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Bedwetting FAQ

Bedwetting is instigated by a malfunction in the reflex system that regulates bladder control. It represents a breakdown in communication between the bladder and the nervous system
The bedwetting alarm, in conjunction with expert guidance and support, is renowned as the most effective treatment for bedwetting.
Bedwetting alarm treatment is appropriate for nearly every child who experiences nighttime wetting. Children can begin treatment as early as age 3, and it is recommended to commence treatment not later than the age of 5.
Numerous obstacles can vary from one family to the next. Among the most prevalent and formidable challenges are deep sleep and frequent nocturnal bedwetting episodes. Drawing from our extensive experience at my clinic in Israel, we’ve devised customized tools for each child, enabling us to conquer even the most intricate hurdles.
Following my step-by-step guidance, the success rate is exceedingly high, making failure a rare occurrence.
The treatment duration varies from child to child. In most instances, it spans between 5 to 6 months. While some children achieve absolute dryness much sooner, others may require treatment for up to 18 months or longer. It is always advisable to maintain persistence and start treatment without delay rather than postponing it to later ages.
The primary effort revolves around consistently using the alarm and waking up during the night. My step-by- step instructions are designed with utmost consideration for this challenge, offering guidance that ensures both the child and the parents can persist without feeling overwhelmed or frustrated.

My step-by-step guide draws from over four decades of therapeutic experience and research involving nearly 40,000 children in our Israeli clinics. Through our extensive work, we’ve honed our ability to effectively guide both
children and parents in conducting the treatment and conquering nearly any obstacle they may face during the
course. Additionally, parents seeking further assistance can always find support via various resources described in my website.

Drug treatments only yield results in approximately 60% of children, and their effects often vanish once the medication is discontinued in nearly 100% of cases. On the other hand, alarm treatment, when administered with professional guidance and support, boasts a success rate of around 85%. Approximately 20% experience a relapse and revert to bedwetting after initially achieving dryness. In such instances, alarm treatment can be repeated, and even then, only about 5% face a second relapse.

No!

Bedwetting is not typically triggered by excessive drinking before bedtime. Children who do not have
bedwetting issues can freely enjoy their everages before bedtime and remain dry throughout the
night. They either hold their urine all night or awaken when they feel the urge to use the bathroom.
This is precisely the experience that children with bedwetting should strive for.
Efforts to limit evening drinking do not effectively address the problem. Instead, they can lead to conflicts between the child and the parents, creating an unfavorable atmosphere at home.

No!

Bedwetting is typically not caused by the absence of pre-bedtime bladder emptying. Children without
bedwetting issues can skip this step and still remain dry all night. They naturally either retain their urine throughout the night or respond to their bladder’s signals by waking up to use the bathroom. This is the same experience that children with bedwetting concerns should aim for. 

Encouraging children to visit the bathroom just before bedtime does not effectively prevent bedwetting. Instead, it can lead to conflicts and create an unfavorable atmosphere at home. Misinterpreting their reluctance as indifference, a lack of concern, or even a deliberate desire to wet the bed only compounds the child’s emotional distress and feelings of inadequacy and helplessness.

No!

Bedwetting is not typically triggered by specific foods or drinks consumed before bedtime. Children without bedwetting issues can enjoy a wide range of foods and beverages before bedtime without experiencing any problems. They naturally either retain their urine throughout the night or respond to their bladder’s signals by waking up to use the bathroom. This is the same experience that children with bedwetting should aim for.

Efforts to control the types of foods or drinks consumed before bedtime do not effectively prevent bedwetting. Instead, they can lead to conflicts and create an unfavorable atmosphere at home.

No!

Deep sleep is a positive and essential aspect of sleep that significantly contributes to daytime well-
being. Most children and adults experience deep sleep without bedwetting. Once bedwetting children
undergo treatment and resolve their issue, they can also enjoy deep sleep without wetting the bed.

It is advisable to permit children who wet the bed to engage in play, physical activity, and tire themselves out during the day. There is no need to impose restrictions or enforce an early bedtime in an attempt to prevent nighttime wetting. Such measures often lead to conflicts and create an unfavorable atmosphere at home.

No!

In the majority of cases, bedwetting is not related to whether a child is woken up during the night or not.
Bladder control is an automatic and self-regulated process. Most children, as well as adults, experience uninterrupted nighttime sleep. When their bladder becomes full, they naturally wake up and go to the bathroom.

