Dear Jenna: | Bed Wetting/Enuresis

Dear Jenna,
Our newest member of the family has been regressing in his potty training since coming to live with us full time. He was fully potty trained. But in the past month he has been wetting the bed nearly every night, and sometimes having accidents during the day. I am going to pull my hair out if I have to change another sheet.
-Losing Hair

Dear Losing Hair,
  I actually just wrote an article about this a few months back for some friends at my church who were experiencing the same difficulties. (See below.) Be encouraged you are not alone. 
-Jenna

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Enuresis: Bedwetting and Regression

Jenna J. Gough, ACSW

(Written for foster and adoptive parents.)

Your child has been potty trained for a year or more even. You’re enjoying the diaper free life, and bam… all of the sudden they are wetting their pants, or pooping their pants, peeing and pooping in strange places, hiding it under the bed, or in their clothes. In the blink of an eye, you are back to washing sheets every morning and re-making beds like its your morning cup of coffee. Not cool.

To start with lets look at peeing and pooping our pants as a behavior. I’m going to share something with you that changed my life. It’s worth a lot of money, and it is a major shortcut in addressing child behaviors. Are you ready?  “Every behavior is rooted in a need.” Needs cannot be argued or disputed they are present and present to stay. Some of our basic needs include, the need for food, water, and shelter. But in addition to being a body, we are also a mind and spirit. Some of our psychological needs include; safety, security, love, and affection. Abraham Maslow, was a guy who explained what he called a “hierarchy of needs.” Maslow drew a pyramid and at the very bottom of the pyramid he placed our most basic needs. Maslow explains that if our most basic needs are not met, that we will be unable to function on higher levels such as learning new things, developing social skills, performing well in school, etc. 

Now this may surprise you, but “bedwetting” is a behavior. As we now know, bedwetting emerges because of unmet needs. The number one thing that bedwetting is associated with is a need for a sense of security. What we mean by “security,” is the belief that everything is going to be okay. At this age, children don’t believe necessarily because they are told so, but rather they believe because they experience it. A child must know that their needs will be taken care of. Many children have not experienced this while living with their biological mom or dad. As a result their mind spends time thinking about when they will get food, rather than being filled with thoughts of play doh and crafts or something that your own child possibly would think about. When a child’s mind is consumed with thoughts on how to get their basic needs met, this produces anxiety and uncertainty. Anxiety is also closely related to bedwetting. So its stands to reason that a great start for addressing your child’s regression, is to work at various ways in which you can restore their sense of security and reduce the level of their anxiety right?

Easy for you to say lady. How exactly do I do that?

Nighttime

There are several practical ways to address bedwetting. In addition to the approaches listed below I recommend seeing a licensed child counselor who can work with you to identify patterns in the child’s behavior. Never-the-less here are a few practical approaches.

Limit the child’s fluid intake several hours before bedtime. 

Set an alarm and take the child to the restroom in the middle of the night. 1 or 2 times depending on what you feel is needed.

Consult with your pediatrician about medications that can help with bed wetting for a period of time before weaning them off when the child is ready. 

Use a special bedtime spray (for example a lavender scent) and explain to the child that it is a special spray. You can be creative with small children explaining that it keeps monsters away, or that it attracts guardian angels, etc. From my experience dad’s can be really good at this part.

Go to the store with the child and purchase something that is very soft and cuddly, like a blanket or a stuffed animal. Make a BIG woohaa about how this is her special bedtime blanket or rabbit or what have you. The point is to give the child an added sense of comfort during nighttime hours.

Daytime

Since the child is expressing outwardly, what they are feeling inwardly, a highly recommended approach to day time accidents, when they occur, is to remain calm. This will reassure the child that although they are feeling anxious and out of control, you are not. Even though it is tempting to believe this will go on for all of eternity, it will not. The child will eventually regain a sense of security and will be able to do this more quickly if you the parent also exude a calm energy. Whatever they are experiencing does not scare you. 

Some things you might say to the child during one of these time are:

“Oh you had an accident. I understand you are not feeling well. You will feel better soon. Let’s clean you up.” After cleaning up, a quick hug and a reassuring “You’ll be okay” will go a long ways.

Keep it brief and have a “no big deal” attitude whenever possible. If you need to go pull your hair out after… feel free. The more frustrated you become with the child, the longer it will be before they are able to regain their footing. Talk to a counselor or a friend and express your frustrations in a safe place, away from the child. Do not forget the more calm reassurance you offer, the quicker they will get through it.

In closing, remember that this child will need some time to experience a new way of life. It will take him several weeks if not months, to learn (without you telling him) that your home is different then what he has experienced before. Essentially, the child will need to begin to trust that he will be okay with your family and in your home. And kids can’t be tricked about this kind of stuff. They don’t feel safe because someone simply told them they will be safe. They tend to wait and see for themselves if the coast is clear. I would encourage you to be yourself, have fun, and let your new family member observe all the wonderful things that make your family the special family that it is.