Children's Health: Beating the Bed-wetting Blues (cont.)
On the other hand, if there is secondary enuresis and the child has been dry for a while, we know that he or she is capable of being dry and wonder what might be causing the recurrence of the wetness. In that case it's especially important to look for a medical problem. Stress can also be an inducer for the enuresis to recur.
In your child's case, since he is dry all night, it's possible that stress has something to do with it, but it's hard for me to understand why the wetting only occurs in the morning.
I almost never think that bed-wetting is due to 'laziness'. Almost any child is going to stay dry when they can -- it's such a sign of maturity and being a big boy or girl. To wet the bed voluntarily, or because one is lazy, is really rare. I think some children get a bad rap from their parents because the parents believe that the child is doing it on purpose. That's always the last on my list.
Why your little guy waits until morning to wet the bed is not clear to me. Most kids who wet the bed do so a couple of hours after they have gone to sleep at night, when they are in a very deep sleep and in the first few stages of sleep. Perhaps his bladder is filling up a lot and exceeds its capacity to hold it by the morning, but this doesn't happen earlier on in the nighttime.
I would suggest if he is wetting at a certain time every morning, that you try awakening him a half hour or hour before that time and getting him up and letting him pee and see if you can short circuit the whole thing by pre-empting the morning wetness through waking him up and having him go on his own. Good luck and let me know how it goes.
If the parents are not positive but also negative about it -- they call the child lazy, ask why the child is such a baby, why can't he or she stay dry, what's going on, and if they are very angry about the whole thing (which many parents understandably are) that can really have a devastating effect on the child's self-esteem. This can continue long after the bed-wetting stops -- the child still thinks of himself or herself as not an adequate child and having these major problems.
So, I think the parental attitude is in fact the most important aspect of all of this because the odds are 98% that no matter what you do your child is going to stop wetting the bed at night. The key more is the process you go through and how your relationship is changed by dealing with this issue in those early years. That's why I think punishment has no place in the treatment of bed-wetting because one, it does not work, and two, it just makes the child feel terrible.
Think about it: If I offered you a million dollars to stop snoring at night, it wouldn't work -- you're asleep, you can't help it. If I offered you a million dollars to not sleep with your mouth open, you couldn't do it. The reason is, of course, when you're asleep, you're not responsive to rewards or punishments and neither is your child. So rewards are an adjunct.
You can use sticker charts and rewards to reinforce your child, help them and motivate them through the bed-wetting blues, but it's not going to have nearly as big a result as many parents would like to think. There are much more effective techniques which I'm sure we'll talk about later, than rewards and punishment. So sure, keep your sticker charts, encourage your child with rewards for success, but don't expect that rewards are going to do the trick either.