Just the facts: The latest bedwetting research to help your child

In this age of the internet and instant communication, there is more information available to parents than ever about bedwetting, but it's often difficult to navigate. With new studies constantly being published, it's difficult to stay on top of the latest health information and understand what applies to your child. Here are some studies from the last five years or so that, according to Dr. Patrick C. Friman, director of behavioral pediatrics at Girls and Boys Town in Nebraska, may be able to help you and your child. It's in the genes One of the biggest pieces of news, and one that also comes as a relief to parents, is the scientific confirmation that bedwetting is not due to poor parenting or discipline. Genetic studies increasingly support the hypothesis that bedwetting is hereditary and involuntary. DNA research has identified genes that may be responsible for bedwetting on chromosomes 13 and 22, confirming the empirical evidence of a hereditary problem. Dr. Friman also discusses the real possibility that punitive and guilt-inducing family reactions to a child's bedwetting can cause stress and anxiety that can lead to emotional distress. Medically speaking Research on the use of medications to treat bedwetting remains pessimistic. The most commonly used medications for treatment (imipramine, desmopressin, oxybutynin) are prescribed as palliatives until the bedwetting stops on its own. With the exception of one study using two simultaneously, no evidence has been provided that these medications "cure" bedwetting. In fact, according to a 2002 article in the British Medical Journal, the company producing desmopressin (ddAVP) was publicly reprimanded in 2002 for providing "falsely optimistic" success rate statistics. On the physical level Bladder capacity is also a common topic of bedwetting research. A study published in the May 2003 issue of the journal Urology found that the bladders of bedwetting children appear to have reduced capacity at night. Researchers measured the daytime and nighttime bladder capacity of children with bedwetting and found that there was no difference from their peers in the amount of urine their bladders could hold during the day. They also found that at night, however, the bladder capacity of bedwetters was significantly lower than the daytime capacity. According to Dr. Lane Robson of the National Kidney Foundation's Committee on Bedwetting, such research is very important. "I think the biggest advance in research over the last five years has been the recognition that many children with bedwetting have a reduced bladder capacity at night," says Dr. Robson. "This impacts treatment in several ways. Many experts also believe that wearing disposable underwear does not delay a child's ability to become continent. Many of our patients wear disposable pants at night for comfort," says Dr. Ritchey, a pediatric urologist at Hermann Hospital in Houston, Texas. "I don't find they respond any differently to treatment than children who continue to wet their sheets." Researchers have also had some success in intensifying children's signal that the bladder is full through an approach aimed at stretching the bladder to its full capacity through "hold control." On the question of sleep Much of the popular literature on bedwetting discusses the role of sleep structure, but there is still disagreement over whether bedwetting should be classified as a "sleep disorder." An interesting study in the Swedish journal Sleep concluded that the sleep structure of bedwetting children does not differ significantly from that of their peers who do not wet the bed. However, it was discovered that the heart rate during sleep is different in bedwetting children. Alternative approaches There are some interesting approaches on the horizon, many of them being researched abroad. A study conducted in the United Arab Emirates reports "a marked decrease in bedwetting episodes" when using the nonsteroidal anti-inflammatory drug indomethacin. Additionally, Japanese researchers observed a 40% improvement in bedwetting following acupuncture treatments, increasing to 47% after two months. These approaches, however, should only be considered after consulting a medical expert or physician. Parents get information from many sources. But ultimately, they have to use their judgment about what advice to follow. “I've looked for information online, on websites and forums, from pediatricians, and in books on the subject,” says Susie*, a mother of an 8-year-old in Wisconsin. “I trust my instincts and advice that I don't think will have a negative effect on my child.”