Tips for Using an Enuresis Alarm



Set Realistic Expectations

 

It takes 10 to 12 weeks for the average child to be consistently dry.  Some may take longer.

 

It is rare for a child to hear the alarm and walk to the bathroom alone the first night.  This is a learned response and requires the help of a parent.

 

First Month Is the Most Difficult

 

Some success can occur in the first week, if the child is eager and does not sleep as soundly as normal.  In some cases, the second week is harder as the child and family relax and more wetting takes place.

 

Responding to the Alarm

 

Parents should respond to the alarm by going to the child’s room and noting his response. Remind the child of the next step—“put your feet on the floor and walk to the bathroom.”  This may require helping the child put his legs over the side of the bed to stand up.  The alarm should be turned off only after the child’s feet are on the floor.

 

Rules of Thumb

 

• A nightlight can help the child locate the bathroom without problems.
• Do not worry if the child has no recall of the alarm and bathroom visit in the morning.  Learning can still take place.
• Progress can be measured by keeping track of how often wetting events happen per night, the time of the wetting, and the size of the wet spot before the child responds.
• Many children wet more than one time per night at first.  Attach the alarm to clean underwear after each wetting event.  As they make progress, the nightly wetting events decrease.
• Wetting within an hour or two of going to bed is common.  This is the hardest time to arouse a child, and she rarely remembers this in the morning.  With time, this first event will go away or occur closer to morning.
• Attach the alarm to close-fitting cloth underwear (not boxers or pajama bottoms).  Do not use disposable pants.
• A waterproof pad on the top of the sheet allows for easy cleanup in the middle of the night and in the morning.
• At first, the child will have emptied his bladder by the time he hears the alarm (or the parent responds).  Over time, the new response will be one of stopping the urine flow when the alarm sounds.  Many of the alarms sound when they sense only a drop or two of urine.  As the child makes progress, there will be only a small spot of urine on the underwear.
• Keep charts to allow the child to track his progress.
• Think about giving rewards (stickers, time for fun activities) for your child wearing the alarm and walking to the bathroom when parents come to get him, as well as dry nights.

 

Dry Nights: What Next?

 

Have the child use the alarm until she has had 2 weeks of consecutive dry nights.  Then use the alarm every other night for 2 more consecutive weeks of dryness.  If wetting occurs during this process, start the 2-week weaning over again.

 

Having the child drink an extra glass of fluid before bed while wearing the alarm can help you to figure out whether he has learned how to expect the alarm and wake up when he needs to go to the bathroom.  Your child should be able to do this before you stop using the alarm.

 

Stopping the alarm too soon can lead to a relapse of the wetting.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 05/06/2010

Copyright © 05/06/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6321

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