD, believes that open communication is the essential first step in addressing a wetting issue.

“Kids have a hard time talking about their wetting problems for one obvious reason: It’s embarrassing,” he says. Over time, that embarrassment can build and build. In fact, Estrada explains, for some boys and girls, urinary incontinence “becomes a focal point for a family, and the negative attention results in kids turning inward.”

Watch this video to learn how Boston Children’s offers treatment for bedwetting:

Adding to the embarrassment are feelings of helplessness. Estrada says that wetting the bed at home or having an accident at school or on the playground can trigger these feelings and cause kids to postpone voiding. “Holding too long can lead to an overactive bladder and possibly more serious problems,” Estrada reports.

Parents can compound the problem by failing to discuss wetting with their children. Some fear that they will further embarrass their child, so they ignore urinary issues, hoping they will simply go away. What’s more, kids with wetting issues feel worse and worse over time, so it’s important to talk about them early. “As they get older,” Estrada explains, “the expectation becomes greater that this problem should be gone by now.”

“Positive communication is essential to creating a feeling of comfort and to creating a plan to deal with enureris,” Estrada says. He offers a few communication tips for talking about bedwetting:

  • “Tell your kids that the condition is very common,” he says. “It’s important for children to know that there is nothing unusual about them and that the problem is not their fault.”
  • Estrada urges parents to “be proactive and bring up the problem with their pediatrician during a regular check-up.” He explains that many PCPs may simply not have time to fully cover the condition during a routine visit. “VIP appointments for new patients take 45 minutes to an hour,” he says. “A PCP usually doesn’t have that much time to talk about wetting.”
  • Carlos Estrada, MD

    Once the problem has been discussed and a treatment plan has been created, kids need to be thoroughly involved in the process. At the VIP, Estrada says, “kids know everything.” That’s because “unless they are fully engaged and motivated, they’re not going to do what’s necessary to overcome their problem.”

  • Also, kids need to know that the problem can be solved, usually through noninvasive methods. Many children, Estrada reports, are fearful that treatment for wetting could be painful or involve surgery. “We have a set of tools to help children fix their problem and put it behind them,” he states, and most of those tools are noninvasive and painless.
  • Positive reinforcement is essential. At the VIP, when kids complete goals and hit milestones in their treatment, there are celebrations, certificates, even graduation ceremonies. “Our program is very goal oriented,” Estrada explains.  “The vast majority of kids respond well to that, and they respond poorly to the opposite,” he says.

The girl’s mother quoted above worked with the VIP and saw first-hand the importance of positive reinforcement:  “Watching our daughter do everything asked of her and showing no results for a while was tough.  But when small improvements began to arrive, the celebrations with staff were wonderful.   We began to look forward to trips to Boston Children’s. In a way, we were sad when our visits began to be less frequent because we enjoyed our time with the staff and looked forward to the stories we shared.”

Turning a negative into a positive through shared goals and constant encouragement are the hallmarks of the VIP program. But ending a wetting problem starts with communication. As Estrada says: “Don’t be afraid to talk about it.”

The VIP is available at Boston Children’s Hospital locations in Boston, Peabody, Waltham and Weymouth. Call us for more information at 1 (866) 982-1065 or visit our website at bostonchildrens.org/vip