The current choice of most parents to manage their child,adolescent,or teenager’s bed-wetting are pull-ups  and “Goodnites” Both the idea for introducing pull-ups and “Goodnites” into the marketplace and the use of these products is that they are a more underwear like product and therefore it is believed they are less stigmatizing to the youngster,but for all intents and purposes they’re still diapers-the only difference being they don’t have tapes. No amount of cosmetic changes is going to change the fact that they’re still diapers. However most people seem to feel that wearing the product will make the user feel more “dignified” which by default implies that the people who decide to use diapers instead for their bed-wetting should feel undignified,and unfortunately many people using diapers to manage their bed-wetting do feel this way.

While it is good to have different choices to manage one’s incontinence we must not forget that these products are designed for the same purpose-keeping the person dry at night-and therefore no matter what you call them or how they look they’re all basically diapers. Like the saying goes- “a rose by any other name is still a rose.” While the pull-ups and “Goodnites” work for a large number of people I’ve read and heard about cases where these garments proved ineffective at keeping the youngster dry at night. Many youngsters are very heavy wetters particularly at night and wet right through the pull-ups or “Goodnites.” If the pull-ups or “Goodnites” don’t work then the parents should have the child or teenager wear diapers instead.

There are many different diapering options available for older children,adolescents,teenagers,and adults that wet the bed including pin-on cloth diapers covered with plastic pants and disposable tape-tab diapers(known as disposable briefs).We must remember that with most problems in life there is no one size fits all solution. Bed-wetting and choosing an appropriate garment to manage it is no exception.

Disposable briefs are the term for adult diapers. They come in youth and adult sizes and look and fit just like Pampers-they have tape tabs,elastic leg gathers(in addition some have elastic waist bands for added protection) and either a non woven cloth like outer cover or a plastic outer covering. It seems like within the past several years the adult diaper manufacturers are following the lead of the baby diaper manufacturers and are using a non woven cloth like outer covering with their diapers. I think the reason for this is twofold. The first reason is that perhaps it makes the diapers more breathable which means they might be  more comfortable with some users,and second it makes the diapers more discreet-i.e. there is none of the telltale crinkling or rustling sound that diapers with a plastic outer covering make when the user moves around. However some people claim that the non woven cloth outer covering makes the diapers feel clammy when wet,they cause  abrasion between the legs,and they’re not as effective at protecting the individual. As for purchasing diapers that have a plastic outer covering and make a rustling noise,if the person is only wearing them at night this shouldn’t be a concern.

If parents decide to purchase plastic pants and cloth diapers to manage their youngster’s bed-wetting there is one thing to keep in mind and that is the terminology used in referring to waterproof pants. Before plastic pants came out parents used rubber pants for their babies. Then plastic pants came out and even though people used  both styles of pants for awhile,eventually the rubber pants were phased out. I don’t know of any companies that make rubber pants for babies but there are a couple companies that make rubber pants for older children and adults.

Many people use the term “rubber pants” as a generic term for waterproof pants particularly plastic pants. Nowadays when people use the term “rubber pants” they actually mean plastic pants. I guess after rubber pants were phased out and plastic pants became the dominant pant used for both babies and incontinent adults the term “rubber pants” just kind of stuck and many people continued to use the term “rubber pants” as a catch all term for waterproof pants. Also “plastic pants” are the same as “vinyl pants”-vinyl is a type of plastic so people use the term interchangeably. Finally if you decide to buy waterproof pants from another country such as Canada or England it’s important to beware of the following. Some companies manufacture and sell “PVC(which stands for polyvinyl chloride) pants. This is also a plastic material and these pants are the same as the “vinyl” and “plastic pants.” I just wanted to bring this up so people aren’t confused when buying waterproof pants. I’ve also heard some people use the term “rubber sheet” as a generic term for waterproof sheets-particularly plastic or vinyl sheets.

Regarding choosing a product to manage the youngster’s bed-wetting this can be a tough choice for many parents. There are a couple of reasons for this. First,there are a number of different styles of garments out there. Second there are many brands of diapers to choose from. This can be very overwhelming. To make things more complicated there are styles within styles. For example if parents use cloth diapers there are many different ways to fasten the diapers and as a result different styles. These include pin-ons,diapers with Velcro, snap-on diapers,and pull-ons. The pin-on diapers come in different  styles-prefold, flat,and contour. Contour diapers are hourglass shaped diapers without elastic in the legs or back. Flat diapers are rectangular diapers made with one layer. Prefold diapers are also rectangular shaped but have layers built in with more absorbency sewn into the middle part.

