Monday, February 11, 2019

Mommy Mondays: In the Night

Mommy Mondays have been a little quiet around here - which goes along with the fact that having a second child means you've already dealt with anything they can throw at you, but also because Thatkid is getting to the age where I'm trying to respect his privacy by not sharing "stories that aren't mine."  He doesn't need his issues memorialized on the internet where everything lasts forever.

However, lately in my own corners of the internet I've seen certain issues that keep popping up, and certain advice that keeps circulating which is not of the true or helpful variety.  So without going into too much detail about why I have become an expert on the topic in the past year, I thought I would share some stuff I've learned in the hopes that maybe it'll help another mother out - which was always the goal of these Mommy Mondays to begin with.

So let's talk about wetting the bed or enuresis.  We've had a very unusual path in this department, that no one I know has gone through, so if you think your child is doing something weird - I'm here for you and happy to share more details privately.  This has happened to me once and I know that mom was so thankful that someone got where she was coming from. 

There are 2 types of enuresis: primary and secondary.

Almost everyone you know (and probably even you!) has experienced primary enuresis.   That's your typical "I'm not quite potty trained" bedwetting.  When they're great during the day when they're aware they have to go, but not so great when they're asleep.  Secondary enuresis is when your child, who hasn't had an accident in years, starts suddenly wetting the bed.  There's always a medical cause for that, so if that's going on, contact your pediatrician.  Today, we're just going to focus on primary enuresis - which affects more children.  (Although, as before, if you're dealing with secondary enuresis and want to chat - I'm here for you.)

 Lately I've been hearing so many moms complaining about this, and asking for how to "night train" or how to get their child to stop doing this.  And then comes all the really really really bad advice. 

So let me break this down for you.

There is no such thing as "night training."  Primary enuresis is completely not within anyone's control.   Not yours, not your child's.   It's controlled by hormones.  That's right.  Pesky little hormones.

Anti-Diuretic Hormone (ADH) is the hormone that regulates urination.  At night, the brain increases this hormone which slows down urine production, for most of us to a complete stop.  Which is why most of us are able to sleep through the night without getting up to pee.  But, like most hormones, this one doesn't kick in right away.  And it doesn't kick in for everyone at the same time.  So for some children, this hormone starts regulating urine production at 3, and for others maybe not until 13. 

What does all this mean? That means that until this hormone kicks in, nothing you do is going to stop your child from urinating at night.  No praise, no reward, no punishment.  They physically cannot stop themselves from urinating.

And let's talk about the most famous advice out there - "Just limit their liquid intake in the evenings."  I'm including this part because I've been lucky enough to get to visit with a pediatric urologist who told me this is the bane of his existence.  He hates this advice, because not only is there no relation between limiting fluid and bedwetting, but because it can be really dangerous for kids.  If your body is going to make urine at night, it's going to be using whatever fluid is in your body from the day, which you need!  Kids especially need water because they're doing all that growing and learning.  The doctor said that parents who do this often find it doesn't work, and then keep restricting liquid earlier and earlier, and kids are only awake for so many hours a day - again, needing water for their growing bodies during those waking hours.

The other advice that is oft given out that he hates?  "Wake them to use the toilet before you go to bed."  This actually trains your child to go at that specific time.  Now remember how we talked about the fact the hormone doesn't kick in for some kids until they're teenagers?  Well, in less you want to wake up your children for potentially years, you're pretty much guaranteeing a bedwetting at that exact time.  Good times!

So what do you do?  Wait it out.  It will happen.  Nighttime diapers, pullups, and all sorts of specialty underwear exist.  Reassure your child that this is normal and will not last forever.  And reassure yourself that this is normal and will not last forever!

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