Follow the previous recommendations in addition to the guidelines
given below:
1. Help your child understand
his goal.
The key to becoming dry is to learn how to self-awaken every
night and find the toilet. Getting up and urinating during
the night can keep your child dry regardless of how small
the bladder is or how much fluid he drinks. Help your child
assume responsibility for doing this. Some children think
that enuresis is the parent's problem to solve; they need
to be reminded that "only you can solve this."
2.
Have a bedtime pep talk about self-awakening.
To help your child learn to awaken himself at night, encourage
him to practice the following routine at bedtime:
3. Daytime practice of self-awakening.
Whenever you have an urge to urinate and you're home, go
to your bedroom rather than the bathroom. Lie down and pretend
you're sleeping. Tell yourself this is how your bladder
feels during the night when it tries to awaken you. After
a few minutes, go to the bathroom and urinate (just as you
should at night).
4. Parent-awakening.
If self-awakening fails, use parent-awakening to teach your
child the correct goal: urinating into the toilet during
the night. It makes much more sense than putting your child
back into pull-ups and having him urinate in bed every night
(the wrong goal). Your job is to wake your child up; his
job is to locate the bathroom and use the toilet. You can
awaken him at your bedtime. Try a hierarchy of prompts (the
minimal one being the best), ranging from turning on a light,
saying his name, touching him, shaking him or turning on
an alarm clock. If your child is confused and very hard
to awaken, try again in 20 minutes. Once he's awake, he
needs to find the bathroom without any directions or guidance.
When he awakens quickly to sound or touch for 7 consecutive
nights, he's either cured or ready for an enuresis alarm.
5. Encourage changing wet clothes during the night.
If your child wets at night, he should try to get up and
change clothes. First, if your child feels any urine leaking
out, he should try to stop the flow of urine. Second, he
should hurry to the toilet to see if he has any urine left
in his bladder. Third, he should change himself and put
a dry towel over the wet part of the bed. (This step can
be made easier if you always keep dry pajamas and towels
on a chair near the bed.) The child who shows the motivation
to carry out these steps is close to being able to awaken
from the sensation of a full bladder.