If your child is older than 7 and still not quite yet dry at night, read on!

Bedwetting is considered normal until at least age 5 or 6. But if your older child is still not dry at night, he or she is likely to be a very deep sleeper who may not be able to wake in time to go to the bathroom. About 8% of 12-year-old boys, for example, still struggle with this issue.

Unfortunately, only about one third of families with this problem seek treatment. One of the most successful treatments is the use of a bedwetting alarm for a few weeks; this approach has a success rate of 85%. A bedwetting alarm is very likely to help your child learn to be dry at night and it is not at all difficult, embarrassing or uncomfortable to use.

First choose and purchase a bedwetting alarm. These are readily available online for $30-50.  These have a small moisture sensor that triggers an alarm to go off when your child begins to urinate at night. Most bedwetting alarms have a 3-5 different alarm sounds for you to choose from and most add a vibration as well. Note: if your child is on the spectrum or has any type of sensory disorder that may make the use of a bedwetting alarm more difficult, there are two other types of alarms that may make this process easier for your child. There is a type of bedwetting alarm that sounds only remotely (in the parent’s room) and another type that does not have to worn by the child at all (the mattress pad itself senses the flow of urine).

Next, you will want to purchase at least two mattress pads and I recommend the saddle-style type. These are easy to find online as well. They are very simple to remove and replace because they have “wings” that tuck very easily under both sides of the mattress, as in the picture below. They hold up to six cups of liquid.

Next, begin familiarizing yourself with the steps below and rehearse these steps a few times with your child in the daytime.  You may wish to begin the actual process on a weekend since everyone’s sleep will be interrupted initially.

On the night you’ve chosen to begin, rehearse once more what you and your child will do at night. Clip the small moisture sensor into your child’s underwear in a spot where the first few drops of urine would come in contact with the sensor. Your child can wear a pull up over his or her underwear, too, if desired. Place a small flashlight near the bed, if needed, so that you can both find your way safely to the bathroom during the night. Put the mattress pad on the child’s bed and put the spare dry one nearby along with a spare dry pair of underwear and another pull up.

During the night, the alarm will begin sounding when the first drops of urine begin to flow. You, the parent, are responsible for listening for the alarm and responding to it. You could either put a baby-style monitor in your room so that you will hear the alarm or you could sleep close by. Remember that your child is not dry at night because he or she is a very deep sleeper. You must be the one to listen for the alarm each and every night until your child begins to hear it.

When you hear the alarm sounding, come quickly to your child’s room, and say “That’s your alarm. Please stand up and walk to the bathroom now.”  Repeat this sentence while helping your child do those two things.

After reaching the bathroom, your child can finish urinating, if need be.  You can then help your child to

• put on dry underwear and a new pull up
• clip the sensor back on
• remove the wet mattress pad
• replace it with a dry one
• help your child drift back to sleep.

This pattern would be repeated each night.

When your child awakens the next morning, have him or her write on a calendar what happened.  Your child can write:

• DRY (slept through the night without wetting)
• ALARM (got up after the alarm went off) or
• BATHROOM (woke up and went to the bathroom without the alarm).

Rewards are often VERY helpful!

Some simple clean-up chores could be given to the child (for example, changing the pad, putting the wet pads into the washing machine, and so on) but these should never be presented as any type of punishment but rather as a step toward independence.

After a few weeks, your child is likely to either be dry all night or will have learned to wake up and go to the bathroom independently.

Everyone wants to see dry nights immediately but this does not usually happen! Learning to be dry at night is a conditioning process and takes time. The average child takes 6-9 weeks to become permanently dry at night.

Watch for signs of progress.  Perhaps the pad is less wet or the alarm is sounding fewer times each week. Once your child has 2-3 dry nights, these will come more often. Don’t stop using the alarm nightly until your child has been dry for four weeks. If your child is wet again after two dry weeks, simply restart the four week countdown.

Once your child is dry for 4 weeks, you can also try a technique called “over-learning” and this can help ensure your child’s long-term success.To use this technique, have your child drink one ounce of fluid for every year of age (8 ounces for an 8-year-old child, for example) at bedtime.  Make sure to keep using the alarm nightly until your child is dry for another 4 weeks.

You can also help your child to learn this skill more quickly by encouraging your child to practice starting and stopping the stream when they are urinating during the day as often as they can. Timed voiding during the day (every two hours) is often helpful. You can find watches online that will vibrate on your child’s wrist every two hours to remind him or her to go to the bathroom.

Your child is likely to feel much more self-confident once he or she is dry every night. Your child is also likely to be much more willing to participate in typical childhood activities like sleep-away camps, sleepovers with friends, overnight school trips, weekend visits to the homes of other relatives and so on.

This confidence carries over into the daytime, too.

Good luck and please email me with any questions!