Waking children during the night at the parents’ initiative may prevent bedwetting for a particular night, but it does not foster the development of the ability to control the bladder automatically. Over time, such actions may disrupt the quality of their sleep and negatively impact their daytime concentration and functioning.

Attempting to wake children who are sleeping deeply and resistant to being disturbed for bathroom visits often results in exhausting and fruitless arguments, causing additional distress for both children and parents.

No!

Bedwetting is not under the child’s control. It is related to an issue with the automatic reflex system
that governs bladder function. Bedwetting alarm treatment aims to correct this underlying problem.

Introducing rewards or employing threats of punishment may increase alertness, result in lighter sleep, and potentially lead to temporary bladder control. However, this control is not based on the typical, self-regulated functioning of the reflex system, and it often regresses after a few days, resulting in a return to bedwetting. In this context, some children may appear dry when sleeping in a different environment, such as at a relative’s or friend’s house. However, it is a common misunderstanding to interpret this as proof that the child can overcome the problem if they wish to.

Furthermore, offering rewards sends an implicit message of distrust toward the child and a lack of understanding of their difficulty, placing responsibility for the issue on their willpower. This misconception can harm their self- esteem and exacerbate feelings of isolation, frustration, and helplessness. Therefore, providing rewards or using threats of punishment is both incorrect and potentially harmful.

No!

Assigning the responsibility of laundering bed linens to bedwetting children as a form of punishment,
with the intent of motivating them to stay dry at night, is incorrect, harmful, and humiliating. Bedwetting is
primarily a result of a physiological issue. The child lacks genuine control over this, and punitive measures not only fail to address the problem but also inflict harm and humiliation upon them.

It depends on… The optimal approach to address bedwetting is through bedwetting alarm treatment.

For children who are not undergoing treatment, disposable absorbent night underpants can be a practical
solution, reducing the physical discomfort, odors, and the constant laundry associated with bedwetting. Their use enables children and families to sleep away from home, go on vacations, and maintain their routines.

Moreover, diapers can be employed during the treatment process itself, with the bedwetting alarm attached to the underpants. This approach completely prevents wetting of clothing and bedding, ensuring a more comfortable experience during the treatment period.

No!

Many children achieve nighttime dryness between 18 months and 3 years of age as a part of their natural developmental process. Bedwetting is not contingent on any specific actions taken by parents.
In reality, there is no single “correct” step parents can take to prevent their child from bedwetting at night.

Therefore, there is no need for parents to seek out their own mistakes or harbor feelings of guilt or failure in this matter. Nearly all children who are not naturally dry at night by the age of 4 can be effectively treated with the Bedwetting alarm.

Highly probable!

The bedwetting alarm treatment is generally well-suited for most children. For a more tailored assessment, please complete our Preliminary Diagnostic Questionnaire (www.dr-b-kushnir.com) to receive specific guidance regarding your child.

Not always…

If bedwetting occurs exclusively during nighttime, there is typically no requirement for medical tests. However, when bedwetting is a concern both at night and during the day, it may be advisable to consult your pediatrician for urine tests and an ultrasound of the urinary tract.

No!

Treatment with the Bedwetting Alarm is entirely safe and free from harmful effects. In fact, resolving
bedwetting has a significantly positive impact in various areas. The overall home environment improves, with  reduced laundry and elimination of unpleasant odors. There is no need for frustration or keeping the issue a secret. The child’s self-esteem experiences an uplift, moving from a sense of failure and embarrassment about bedwetting to increased confidence and improved social adaptation skills.

Absolutely!

When the bedwetting alarm is employed without the proper professional guidance, success can
be challenging to attain. However, when treatment is conducted within a professional framework that offers guidance, support, and follow-up, the likelihood of success is significantly enhanced. So, even if you’ve encountered previous setbacks, success is certainly attainable this time around.

It makes no difference. You can apply the bedwetting alarm treatment at any time and during any season of the year without issue.

Not necessarily!

Although bedwetting tendencies can run in families, it does not guarantee that a child will continue bedwetting until the age their parents did. Bedwetting can be effectively treated as early as age four or even 3.

