The very worst thing a doctor can do to a child who wets the bed is to shame or blame the patient. Sadly, this happens all the time, which is why I wrote Bedwetting and Accidents Aren’t Your Fault. Many physicians believe accidents are caused by “attention seeking” or “laziness” and refer their patients, especially older kids, to psychologists. By the time kids like these end up in my clinic, they’re plenty demoralized.
But the second worst thing a doctor to a bedwetting patient is to normalize the accidents.
These days, “bedwetting is normal” has become a mantra among physicians, overtaking “your child is acting out.” This is progress, but it’s still disconcerting, because bedwetting — while extremely common — is not normal. Considering it so deprives children of treatment that will solve the problem.
I have a Google alert set for “bedwetting” and constantly read blog posts from doctors assuring parents that bedwetting is a normal part of childhood. These blog posts get widely shared, which makes them more damaging than any private conversation between doctor and patient.
One pediatrician recently posted that some children “bedwet up until the age of 15, and yet we consider that normal.” If your child is having frequent bedwetting around age 9 or 10, she continued, “that’s a great time to bring it up with your pediatrician or family physician.”
Reality check: That’s 5 years later than you should bring it up to your pediatrician.
Unfortunately, even if you do bring up the issue to your pediatrician when your child is in kindergarten, you may not get any help.
Most pediatricians will dismiss a 4- or 5-year-old who wets the bed and/or has daytime accidents. They’ll use the “normal” line and assure the child, “Don’t worry, you’ll outgrow it.” They’ll tell parents the child’s “bladder hasn’t caught up to his brain” or the child is a “deep sleeper” or “she’s just stressed from a change in routine” or “he’ll stay dry when he’s ready.”
One pediatrician even wrote that in children who wet the bed, “it takes longer for your bladder to know how long to hold the pee, and when is a good time for it to let go of the pee. And quite often the bladder just doesn't realize when that time is, and just leaks.”
That is the most incoherent explanation of bedwetting I have ever read!
Fact is, almost all children age 4 or older who wet the bed do so because they are chronically constipated. Their stool-stuffed rectums are pressing against and aggravating their bladders.
Children who also have daytime accidents are even more severely constipated. Research shows these are the kids least likely to outgrow accidents without aggressive treatment. I discuss this research in “Don’t Assume Your Child Will Outgrow Bedwetting.”
For their accidents to resolve, these kids need to be cleaned out daily, ideally with a combination of enemas (yes, enemas are safe for kids!) and osmotic laxatives, such as the Modified O’Regan Protocol (M.O.P.). Only then will the rectum shrink back to size, regain tone and sensation, and stop bothering the bladder.
For the most challenging cases, even M.O.P. isn’t enough. These kids need high-volume enemas (M.O.P.+), sometimes in conjunction with oil-retention enemas (aka “Double M.O.P.”). These treatments are described in The M.O.P. Book: A Guide to the Only Proven Way to STOP Bedwetting and Accidents.
But you won’t get any advice similar to this from physicians who consider bedwetting “very normal.” Most simply advise patience. From others, you’ll hear “definitely take a look at their sleep hygiene” and “after dinnertime, stop the fluids.”
You may also hear about bedwetting medication (here’s why it doesn’t work) and alarms (useful only in addition to an enema regimen, not as a substitute).
I am glad that among medical doctors, shaming and blaming children is on the decline. But those who promote the “bedwetting is normal” line of thinking also do damage, despite their good intentions.
As one mom in our private Facebook support group noted: “Uninformed medical doctors do a lot of harm out there because we parents believe them.”