Cloth diapers are also made of different fabrics such as gauze, birdseye ,flannel,and diapers lined with terry cloth. Some of these fabrics are more breathable(and as a result more comfortable) than others and some are more suitable for bed-wetting. For instance some companies have cloth diapers specifically designed for night use-i.e. they have extra absorbent layers sewn into the diapers for added protection at night. Cloth diapers like disposable diapers come in both youth and adult sizes. Also if the parents choose to use cloth diapers they must use waterproof pants to cover the diapers.

The most popular form of waterproof pants are plastic pants. The current crop of adult and youth size plastic pants seem to be better made then the plastic pants made years ago. Comco, Suprima, and the Leakmaster Deluxe pants (made by Gary and sold by  Adultclothdiaper.com) are just three brands of plastic pants that have a reputation for being made of a real thick durable plastic and thus well made. I’ve also heard that with some waterproof pants if the person uses various protective creams before putting on their diapers these have a tendency to break down the material of the waterproof pants. This seems to happen primarily with rubber pants(although this might just be the case with certain brands).

Waterproof pants  come in two styles-pull-on and snap-on. From what I understand the snap-on styles are used primarily with bedridden and non-ambulatory patients because with these types of patients the pants are easier to get on and off. In addition it’s to my understanding that snap-on plastic pants are used by parents for their babies because presumably these are easier to put on and take off(although personally I would think it would be just as easy using pull-on plastic pants since we’re dealing with a small child. I would also think in a situation like that it would be relatively easy to put the pants on as opposed to putting them on an incontinent adult which would probably  be harder for various reasons).I’ve also heard that snap-on plastic pants might be more breathable due to the fact that there’s a slight opening because of the snaps. This in turn allows air to circulate more freely. That being said from what I understand  the snap-on plastic pants are prone to leaks with some users at night especially if the user moves around a lot or sleeps on his or her side. Also I’ve heard that there’s a tendency for the snaps to break in some cases. Finally snap-on plastic pants are more expensive than pull-ons.

Disposable diapers for heavy urinary incontinence such as bed-wetting come in two styles-pull-on and tape-on briefs. Disposable briefs as mentioned previously have the same design and fit as baby diapers. You can also get diaper doublers known as booster pads, liners,and diaper inserts to put in disposable diapers to increase the level of absorbency in the diaper. Some companies also have inserts for cloth diapers. I’ve heard of some people lining their cloth diapers with baby cloth diapers which can be purchased in places such as Walmart and Target.

People have different opinions as far as what type and brand of diapers to use for bed-wetting-some people swear by a certain brand or style of diapers whereas others try the same brand or style and don’t like it. Many companies have samples of  disposable briefs for various  incontinence needs which they will send you  either for free or for a nominal fee. In addition to using diapers the parents should cover the bed with a waterproof sheet in case the diapers leak. Waterproof sheets generally come in two styles, flannel  with a rubber backing and plastic(also known as vinyl).The vinyl sheets in turn come in two styles-zippered or fitted. Although there are other styles of waterproof sheets the vinyl and rubber sheets seem to be the most popular ones.

I’ve heard about people using all types of covers to protect their youngster’s bed. One woman on a parenting forum said she used a plastic tarp to cover her child’s bed. In addition I’ve read that vinyl shower curtains are a good way to protect the bed. One woman I knew covered her daughter’s bed with a regular plastic sheet.  For example if you have a roll of plastic sheeting (like the kind you get in  a hardware or contractor supplies store) or are considering buying one you could cut off a piece and place it under the fitted sheet or mattress pad. Many people have a roll of plastic sheeting to use for stuff such as yard work,painting,remodeling,concrete work,covering materials stored  outside,covering mulch,etc. In addition some people probably have a roll of plastic sheeting from back when Homeland Security was encouraging everyone to buy plastic sheeting to protect against terrorist attacks.

If you do have a roll of plastic sheeting you might consider using some of it to cover your child or teenager’s bed. There are several reasons for this. One,since you already have the plastic on hand it saves you money because you don’t have to purchase waterproof sheets(not that waterproof sheets are all that expensive but in today’s day and age every penny counts).Two,the hardware store plastic is pretty durable and will last for a long time. Three,you can customize  how much plastic you cut to lay over the child’s bed. Fourth,you can cut multiple sheets which means you don’t have to use the same sheet over and over which cuts down on wear and tear. Plastic sheeting comes in several thicknesses including 3,4,and 6 mil. My feeling is the thicker the better because if the youngster  rolls around a lot at night there’s less wear and tear on the plastic which means it will last longer. Besides the woman I just mentioned I’m not sure if anyone else uses this type of plastic to protect the bed from bed-wetting but sometimes it’s good to be a trend setter. Like with any other situation in life it’s good to think outside the box and experiment with new ideas. This might be a cost effective and practical way to deal with bed-wetting.

