Dry Bed Training
Dry Bed Training (Part 1)
Many of the parents who contact me regarding behaviour issues with their children also deal with bed wetting, and dry bed training is sometimes a secondary goal that we address.
First the Good News !
1. Bedwetting is not an illness.
2. Bedwetting is not the child’s fault.
3. Bedwetting is not the parent’s fault.
4. Bedwetting can contribute to emotional problems ~ but it’s not
inevitable.
5. There are a variety of treatment options.
6. Night time bladder control can positively influence daytime
behaviour.
7. Night time control will eventually develop
Basic Anatomy & Physiology
The urinary system’s main task is to maintain a constant alkalinity and chemical composition of the blood. It does this by removing waste products and excesses of water and salts from the blood. The organs involved are the kidneys, ureters, bladder and the urethra.
The structures and organs surrounding the internal “plumbing” is obviously different in males and females. Everything that is in the body cavity can impact on the functioning of the system in different ways.
Developmental Factors
Urinary control develops gradually. At birth the release of urine is a completely involuntary reflex. The bladder collects urine and sends a message up the spinal cord to the brain and the brain sends a message back to the bladder relaxing the sphincter, contracting the bladder which creates pressure on the sphincter and the urine is expelled.
The developmental part comes in because, with the passage of time (from birth to approximately age 5) the reflex action gradually becomes under control.
Normal Development
Newborns void approximately ever 2 hours (12 – 14 times per day) and the baby is unaware of urinating and has no control. As the infant grows, the time between voiding increases and the volume of urine becomes greater. A toddler will develop an awareness of the bladder filling (the neurological connections between the bladder and the brain begin to connect) and the desire to void in a socially acceptable place begins to become more important due in large part by parental expectations and reinforcements. Somewhere between 2 and 4 years the muscular and neurological systems begin working together and daytime bladder control is achieved. Often times night time control spontaneously happens soon after. Incidentally, children usually achieve bowel continence before urinary continence.
In a perfect world, children achieve bladder control between the ages of 2 and 4, however we all do not live in a perfect world. My next posting will address the “less than perfect” urinary world of children.