Update

The medication I’m taking seems to be having an effect. I’ve only wet three times in the last month, and only once in the last two weeks.

The doctor says it’s unlikely that I will stop wetting altogether. As I wrote before, an occasional accident might be more irritating than chronic, nightly bedwetting.

I might also re-think what I wear. I’m certainly going to keep wearing something – I don’t want to wake up in a wet bed (or have my husband wake up in a wet bed), even if it is only once a month or even once a year. But I don’t really like the idea of throwing away a dry pad every morning.

I don’t love the idea of cloth – I’ve been there before – but it seems a better option. My daughter chose cloth when her wetting was down to the occasional accident. She (and I) have been satisfied with that program. I’ve been using a PUL pant over a disposable pad for some time. Replacing the disposable pad with a cloth diaper (or one of my daughter’s pocket diaper inserts) seems a logical choice.

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Medication

As I’ve mentioned, standard bedwetting medications have not been effective for me. My wetting has a cause that the medications don’t address.

My doctor had a thought about a drug that treats a related problem. It doesn’t typically have adverse side effects, other than that it can make one drowsy if combined with more alcohol than a couple of glasses of wine. I don’t drink much, so that shouldn’t be a problem. So I’m trying it on a low dose.

So far, no change. But she says it may take a week or two.

Tonsils and Bedwetting

Interesting study indicating that about half of the bedwetters (ages 5 to 18) with breathing difficulties while asleep (apnea or snoring) stop wetting the bed after a tonsilectomy. Those who stopped wetting “had significantly more arousals and obstructive apnea episodes but fewer awakenings than” those who continued to wet.

Confirming again a connection between sleep patterns and bedwetting.

Protection for better sleep

A very interesting article, suggesting that bedwetting children should wear protection to get a good night’s sleep.

The first finding is perhaps not surprising: undiapered bedwetting children have significantly worse sleep quality than non-bedwetters. Undiapered bedwetters have more activity during sleep and shorter periods of continuous sleep.

The second finding may be more surprising, and is certainly more interesting: Diapered bedwetters have significantly better sleep quality than undiapered bedwetters – indeed, the sleep quality for diapered bedwetters is substantially similar to that of non-bedwetters.

Results

In comparison to [non-bedwetters], children with enuresis who did not wear night diapers had poorer sleep quality as reflected by both actigraphic measures (more activity during sleep and shorter periods of continuous sleep) and one reported measure (lower sleep quality). However, no differences were found on any of the sleep measures between children with enuresis wearing night diapers and [non-bedwetters]. The reported sleep quality of all children with enuresis with and without night diapers was lower than [non-bedwetters].

Given the importance of quality sleep, the authors conclude that doctors and nurses should recommend that a bedwetting child sleep in a diaper:

Conclusions

Our results suggest that sleep patterns of school-aged children with enuresis who do not wear night diapers are impaired, and the sleep quality of children using night diapers is similar to those of [non-bedwetters]. Thus, clinicians and healthcare providers should consider recommending sleeping with night diapers for untreated children with enuresis, based on its positive impact on sleep.

This confirms my advice that parents offer protection to a bedwetting child. Indeed, this indicates that my advice was not be strong enough:  For a good night’s sleep, protection may be essential. As I say in the update to that post,

A bedwetter should wear protection.

A parent of a young bedwetter should insist on protection.

A parent of a bedwetter old enough to make a mature decision should offer and very strongly recommend and encourage protection.

The authors close with an interesting comment: Diapering at older ages does not have a negative effect on a bedwetter, nor does it perpetuate bedwetting. Diapering will lower stress and shame and improve “the child’s well-being and psychologic functioning”.

Speaking from my own, my siblings’ and my children’s experience, I think that is certainly true. A wet diaper is less stressful and shameful than a wet bed, and no child wants to wake up in either a wet bed or a wet diaper.

Of course, as I have suggested, it is probably not good salesmanship to call it a diaper, even if the authors of the study do!

Kushner, Cohen-Zrubavel, Kushnir, “Night diapers use and sleep in children with enuresis”

[Thanks to commenter George for passing on this citation.]

PUL Wrap

While I have posted on the products that I use to manage my bedwetting, I haven’t explicitly endorsed any. Until now.

When I travel, I wear a plastic pant over the stretch panty and Tena Night Super pad that I wear every night. In the past, it’s been a lightweight, waterproof, pull-on nylon pant, which is compact and easy to rinse off and dry.

I have had lined PUL wraps for many years. I hadn’t used them as much as the pull-on pants. I thought that the pull-on would be less likely to leak out the side. (I’m a side-sleeper.) I also thought that they would not be as easy to quick-clean and dry as a nylon pant.

On a trip this spring, I tried the PUL wrap instead of the nylon pant. I (correctly) expected some hot nights. PUL is breathable, so I thought (correctly) that it would be more comfortable than the nylon pant. I was on a multi-city trip, and forgot the stretch panty in my hotel. For the rest of the trip, it was a pad directly under the PUL wrap. That was as comfortable as wearing a stretch panty with no plastic pant at all.