If parents decide to use either the plastic sheeting from a hardware store or a plastic tarp to cover their child or teenager’s bed it’s important to keep in mind that this type of plastic makes a rustling sound which some people might find unpleasant. The crinkling noise of the plastic might make some children,adolescents,or teenagers feel self-conscious. On the other hand some individuals aren’t bothered by this. Some children might be bothered by it at first but eventually get used to it. Since most bed-wetters are deep sleepers they might not have any problem adjusting to the crinkling of the plastic. One way to deal with this is to put the plastic under the fitted sheet or mattress pad and to place several layers of sheets or towels over the plastic. This will muffle the crinkling sound of the plastic. If however the  youngster does have difficulty sleeping in a bed covered with this kind of plastic the parents should consider covering the bed with another type of waterproof sheet.

If you  decide to go the cloth diaper route and if your budget permits  you  might want to consider purchasing the various styles of diapers such as pin-ons and pull-ons in addition to choosing diapers made of the different fabrics previously mentioned in order to determine what works best in your particular case. Pin-ons might be the best choice in many circumstances particularly for bed-wetting. There are several advantages to using pin-on diapers for bed-wetting: a.)these tend to be the most absorbent of all the styles of cloth diapers b.) with Velcro diapers the Velcro can wear out after a number of washings and c.)with snap-on diapers sometimes the snaps  come off. d.)you can layer more material in a pin-on diaper(i.e. you can put more inserts in a pin-on diaper) than a pull-on diaper in order to make it more absorbent which is especially good for night use as people tend to wet more at night..Adding more material to a pull-on cloth diaper isn’t as feasible because it tends to bunch up and one woman I spoke to at a company that sells both kinds of diapers says the pin-ons are more secure and the pull-ons tend to sag if the user is a heavy wetter. In addition it’s hard to keep the inserts in place in a pull on cloth diaper. A couple other people  I spoke with also said that in general you have more flexibility with the pin-on diapers as opposed to the pull-ons. For instance you have a lot of latitude with how and wear you fold them in order to prevent leaks-you can make them thicker on the sides,in the front,or in the back. I read about an individual who is a side sleeper and he overlapped more material in that area in order  for the diapers to offer better protection with this particular situation.

I suspect that the pull-on cloth diapers are better suited for daytime use and people who have light incontinence-the pin-ons on the other hand are generally better for people suffering from heavy incontinence  such as bed-wetting. In fact many people consider pin-on diapers to be the best diapers to manage bed-wetting.

There is one more thing I’d like to bring up regarding cloth diapers and plastic pants. Some people find that the cloth diapers and plastic pants are too hot and as a result too uncomfortable to wear in the summer months  and during this time  they switch to disposable diapers. Also some people alternate between disposable tape-on diapers and cloth diapers-on some nights they wear the cloth diapers and plastic pants and others they wear the disposable diapers so they don’t have to wash the cloth diapers as much. The thinking behind this is that it saves some wear on the cloth diapers. Parents might want to consider experimenting with both kinds of diapers to determine what works best in their particular situation.

Choosing an incontinence product is like everything else in life-there’s no one size fits all solution. It requires a lot of experimentation and trial and error. This entails getting other people’s opinions(there are incontinence forums where you can pose questions about various brands and styles of garments) and then trying the brand or particular style of diaper. Keep in mind that a person’s recommendation of a particular brand or style of diaper is just an opinion and while it’s good to get other peoples opinions you have to try the brand or style of diapers out yourself and come to your own conclusion.

Also before buying a whole case or pack of a particular   brand  of diaper it’s advisable to contact the company to see if they have samples available-after all you wouldn’t want to spend a lot of money for a product that might not work for you. A person shouldn’t get discouraged if they have difficulty finding the right product to manage their bed-wetting. With a little persistence and patience they’ll eventually find a garment to suit their needs.

Right now I’d like to give a list of several companies and their contact info that  manufacture and sell both cloth diapers and plastic pants and disposable briefs for older children,adolescents,teenagers,and adults that wet the bed. I’d also like to mention several brands of both cloth diapers and plastic pants and disposable briefs that have good reputations particularly for night use. There are several companies who sell disposable diapers that are highly regarded by many people. One such company is HDIS which stands for Home Delivery Incontinence Supplies. Their web address is www.hdis.com and their phone number is (800)269-4663.HDIS has a personalized delivery plan in which you can set up a schedule in which to have your products delivered. For example if you order a case of diapers and they run out in 4 weeks you can set it up with them beforehand to have another case delivered before you run out. You can set it up for whatever delivery time you need. You also get a five percent discount on cases of diapers if you order this way. I would check their website or give them a call for further details. Continence Connection is another place that sells a wide variety  of incontinence supplies. They’re  run by a nurse named Robin Howe who specializes in incontinence. Their web address is www.continenceconnection.com and their phone number is (888)356-6993. They’re also open 24/7.

