“You will grow out of it” – followup

Following up to “You will grow out of it”:

I don’t want to encourage pessimism. Nearly everyone does outgrow it, almost all (97%, if this and many similar surveys are accurate) by age 10. Even 7-year-old bedwetters are overwhelmingly likely (80%) to stop by age 9.

Parents tend to start worrying about bedwetting at a ridiculously early age (3 years, if this study is to be believed). Judging from postings on the internet, worry becomes obsession by school age.

Doctors, on the other hand, are generally unconcerned about bedwetting per se up to age 7, and downplay concerns even up to age 10. And with good reason; almost everyone in those age cohorts does outgrow it.

On the other hand, doctors are concerned if there are other symptoms of something other than late-developing hormones or bladders.

The pessimism is for teenaged bedwetters. That study indicates that a child that wets at age 10 is probably still going to be wetting at age 20. That’s a very tiny fraction of the population, but it’s a real problem for those in that fraction.

“You will grow out of it”

An interesting medical journal article, which is likely to be depressing to a teenage bedwetter (and parents).

Nothing surprising in the basic findings: Parents of a 5-year-old (or even 8-year-old) bedwetter shouldn’t be very worried. First, it’s common: About 16% of 5-year-olds wet the bed, with boys about twice as likely as girls. More important, the vast majority (about 80%) of 5-year-old bedwetters will stop wetting by age 9, and 85% will outgrow it by age 19.

Unfortunately, that means that a teenager who wets the bed is unlikely to outgrow bedwetting. Most 9-year-old bedwetters will still wet the bed at age 19.

And frequent bedwetters are the ones least likely to outgrow it. Kids who wet at least 3 nights a week are more likely to continue wetting the bed. At age 5, less than 15% of bedwetters wet every night. By age 19, almost half of the remaining bedwetters wet every night.

Conclusions:

The present finding suggesting that PNE [primary nocturnal enuresis, i.e., bedwetting] spontaneously resolves with increasing age probably applies only to those with mild enuretic symptoms. There are significant differences in characteristics between younger enuretic children and older subjects. As age increases there is an increasing proportion of enuretic patients with more severe bed-wetting. Enuretic children aged >10 years and adolescents have significantly more daytime urinary symptoms and incontinence.

“Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study”, Yeung et al. Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong. BJU International. Volume 97, pages 1069 to 1073 (May 2006).

Attitudes

Recently, my daughter (11) invited a friend for a sleepover. The friend’s mother called to tell me that her daughter wore a pullup when she slept away. She wanted to be sure that the mattress was protected against a leak. She asked me to give her daughter an opportunity for a discreet change in the evening and the morning. It was unlikely that the daughter would wet the pullup, and even more unlikely that she would wet the bed, but the mother asked me to give her daughter cover if she did. If that was all OK, she would let her daughter know that she could rely on me.

She was comfortable making the call. Her daughter is popular, outgoing and friendly. She has probably been to many sleepovers. The mother had made this call before.

I assured the mother that her daughter would be in good hands. I told her that her call was thoughtful – both for me and for her daughter – and refreshing. She had a good laugh when I told her that our beds were well protected, and that we could provide her daughter with a pullup from our own inventory. I was touched that she thought enough of my discretion to share the embarrassing confidence. She said that she always called before sleepovers, and parents were always discreet and helpful.

We had a little more talk about the subject. Our attitudes and approach were the same: Neither of us was (as J would say) fussed. It’s not a big deal.

I cannot imagine my Mom or any other mother of her (or any earlier) generation doing that. I can’t imagine them discussing this with even their closest friends. It was a shameful secret. Although I don’t think either of my sisters would have cared whether Mom discussed it with other parents, it would have mortified me that someone outside our family – and, worse, a parent of a friend! – would know.

Maybe I’m more old-school than I thought, because I’ve never made a call like that. I’ve never even thought of it.

Maybe it’s a sign that parents are accepting bedwetting for what it is: a delay in one (minor) element of physical development. It isn’t an emotional or intellectual defect.

And maybe parents are also confident that other parents see it the same way.

Improvement in options is probably the major factor. Life is a lot easier for a bedwetter and her mom than it was when I was a child. Today, the unpleasantness of adolescent and teenage bedwetting is insignificant, at least compared to my childhood.

A pullup is discreet. It disappears under pajamas. Even if someone else sees it, it doesn’t scream, “Bedwetter!” or, worse, “Baby!” It’s as comfortable as underwear. It prevents all the awfulness of a wet bed. It doesn’t stink. In the morning, you toss it in the trash.

The old days were uncomfortable, smelly and obvious. They required laundering. They required a hot, sticky plastic sheet, not a breathable and comfortable bed pad.

It’s easier now to accept it, and even to ask other parents to accept it.

On the other hand, the friend’s mother and I agreed that we’d never have that conversation with our mothers-in-law.

Frequency

I’ve always had a few dry nights a month, sometimes two or three in a row.

Lately, I’ve had dry weeks. Last month, I had two dry stretches of over a week each.

When I was in high school, I had a similar pattern. After a few years of chronic wetting, I wet only a few times a year. I thought that I was finally done with it. But it came back. The cause was (and is) still there. There’s no current or likely treatment for it. Even if I stop wetting for a while, it will probably come back.

Still, it’s nice to wake up dry.

