Friday, October 7, 2011

Update on night pottying




 For the unusually curious, or intense fan of my children...and more, for my own memory and future reference.

So.  There has been a lot of progress on nighttime pottying.  I am thrilled to be able to say this!!  When we started thinking about pushing toward nighttime training, our initial stab in the dark was to run out of pull-ups, put on thick, rewashable nighttime underwear that was supposed to hold liquid, but allow the feeling of wetness, and to make the investment in changing sheets and clothes as often as needed at night in the hopes that this unpleasant nighttime interruption would help something click for Owen and prompt him to wake pre-release and head for the toilet.  In a phrase...not so much.  For at least 3 solid weeks we did this and the only result was feeling like we were on a newborn schedule again (as Owen predictably wet 3 times per night in trainers that did NOT hold much liquid), an unhappy child, a WHOLE lot of laundry, and a kid who would just as happily sleep wet as dry, his brain never waking him to prevent the event.  Fast forward after doing a fair bit of reading, research, reviews, and prepwork with Owen to get him excited about a new plan.

Key book for understanding the issue:  Getting to Dry by Maziels, Rosenbaum, and Keating of Children's Memorial Hospital Chicago
Alarm purchased, and approach based on included instructions:  Dri Eclipse wireless from anzacare.com (no small investment, but one we thought well worth it in order that a 4 year old not have the added hassle and discomfort of a wire running along their pj's and an electronics box clipped to their shirt)

There was LOTS of parental propaganda designed to incite excitement about using a 'beeper' at night.  We thought of some incentives and rewards and made it just a really fantabulous thing to get to wear a beeper in your underwear.  Oh yeah!  Owen would even say, "Look Asher, here's my beeper, you don't get to wear one yet because you're not big enough!"  Then, the hard work.  Every time he wet, which as I mentioned was an extremely consistent three times a night, 2 on a really good night, one of us would hear the alarm, get up and wake him (he did not wake to it readily), take him to the potty, change everything as needed, reset alarm and back to bed.  In the beginning this happened 3 times per night :}  Eventually we learned the trick of having him wear the alarm+undies, covered by a pull-up, so at least all we were changing was underwear and pullup, and not sheet and jammies too.  It wasn't even a week until he was down to one or two wets per night, and shortly thereafter, it was almost always just once, and after maybe a month...some nights with no alarms at all.

Just a couple weeks ago we were feeling great that the wetting incidents were so diminished, but the real goal--getting up BEFORE the beeper and using the potty--hadn't yet happened.  He was wetting less, but still a beep that he didn't wake for if there was a need to potty.  My feeling was that he didn't really mind the beeping since we'd talked it up so much, and there wasn't a mental incentive to change status quo.  So we had MORE talks and hype about someday being able to not use the beeper at all, being able to pass it on to Asher someday, having a party when he could start waking up to go potty before the beeper, and...drum roll...the real thing that probably worked...a loft bed (we've been planning to move O & A into a room together before the new baby comes, and this was going to happen anyway ;).  After that round of discussions, he actually woke up one night screaming and it turned out he needed to go.  Then, after praising him no end, and explaining that next time the screaming could be bypassed, he next came and got me in bed, and we WENT TO THE POTTY BEFORE THE BEEP!  Glorious.  It's happened a few nights since, and between that and nights he doesn't go at all, he's now gone for 10 nights completely dry.  The instructions with the alarm say that 14 nights can be considered home free, with the occasional possibility of relapse months later, in which case, use alarm again until 14 nights dry.  So exciting!!  We've been buttering that boy up both sides every time he makes a baby step and he is pretty big in his britches about this achievement.  And really, it is a huge thing isn't it!  I'm proud of him for working with us.  (And grateful for the research that a New Zealand pediatrician has put into the bedwetting alarm...so awesome for us parents to have something tested to try with some confidence it might work.)

So now, if you can believe it, on my IOU list to Owen is a 4-round-tier cake with a frosting-depicted beeper on the top layer (the top layer's diameter is to be approximately 2 inches...this is all Owen's description), and a party to which friends will be invited (Owen's insistence).  Perhaps 4 year olds are young enough to not really have a heyday with the concept of a party focused on the cessation of bedwetting.  I think we'll try to keep the theme subtle.  And, something like this setup, which will go over the cubby in his room and have a beanbag underneath (my idea).  I need to get to IKEA to pick up the bed and mattress. 


Lest one worry that we are overly hopeful that we've reached the end of this journey, we are fully aware that relapses may be in store.  But now that we have a system and a good deal of success, we're hopeful the setbacks will be fewer than greater.

Interesting notes.  Apparently there is a hormone burst produced in the early evening that causes the production of urine to slow down overnight.  It's apparently missing in some kids, or doesn't develop.  The Dr. who makes the alarm says that they don't really understand why, but using the alarm must actually help to develop the hormone pattern, because the general reaction to the alarm is not just to get up and go to the bathroom more, but rather to stop having the need to go as much and to produce less urine.  How mysterious.  But it totally seems to be the case.  Also, forgot to mention that we began the alarm use in early August, took a week off for family camp in late August, and now it's early October.  So, it was about 2 months, and the alarm instructions indicated a 1 to 2 month process, shorter for older kids.

Finally, for anyone reading who thinks we're crazy.  We might be.  About 90% of anecdotal evidence we collected from family and friends indicated that in all likelihood, kids stop wetting on their own, maybe with some mild encouragement, by age six or so.  We have so many friends who just waited and it all worked out.  Then, there were a few stories where it didn't.  So, while we really weren't desperate to push him, he was willing, and when we would talk about it, he was ready to be done with pullups and to try the alarm (we weren't twisting his arm to do something he was against).  Also, saving throwing all those pullups in the trash (and all the money) sounded good.  And, if it's just a matter of working on a problem sooner or later, why not do it sooner when he's less self conscious and not feeling a sense of embarrassment at all.  So, that's why we went for it.  We figured we'd back off and wait if it wasn't working.  There was no harshness on our part or even a sense of discipline, just working together and encouragement.  I don't think it would have been bad to wait (actually after we'd already ordered I finally found the section in the literature where the alarm is recommended for kids 5 and over!), but since we've had some success now, I'm glad we went ahead.  But it *was* quite a bit of work for all of us :}

I'll make sure to post that I've had to eat these words if we have a big setback, in the interest of our case study.

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