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Sunday, December 10, 2017

What is Using a Bedwetting Alarm Actually Like? Practical Tips and Pointers

 Enuresis is very common and can be especially difficult to conquer in a child who has ADHD.   Bedwetting alarms are a behavioral way of treating enuresis that has relatively high success rates and few side effects compared to medications and surgery.   We've recently started using a bedwetting alarm with one of our children so we thought we'd share some tips with you.

 When should you start?  Like many other things potty related, you should only start using a bedwetting alarm when your child is ready.  Bedwetting can be very tiring for a parent, but you need to have your child's buy-in or this technique will not work.  Getting up in the middle of the night is not fun for you or the child.  You need to have everyone be motivated for this or someone will quit before they are done.

Generally speaking, I would recommend waiting until your child is at least 6 or 7 before trying a bedwetting alarm, and I would also wait until your child talks to you about wanting to get out of diapers at night.  Prior to 5, most children do not need to go through this involved of a procedure to get dry at night.

The beginning stages of alarm use will be easiest if they take place at home and when your bedtime schedule and routine can be fairly normal.  However, once your child is fairly secure with alarm use,  it should be fine to go on vacation or stay up a little later than normal, provided the bed is protected in case of an accident.

 What type of alarm should you get?  There are many different types of moisture sensor alarms.   Some are pads that go under the child, and some clip to the underwear.  Pads are difficult because you have to make sure your child stays on the pad, which many ADHD kids will not, due to lots of in bed movements.  Pads also require a lot more liquid to come out which means bigger cleanups for the adult.  You should look for a secure clip, a fairly loud alarm (because the adult has to hear it, get up and get the child out of bed), and a wire that is long enough to extend from the underwear to the child's shoulder area, with a secure clip for the alarm to go on the pajamas.  If the alarm is not loud enough to wake you, you may need to use a baby type monitor in your child's room.
Some alarms have a variable feature, which could be handy if you or your child do not wake up to alarms after the first few nights of hearing them.  I can't say how likely this is, however.  I tend to wake up to an alarm more readily if it is the same one over and over again because it is a conditioned response.

 What else do you need to have to get started?
The alarm works best with tighter fitting underwear (i.e. briefs, not boxers).  Your child will have accidents, so a waterproof mattress cover is a must.  You can also try a waterproof pad, however, if it does not secure to the mattress it may slip off during the night.  Leftover waterproof pads from the crib could also be used if you still have them.

If your child sleeps with a sibling, the alarm probably will be loud enough to wake up everyone in the room.  If the sibling isn't good at getting back to sleep on their own, you may want to move one child to a different room.  It's not possible to predict how long the alarm will actually go off at night.  Some children only need it to go off for less than a week, but some will have alarms over several weeks time.

 How much parental involvement does it take?
At least one adult must get up when the alarm goes off to make sure the child does what he is supposed to do.  You should not count on your child doing this for herself.  Many children either do not wake up when the alarm goes off (until they are trained by force of habit to do so) or turn off the alarm and go back to sleep.  Even if your child does wake up fully, he may still have difficulty with taking the alarm off, going to the bathroom, and then reattaching it, or she may be unable to change her bed linens.  You should pick a time in your family's life where it will be ok if you miss a little sleep.

The first week or so, you may find it is better to sleep in the room with your child to make sure you learn to hear the alarm and can get to your child quickly.  After the first week, you can try sleeping in your own bed with the doors open or using a baby monitor to magnify the sound of the alarm in your room.

How do you know it isn't going to work?
If no adult is able to get up with the child despite using a loud alarm and a monitor, then this probably won't work.

Otherwise, it's a good idea to give it several months (up to 6) for your child to learn to hear the alarm and respond.  Most children will not have alarms every night for 6 months, so try not to envision the procedure that way! A more accurate way to think of it is this: typically if your child is making progress, having generally fewer and fewer alarms, it may take 6 months to be sure they are completely dry at night.

When should you stop?
A new habit takes at least 4 weeks to form, so you should continue use of the alarm for at least 4 weeks after the last accident, minor or major.  If there is an accident, you should restart your 4 week count.

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