The kids are outgrowing their bedwetting. Except for a few isolated accidents, Emily has been dry for months. She’s taken pullups to camp again, but that and sleepovers have been the only times she’s worn them in a long time. Jake hasn’t had an accident or worn a pullup, even to a sleepover, in over a year. Megan is getting some dry nights. Maybe by this time next year, I’ll be the only bedwetter in the family.

Dad

My father died of lung cancer. He started smoking when he was in high school and quit when he was about 60. It caught up with him and killed him.

Dad was remote, at least to me. My siblings all have fond memories of Dad from their childhood. I don’t. I don’t have bad memories. I just don’t have many memories at all. He was away a lot on business when I was an adolescent and teenager, but even when he was around, he never took much interest in me.

My older sisters – simply by being older – were more interesting. By the time I was age X, my sisters had already put him through the adventures of a girl of age X. My younger siblings had the novelty of being boys. We were all good athletes, but, in the rural Midwest, girls’ athletics are recreation while boys’ athletics are life-and-death. Also, as my sisters and I moved out, the family at home got smaller and more intimate.

More than that, Dad and I never shared any interests. School and books were everything to me. Dad had been an indifferent student at best, more interested in basketball and girls. I don’t remember him ever reading a book until after he retired. When he was in school, teachers constantly compared him unfavorably to his academically inclined siblings. I imagined, rightly or wrongly, that his resentment at that transferred to me. I won all the academic medals at school, was valedictorian of my high school class, graduated with honors from an Ivy university and earned a graduate degree in a STEM discipline. But Dad never gave me a word of encouragement or praise, while he often belittled academics and mocked perceived lapses in my intelligence. Only after he died did I find out that he constantly held me out to my younger siblings as a model.

He never understood why I left town for the city, why I left the Midwest for the East. As I get older, I start to see some of the charm of my home town, but I could never live there. Conversely, he could never imagine living in a city.

When I was young, I didn’t understand why Mom married Dad. Mom is a lot like me, which is unsurprising: I’ve always tried to be as much like Mom as possible. Love is a funny thing. Dad and Mom loved each other more than any two people I have ever known.

Dad and I grew to appreciate each other over the last few years. I’ll miss him.

The good new days: Managing

The comments to this post by Gabrielle at DesignMom got me thinking about the dramatic improvement in bedwetting products – and, consequently, life for a bedwetter and a parent – since I was a teenager.

There might be a whiff of “in the snow, uphill both ways”, but I never pine for the good old days. The old days weren’t very good. For a teen who wet the bed, they stunk.

When I was a kid (and I’m not that old), the options were limited for a bedwetter older than a toddler. As Gabrielle says of her childhood,

After diapers, I wet the bed most nights. At some point, I was simply too big for the diapers available at the time.

… [T]here wasn’t really much for parents to do but put a waterproof mattress protector on the bed and wish for the best.

I outgrew bedwetting before I faced that. But all my siblings faced it. Drugstores and supermarkets – certainly the drugstore and supermarkets in my home town – didn’t carry products for bedwetters. For the older kids and teenagers, Mom bought hospital disposables (by the case) at a medical supply store.

Those disposables didn’t hold much. They were adequate for my siblings, who weren’t heavy wetters. But they always leaked at least a little, even for my siblings. There was always a little wet spot on the pjs.

Those disposables couldn’t be re-taped. If you took one off to go to the bathroom in the middle of the night, you had to throw it out and put on a new one even if the old one wasn’t wet. They didn’t have odor control, so your room smelled like urine even if they didn’t leak.

Even that was better than the options for earlier generations. For them, it was either (as Gabrielle puts it) a waterproof sheet and hope for the best, or a cloth diaper in a plastic pant. A diaper was effective, but it was a diaper. It may have been better than a puddle on a plastic sheet, but it was the same amount of laundry and the same smell.

That was the option I faced, too. Even the premium adult disposable of the time – Attends – was inadequate. For me, it was either a wet bed or a cloth diaper in a plastic pant. After the initial shock, being a bedwetter didn’t bother me. Wearing Attends didn’t bother me. But it took me a long time to accept a cloth diaper and plastic pant. That was the worst thing about wetting the bed.

These days, there are diapers/training pants available in so many sizes, that parents can now keep sheets protected pretty well if the child doesn’t mind switching from underwear to a “diaper” at night.

And there’s no reason a child should mind – particularly if you don’t call it a “diaper”. It’s just a way to deal with something that he can’t help. There’s no shame in it – either in wetting the bed or in wearing something to protect oneself and one’s bed. It’s nobody’s fault and it’s easy to deal with. Making a child sleep in a wet bed, is cruel and unnecessary punishment for something he can’t prevent.

Excellent blog post (and comments)

Every parent of a bedwetter should read this post by Gabrielle at DesignMom – and the comments (over 150 so far).

The money shot:

Yep. I wet the bed until middle school. And had a few memorable “accidents” into high school and beyond. As a child, of course I was painfully embarrassed about it, but as an adult it’s basically the least traumatic thing in the world. Outside of parenting conversations, I never give it a second thought.

Right. Let me repeat that: As an adult, having wet the bed until middle school – and even into high school – is basically the least traumatic thing in the world. I never give it a second thought.

The comments (over 150 so far) are intelligent, compassionate and good humored. Most are from mothers who themselves wet the bed until a relatively late age, or who have children who are wetting the bed at a relatively late age.

I have a few observations based on the comments, which I plan to post over the next few days.