Some children may find the sensation of the cable passing beneath their shirt and touching their skin uncomfortable with certain types of wired devices. To address this, you can avoid skin contact by using two shirts, with the cable positioned between them. Alternatively, you can suggest to the child that the alarm be installed after they have fallen asleep, ensuring they don’t feel it at all during the initial stages.
Certain children may xperience discomfort with the pad or sensor clip inside their underwear. In such cases, it is advisable to use two pairs of nderwear, with the attachment placed between the two layers. This way, the only item in contact with the child’s body is their own underwear, which can alleviate the ensitivity issue.

While the primary challenge in alarm treatment is deep sleep, some children may be unnerved by the alarm sound. If there is concern, especially when treating very young children (age 4 or 3), it’s crucial to address this potential issue. Preventing traumatic experiences at the start of treatment is vital to avoid resistance and fear of continued alarm use. 

Here are several options:

a. Practice using the alarm with the child before commencing treatment. Let the child turn the alarm on and off multiple times. Ask them to pretend to be asleep and then “awake” and head to the bathroom when you activate the alarm.

b. Adjust the alarm to a lower volume. c. Consider sleeping next to the child for the first few nights or allow the child to sleep near the parents.

d. Initially, place the alarm buzzer outside the child’s room, or even in the parents’ room if using a wireless alarm. This way, parents can hear the buzzer and promptly assist the child. Over time, they will gradually become accustomed to the sound of the buzzer.

Consistent use of the alarm every night is highly crucial during the treatment process. However, practical realities may sometimes make it challenging to use the alarm on specific occasions, such as when staying with friends or due to religious guidelines on observing the Sabbath. In such cases, skipping the alarm on certain nights will not compromise the overall quality of the treatment, as long as it is used consistently on most nights.

Following successful bedwetting alarm treatment, roughly 80% of children maintain their dryness without
any relapses. However, approximately 20% may experience relapses, characterized by varying patterns and timelines, often without a clear underlying cause. If three significant bedwetting incidents occur within a month, it is advisable to revisit the alarm treatment. The likelihood of a subsequent relapse after this step is approximately 5%. In such cases, it is also recommended to reapply the bedwetting alarm  treatment.

To begin, it’s advisable to pinpoint the exact reasons behind the child’s reluctance to adhere to the treatment. Often, this resistance may be due to inconveniences related to the alarm’s usage or technical issues that can be addressed. If the child demonstrates strong opposition to using the alarm, engaging in a conversation to explain the treatment’s importance and patiently waiting for their consent is recommended. It’s important to recognize that the treatment cannot be imposed on the child against their will.

The approach to this challenge depends on the specific circumstances. Several strategies can be recommended, including advising the child to limit evening and pre- bedtime fluid intake, ensuring regular visits to the bathroom before sleep, using an alarm clock to prompt multiple nighttime bathroom visits, considering the use of bedwetting medications, discreetly utilizing absorbent materials, and potentially having one parent accompany the child on school trips lasting multiple nights.

The essential aspect is selecting an innovative approach that ensures the prevention of bedwetting during nights away from home. Additionally, it’s crucial to test any such approach at home initially to confirm its effectiveness.

It is essential to provide all the children at home with an explanation of how the bladder control system
functions in our bodies and the challenges faced by a child with bedwetting. This approach aims to clarify
that bedwetting is a physiological issue, akin to vision or hearing impairments, or even common illnesses
like the flu. It is crucial to emphasize that bedwetting does not reflect the child’s personality or capabilities and referring to my book, “Bedwetting Unmasked,” on Amazon, can be helpful in effectively conveying this information.

The child’s resilience can be bolstered through the unwavering support and empowerment provided by
their parents. This support reinforces the understanding that bedwetting is a physiological concern with no bearing on the child’s abilities or personality. This nurturing environment promotes self-acceptance
regarding bedwetting and acts as a protective barrier against negative responses from others.

This is a common occurrence among children dealing with bedwetting. The ability to stay dry in different
environments away from home is usually short-lived. The bedwetting issue typically re-emerges when
they return to their home surroundings. It’s essential not to interpret this as evidence that the child can
consciously decide when to stay dry.
The explanation likely lies in the fact that when they sleep away from home, some children become
acutely aware of the potential embarrassment of their bedwetting becoming public, which prompts them
to be extra vigilant. This vigilance may come at the cost of their sleep quality but helps them remain dry.
When the body’s reflex system is working optimally, there is no need for such heightened vigilance, and
the children remain dry regardless of their sleeping environment.

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