Coach's Corner

Most chapters in Waking Up Dry end with a section for parents called Coach’s Corner. The material in this section consists of questions and answers about everything from why children wet the bed to tips on how to help them if they’re getting frustrated with the program. I included a Coach’s Corner page on the website to provide answers to questions that were not included in the book. Most of these questions will come from patients in my pediatric practice. However, if you have a question that’s not in the book or on the website, you may submit it for review. Because I am a full-time pediatrician, I will not be able to answer your questions personally. However, I will look through these submissions periodically and will post answers to selected questions on the website. (Questions should be submitted on the Feedback page.)

Our 8-year-old doesn’t remember what happens at night even though he cooperates when his alarm goes off. He was very excited when he woke up dry this morning, but argued with us when we told him he was wet last night.
Sometimes children only partially awaken when their alarm goes off. As a result, they may cooperate with their parents, but not remember what happened the following morning. This can lead to arguments if the child does not believe he was wet the night before. When this happens with my patients, I remind children that their parents want them to be dry as much as they do. Therefore, while it’s frustrating for children to be in this position, I encourage them to believe their parents. If this becomes a recurring problem, a child should fill out his calendar at night so he can see his own accounting of what happened when he gets up in the morning.

Should my daughter lose her weekly reward if she doesn’t cooperate with the program?
The reason I recommend weekly rewards is to motivate children to stick with the program, especially if they’re not having success right away. If a child stops cooperating with the program, the first thing to do is to find out why this is happening (see page 145 in the book). If you don’t turn up anything after this inquiry, review which rewards she’s earned so far and let her know which ones are still to come. If this doesn’t motivate her, gently remind her what she agreed to do when she signed the Waking Up Dry Contract. You can “sweeten the pot” by allowing her to skip a less important task like Waking Up Practice, but let her know that you’d like her to get back into the swing of things in a day or two. If this doesn’t work, you should go ahead and withhold one of her weekly rewards. Remember to do this without expressing anger or frustration, which may sour her attitude toward the program.

My 9-year-old is going to camp in a few months and his doctor recommended a medication called DDAVP. Is this a good idea?
Although DDAVP does not “cure” bedwetting, it definitely has a role to play when children need to be dry for overnights. If your doctor recommends DDAVP, he or she will probably start with a low dose and work up depending on your child’s response. Keep in mind, however, that it’s only effective 50% of the time. When I use DDAVP with my own patients, I like to see it work seven nights in a row before I’m confident that it will do the job at camp. (See page 188 for ways to reduce the possibility of developing side effects from the medication.)

My son has always been wet at night. When we began the program, he had 5 dry nights in the first week. Now he’s been wet 4 nights in a row, and he’s very disappointed.
This is similar to the honeymoon period described on page 46 in the book. I suspect that your son had his initial run of dry nights because he was excited about the program, which subsequently altered his sleep pattern. Now that the program is in full swing, he fell back into his regular sleep habits and the reality of the situation is hitting him in the face. It’s important to let your son know that this happens to lots of kids. Tell him those five dry nights proves that he can beat this problem, but that it will take time for his bladder and brain to learn how to talk to each other at night.

My daughter forgot to do her Water Gulping for the past two days. We want to remind her, but we don’t want to nag.
Because I’ve been teaching kids to be dry for many years, I know it’s hard to do these exercises every day. Sometimes a child may forget to do them and sometimes a day may be too complicated to fit everything in. Remind your daughter that the exercises are important, but that it’s okay if she misses them once in a while. Then suggest that you sit down to discuss the situation. If you work on the problem together, she is more likely to interpret your help in a positive way rather than as nagging.

My son has been doing the program for two weeks. Last night he said he didn’t want to do his Waking Up Practice anymore.
Your son may be feeling overwhelmed with how much he has to do to become dry at night. Don’t get into a power struggle over this issue. Instead, ask him if he thinks the exercise is too much for him to do at this point. If he says “yes,” let him know that his input is important to you and that it’s okay to stop this part of the program. I would gently add that you might restart the exercise at a later time if circumstances suggest that it will help.

Can you say something about the DRI Sleeper? This is a bedwetting alarm that you didn’t discuss in your book.
The DRI Sleeper is a lightweight alarm that produces a loud buzz. The alarm attaches to a child’s shoulder area with safety pins and a Velcro patch. The DRI Sleeper has a thin, flexible sensor, which is inserted into a panty liner that’s placed inside a child’s underwear. (You make a small slit in the liner, insert the sensor, and cover the slit with a piece of tape.) Pulling the sensor out of the panty liner turns off the alarm. This is a comfortable alarm that generally stays in place at night. However, the sensor may become detached if a child is a very active sleeper. Like the SleepDry, it’s also possible that a child may accidentally turn it off while he’s half asleep (see Page 117). I would rate it the same as the SleepDry.

My son is having trouble turning off his Malem alarm. He doesn’t have any problem with the sensor, but it’s too hard for him to push the button on the alarm unit.
Malem alarms are designed to stay attached at night and to prevent children from turning them off when they’re half awake and going right back to sleep. I must admit, however, that the internal spring that controls the off button may be too firm for some children. In this circumstance, help your child turn off the alarm. Guide his fingers to the button and help him push it in. If this is still too frustrating, push the off button yourself.