It was a revelation. PUL is apparently the material of choice for baby diaper covers, and I can see why. It is waterproof but breathable, light and comfortable against the skin. The wrap I used was lined with something called “alova suede“, a microfiber that is even nicer than cotton against the skin. The wrap holds the pad in place even better than the stretch pant, and catches – and holds – the occasional leak.

I now wear the PUL cover every night, without a stretch panty. The wraps I use are from a company called Dependeco, which sells them on eBay. Dependeco also sells a PUL all-in-one (a pant with an absorbent liner sewn in), a PUL pocket diaper (a cover with a pocket for a pad or soaker) and other reusable items.

I can’t endorse these wraps too highly. I’ve had a number of leaks (some fairly substantial) from the pad, but none have made it past the wrap. They are wonderfully comfortable, light and breathable. The cut and the double hook-and-loop fastening make them feel as though they were tailored for me. They have some stretch, too, so they hold the pad close to the skin without constricting.

They are also amazingly durable and undemanding. I have been machine washing and drying them at least once a week with the regular cottons, with no apparent wear.

The customer service is also exemplary. The owner has responded quickly to my questions. She apparently makes the wraps to order, but they ship the same or next day. They are reasonably priced for such an excellent and durable product.

This may be the most satisfactory product I have used in 20ish years as a bedwetter.

The eBay page for the wrap is

http://www.ebay.com/itm/Dependeco-leakproof-PUL-adult-diaper-cover-small-medium-large-x-large-/131046660307

Cloth 2

Emily completed her research project on reusable protection She saw the options as

  1. A pull-up or snap plastic pant over a pin-on or velcro cloth diaper, as I wore as a teenager.
  2. A PUL wrap over a cloth diaper.
  3. An all-in-one – a plastic pant with an absorbent lining sewn in.
  4. A pocket diaper – a plastic pant with a pocket to hold a cloth diaper.

I steered her somewhat based on my own experience.

She immediately rejected a pin-on or velcro diaper. It didn’t bother her that it was like a baby diaper. But it seemed inferior to the other options.

She initially liked the idea of an all-in-one. I steered her away from that. I had a pair in high school and liked it, but they are hard to dry and the plastic wears out before the sewn-in lining.

I have started wearing a PUL wrap (rather than a stretch pant) over the pad. (More on that in my next post), and I like that option. PUL is excellent – waterproof, but breathable, light and comfortable against the skin. The wrap holds the pad in place even better than the stretch pant, and catches the occasional leak.

However, Emily settled on the  Super Undies pocket diaper, because it was was simpler and held the diaper in place without pins or velcro. They fit well and completely contained her only accident so far.

Cloth

Emily, my oldest (11), wants to try a reusable pant. She is only wet a few times a month, and thinks it’s silly to throw out a dry disposable most mornings. She is also worried about the environmental effect.

She doesn’t have any psychological aversion to cloth. When I was a teenager, I initially had an instinctive revulsion: It’s a diaper, for goodness’ sake! I am not a baby! But I was secure enough in my maturity and practical enough to understand that I wasn’t an infant and that cloth was the only adequate protection. Emily is mature enough not to have that reaction at all.

The main argument for disposables – convenience – isn’t that big a difference. A little more laundry (in a household with plenty of hot water whites to wash) is no more burden than disposing of disposables. There’s no need for the stink of a diaper pail if I launder wet things the same day. That’s what I did when I was a teenager, and I’d do that today.

My main worry is the capacity. The bedwetter pants my siblings had in my childhood wouldn’t be capable of holding Emily’s floods. I’m afraid that an adequate product would be the sort of diaper I had to wear.

So I gave her the project to research it.

Jake, my son, hasn’t wet in a long time. He still wears a pullup to sleepovers, out of his own choice. He’s not so much worried about the likelihood of an accident as he is about the consequences. If Emily goes to a reusable pant, perhaps he could wear one when he goes on a sleepover.

Emily’s project has seemed like such a logical idea that I’ve even thought of trying cloth myself when I get runs of dry nights. I’m not going to tell her to include my size in her research, but availability in my size might be a factor in the ultimate purchase.

My main reason for not wearing cloth is discretion. I don’t want my kids to see a big diaper in the laundry. I don’t want my kids or J to see (or hear) me wearing a diaper. The pads I wear are so thin and quiet that no one would notice. That isn’t true of an adequate cloth diaper and plastic pant.

The disposables are also more comfortable than I remember cloth diapers. Even the hourglass diapers Mom made me were a more uncomfortable bulk between the legs. Also, the quality disposable products keep urine away from the skin. That is not only more comfortable, it also reduces the risk of rash or irritation.

I’m not convinced of any ecological or other advantage to cloth. Cloth advocates do a good job of isolating only some of the benefits and costs without taking into account the entire range. Suffice to say that costs of manufacturing, use and disposal are well enough integrated in all forms of protection that I am skeptical that there is any hidden advantage. However, the equation changes if one is throwing out a dry disposable most mornings, and not having to launder a dry reusable.