Bed-Wetting is a Sensitive Subject: Approaching the Problem with a Positive Attitude!

Bed-wetting is a difficult subject for any child, but the problem is aggravated in twins if one is dry at night and one isn’t.  Because multiples often use each other as points of reference, the child who is wetting the bed may feel doubly embarrassed and his self-esteem may be undermined.  There is also a chance that the dry twin will tease him, making the situation worse.  Experts say that children take their cues from the parents:  If mom and dad are relaxed about bedwetting, the kids will be, too.

Children vary enormously in their ability to achieve nighttime dryness.  This is particularly true for boy/girl twins because girls typically achieve control earlier than boys.  Even same-sex twins show a great deal of variation in their ability to attain nighttime control.  According to Dr. Rehka Agrawal, assistant professor of pediatric nephrology at Loyola University, there are two kinds of bed-wetting – continuous and discontinuous.   Continuous bed-wetting means a child has never achieved nighttime dryness.  It is most common in boys and can last to the age of 10, sometimes longer.

Most bed-wetter’s (80%) are continuous, and the condition is simply a matter of bladder maturation.  It also tends to be inherited.  Parents of bed wetter’s frequently were bed wetter’s themselves.

In contrast, discontinuous wetting begins after a child has been dry for a long time.  It is usually triggered by stress.  However, Dr. Agrawal emphasizes that physical problems, such as urinary tract infections, must first be ruled out.  The two types of bed-wetting require different responses, but both must be handled with sensitivity.

If One Twin Has Never Been Dry

Dr. Alexander Goldbin, director of child psychiatry at Cook County Hospital in Chicago, says the best approach to nighttime wetting is a calm, relaxed attitude that doesn’t communicate anxiety and shows confidence in the child’s ability to achieve dryness.  Never punish shame or compare the child to his twin.  If the dry twin is the one who has also achieved other developmental milestones first, parents must be especially sensitive to how this will affect the relationship and the co-twin’s self-esteem.

Most children, who are continuous bed-wetter’s, stay in diapers at night while they are still young.  If one twin is still wetting, put his diapers on quietly and in privacy.  If you’re really tactful, the dry child may not even be aware that his twin wets at night.  However, if the dry twin is aware – and there’s no need to deliberately hide it – Dr. Goldbin recommends dealing with it matter-of-factly, explaining that children mature at different rates and that his twin will be dry soon, too.  Dr. Goldbin also points out that many twins are extremely supportive of each other and that you can enlist the support of the dry twin.

As They Get Older

If your twin does not achieve dryness by the age of 4 or 5, he may begin to resist diapers.  Both Dr. Goldbin and Dr. Lane Robson, director of pediatric nephrology at Children’s Hospital in Greenville, South Carolina, say that a child should not be forced to wear diapers if he finds it humiliating.  Let the child make the decision and then deal as best you can with the wet bedding.  When diapers do come off, there are ways to minimize the bed-wetting problem:

·         Enlist the child’s cooperation in solving the problem.

·         Make it clear that you will be helpful and supportive.

·         If he wakes in the night, he should be able to put on dry clothes and deal with his bedding so he doesn’t disturb the family

·         Let him know that if he is wet in the morning, he should change his clothes and strip his bed

Bed-wetting can also create significant social problems for older multiples who are invited to sleepovers or who want to go to camp.  Being a multiple, and often participating in the same social group, accentuates the issue and hurts the child who hasn’t achieved dryness.

You may have to face the issue of whether one goes and one doesn’t.  If you require the dry one to stay home, he may feel resentful that he can’t go because of his twin.  On the other hand, he may be supportive and not feel it’s a big deal.

Discontinuous Wetting

If one twin returns to wetting in response to stress, you should handle the situation much as you would if he were a continuous wetter, with a few variations.

Carefully consider the issue of whether he will return to diapers.  This is particularly embarrassing for a child who has been dry a long time and whose twin remains dry.  Express confidence in his ability to achieve dryness again.

By being as low-key as possible, the other twin may not be aware of the problem.  If he is, explain what has happened and ask him to be supportive.

If your child returns to wetting, it’s important to identify and reduce the stress that may be causing it.  Dr. Joan Luby, assistant professor of psychiatry at Washington University School of Medicine is St. Louis; suggests that you ask yourself what was going on just before the wetting began.  She also recommends looking for patterns, keeping a log of what happened each day and whether your child was wet that night.

Common childhood problems are frequently accentuated in multiples.  This is certainly the case with bedwetting.  But all doctors emphasize that as the child matures, the wetting almost invariably stops.  Continue to be calm and supportive.  However, do seek help if the child is suffering with the problem.  Many treatments are available.

 Bio/Byline: Christine Ridout, of Wayland, Massachusetts, is a freelance writer and mother of three boys, including twins.