3 things to check before you buy a bedwetting alarm

Bedwetting alarms are the only proven method to cure bedwetting in up to 75% of children who suffer primary nocturnal enuresis.

But before you rush online to purchase an alarm what should you check first to ensure that your child will be successful too?

1. Are there any other factors involved in your child’s bedwetting?

Bedwetting may be caused by several things:

  1. Urinary Tract Infection;
  2. Constipation or faecal incontinence;
  3. Low levels of anti-diuretic hormone (ADH) which results in too much urine production at night, or, an overactive bladder with small capacity, or, all three symptoms together;
  4. Defective response to the full-bladder signals during sleep (high arousal threshold).

If your child has symptoms of a UTI, suffers from constipation, or experiences daytime incontinence including any of the following symptoms: urgency or toileting postponement, excessive frequency or dysfunctional voiding e.g. straining to make the wee come out, then it pays to visit your doctor, or primary health care provider, and get these issues resolved before attempting to treat the bedwetting. In many cases, resolving these issues can result in an improvement in, or cure of, the bedwetting.

Bedwetting alarms in conjunction with bladder training exercises e.g. bladder stretching and pelvic floor strengthening, may be used to treat children with small bladder capacity and low levels of ADH. Where this doesn’t improve the bedwetting significantly, or where an overactive or ‘twitchy’ bladder is the cause of the bedwetting, then you may have to consider using medications as well, under the guidance of your GP or healthcare provider. (If your child exhibits symptoms of urgency and/or excessive frequency during the day without any wetting they may have an overactive bladder).

Bedwetting alarms are particularly effective where a child has a high arousal threshold and doesn’t respond to full-bladder signals at night, but has no problems responding to a full bladder during the day.

2. Do you have a willing patient?

Make sure your child is keen to stop their bedwetting and that they are happy to use a bedwetting alarm.

For most children just wanting to be like their siblings or peers is enough incentive. For others, the opportunity to go on sleep overs and school camps is a motivator. In this case, make sure that alarm training is carried out at least 3 months prior to any major away from home event to enable sufficient time for it to work.

Some children are not at all worried about their bedwetting, which is a good thing -no hang-ups. They have a caring and supportive environment and their attitude to sleepovers and camps is ‘take it or leave it’. However, by the time they are 7-9 years of age, a lot of parents are starting to worry, on their child’s behalf, about the bedwetting and the social opportunities that are being forgone because of it.

If you have a child in this category the important thing is to find a motivator and then provide incentives. For example, making the child responsible for the extra housework (bed changes and laundry) caused by the bedwetting can result in them deciding it’s time to undertake night time toilet training so they can eliminate these chores.

If your child has a social or environmental conscience you could try appealing to this. For example, if they still wear pull-ups to bed, show them research about how many disposable diapers are dumped in landfills every year and how long they take to decompose (200-500 years). Let them know if they can stop using them they will be doing the earth a big favour. You may even suggest that they could keep some of the savings from not buying pull-ups, for a period, to donate to a cause of their choice.

For other kids, a special treat or event upon successful completion of their night-time toilet training may be sufficient.

3. What is the most appropriate alarm for your child?

Bed wetting alarms, like kids, come in different shapes and sizes. So, what type of alarm will suit your child best? Here are some things to consider when choosing the right alarm for your child.

Wired alarms

Wired bed wetting alarms have a sensor on a cord that plugs into a body-worn alarm. The alarm box usually attaches to the shoulder of the child’s night clothes and the sensor cord is run under the pyjamas down to the underwear where the sensor is placed to detect the wetting.

Wired alarms are usually well-priced for the budget conscious consumer and are great for younger kids who are not embarrassed to wear an alarm.

If your child does not usually wear bedclothes because of climate or personal preference, the body-worn alarm will have to be attached to the bedding which may be problematic -possibly restricting movement or risking getting wet with urine. Also, if your child is a restless sleeper their tossing and turning may pull the cord out of the alarm box, or, if they cannot be bothered getting up when it triggers, they can just unplug it to stop the alarm!

Wired sensors that clip onto the outside of the underwear cannot be used with pull-ups or trainers. If you intend to use disposable nappies, look for a sensor that can be used directly inside the pull-up or nappy.

Sensors need to be a good size to capture the first drops of urine particularly for boys who will wee in different spots depending on how they are sleeping e.g. on their backs or side. Also, dual sided sensors that detect moisture on both sides can be more effective in some situations.

Wireless alarms

Wireless alarms come in three versions:

  1. Those that have a sensor that is attached by a cord to a transmitter clipped onto the child’s undergarments. The sensor then clips to the outside of the underwear or goes inside the underwear;
  2. Those that have a sensor that is also the transmitter. The sensor goes directly inside the underwear and there are no wires;
  3. Sensor underpants with a transmitter clipped to the waistband of the underpants.

In all cases, the alarm is a separate unit that can be placed on bedside furniture or plugged directly into a wall socket.

Wireless alarms are usually more expensive than body-worn alarms. They are particularly good for restless sleepers as there are usually no, or much shorter wires, to contend with. They may also suit older children better who tend to be more self-conscious about being seen to wear a bedwetting alarm. They are also better for children who do not wear bedclothes, except for underwear, and because the alarm can be placed remotely on furniture in the bedroom the child must get up to turn the alarm off and not just unplug it and return to sleep.

In terms of the sensor the same issues apply as for body-worn alarms: make sure the size is appropriate and if you intend to use pull-ups make sure it can be used with these. Comfort may also be an issue. If you child sleeps on their tummy, having a transmitter attached to the top of the underwear at the front may be uncomfortable.

If you have a very deep sleeper a sensor that works with two alarms, one for the parents’ room, can be an effective option to notify you that your child has wet and to get up and assist them to respond.

Getting started

Sometimes, because of sleep disruption, it can be easier to start using an alarm during school holidays when there may be less pressure to rise early to go to school. Once you have selected a bedwetting alarm for your child, get the family on board with the treatment programme. Having the encouragement and support of Mum and Dad and other family members will be motivating for your bedwetter.

Disclaimer:
This blog is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professionals regarding any medical questions or conditions.

Lydia and her girls

My daughter loves the alarm. She’s told me to ‘sell my pull-ups on eBay mommy’. She just loves that she doesn’t have to wear pull-ups…

- Lydia Du Buisson