Bedwetting treatment

Bedwetting alarms: Bedwetting alarms work on the principle that although bedwetting is a physical problem, your child can be trained to recognize the feeling of a full bladder. Alarms consist of a moisture sensor and an alarm such as a buzzer, bell, or vibrator, which goes off when your child begins to urinate during the night. Alarms can be effective, but they do require the child and parents to be highly motivated. They also require a supportive family environment.

While most children who use alarms to treat bedwetting don't start wetting again once treatment ceases, it can take weeks or even months to see results. Bedwetting alarms have a high dropout rate, with 30% of families abandoning this method after only 3 weeks, which is before this method reaches its peak effectiveness.

Behavioural therapies: A reward system, where your child receives a star on a chart or a prize, has been helpful in many cases. Motivational therapy involves keeping track of how your child has progressed, usually with bigger rewards for longer periods of dryness. The reward should be agreed upon by you and your child ahead of time. Motivational therapy can be an effective treatment for younger children.

Other coping techniques: There are other techniques for coping with your child's bedwetting problem. Try these recommendations:

• Protect the mattress by using waterproof sheets.
• Diapers may reduce the mess of bedwetting, but they can still leak and can cause an uncomfortable diaper rash due to moisture near your child's skin. The Canadian Paediatric Society classifies a child as a bedwetter when regular (more than twice per week) bedwetting persists beyond the age of 5 years. Part of their recommended strategy to help children achieve continence includes taking them out of diapers.
• Tell your child to go to the bathroom immediately before bedtime.
• Limit beverages before bed.
• Limit caffeine.
• Bladder training, where your child learns to hold their urine during the day to increase bladder capacity at night, may be effective and can be tried.

Medications: Desmopressin is a copy of the same messenger your child's body makes to control the amount of urine produced as they sleep. Desmopressin is taken by mouth before bedtime. It helps bedwetting children reduce the volume of urine they produce at night to that of a non-bedwetting child. The effect from desmopressin lasts from 7 to 9 hours after your child takes the medication. It is recommended to be used along with other non-medicinal therapies such as motivational counselling. Side effects from this medication can include headache, nausea, and abdominal pain.

Imipramine, belonging to a group of medications known as tricyclic medications, is sometimes used to treat bedwetting. The exact mechanism of how it works isn't clear, but it's believed to either change your child's sleeping and waking patterns or affect the amount of urine in the bladder. Side effects can include nausea, vomiting, abdominal pain, irritability, insomnia, drowsiness, reduced appetite, sensitivity to the sun, and personality changes.

Talk to your doctor about whether medication treatment for bedwetting is right for your child.

Alternative therapies: While there are claims that treatments such as acupuncture, hypnosis, and massage can help prevent bedwetting, there is no evidence they are effective.