XP Medical is another company which has a good reputation. They have a large selection of diapers. Their number is (888)485-2268 and their web address is www.xpmedical.com. ABAIP also has a large selection of diapers and from what I understand they are run by a person who is incontinent so they will be especially knowledgeable in this area. Their web address is www.abaip.com and their number is (888)401-5311.If you need cases of diapers for your bed-wetting child or teenager I would check with several mail order places to get the best deal. As with everything else in life it’s important to shop around.

As far as pin-on cloth diapers and plastic pants are concerned there are a number of places that sell them. Angel Fluff diaper company manufactures and sells pin-on cloth diapers for older children,teens,and adults. Their phone number is (800)996-2644 and there web address is www.angelfluff.com. Another company that makes pin-on diapers is Loving Comfort. Their phone number is (717)308-0662.Kins a company out of Canada also makes pin-on cloth diapers for older children,teenagers,and adults. Their phone number is (800)665-2229.Finally Adultclothdiaper.com makes and sells pin-on diapers for older children,teenagers,and adults. Their phone number is (877)215-9004.

With regard to plastic pants, many people recommend the Comco plastic pants. Apparently some employees of the original Comco split off and formed their own company  called Comco Manufacturing. The original Comco is based out of St. Paul, Minnesota and is called Comco  Inc. They sell plastic pants,cloth diapers,and waterproof sheets. I’m not sure if they still do this but if a customer wanted a vinyl sheet of a certain size to cover the bed they will cut it to whatever size the customer requests. If interested you might want to inquire about this. Here’s their contact info: Comco, 2270 3rd. Street, North Saint Paul, MN 55079.Their phone number is (651)779-7313 and their fax number is (651)779-0871.They also have a tool free number-(800)328-9658. Their email address is comco@mindspring.com  and their web address is www.comcoincmn.com. They have a pull-on plastic pant known as the style 230 for $12.60 each and a three pack for $29.85.

The other Comco is based out of  Hinckley, Minnesota and is called Comco Manufacturing. Their contact info is Comco Manufacturing,LLC,  P.O. Box 550,  Hinckley, MN. 55037  .Their web address is www.comcomfg.com and their phone number is (888)250-8577.They also have pull-on plastic pants. The price for one is $10.50,the price for a three pack is $25.50,and the price for a six pack is $41.00.The pants from the Comco in  Hinckley, Minnesota have a wider waistband and are cheaper than the ones from the Saint Paul Comco but the vinyl they make their pants from is different. I spoke with the owner of the original Comco based out of  Saint Paul,Minnesota and he said their pants are nothing like the pants made by the Comco in Hinckley MN. He told me that the pants from his company are made from a different formulation of vinyl than those manufactured from the Comco in Hinckley MN. I’m not sure if this means they’re necessarily better made than the ones from the company out of Hinckley but the fact that they do use a different type of vinyl could play a part in how well made they are. It seems that when the employees from the original Comco left to form their own company they started using a different type of vinyl to make their pants which makes sense when you think about it.

Some plastic pants are better made than others and the fact that the Comco from Saint Paul does use a different type of vinyl could make them more durable. The best way to find out is to give both pants a try and see which one lasts longer. Also the Comco from Saint Paul has been around for at least 30 years(maybe more)  which also might give them an edge with some people-experience means a lot especially in this area. Many people feel comfortable buying products from companies they’ve dealt with for years due to such factors as customer service,the fact that they have a good relationship with a particular individual or individuals in the company, etc .

There are some individuals who might prefer the Comco plastic pants made by the Comco from Hinckley, MN due to the fact that they have a wider waistband and they’re slightly cheaper,whereas other individuals might prefer the Comco plastic pants made by the Comco in Saint Paul MN due to the fact that they’re made from a different type of vinyl which could mean they’re more  durable and as a result last longer. In addition the Comco from Saint Paul has been around longer and the owner whose name is Burch has a lot of experience in this area. With some individuals it might be worth the extra expense to buy pants that are more durable and to purchase items from a company that is more established. As I said it might be prudent to  get a pair from each and see which one you like the best.

As mentioned before Adultclothdiaper.com (also known as All Together Enterprises) also sells a style of plastic pants called the Leakmaster  Deluxe which has plastic covered elastic leg and waistbands. The Suprima plastic pants are another brand of plastic pants that are highly regarded by many people. These pants are made out of pvc (polyvinyl chloride) which as mentioned before is a type of plastic. The  Suprima pants are made in Germany and sold by a Canadian company called B4NS. The web address is www.b4ns.com and their phone number is (514)812-4917. The Suprima pants are made of a real thick type of plastic and some models also have plastic covered elastic leg and waist bands. Many people claim this makes them particularly effective for protecting against leaks especially during the night. I was on their website recently and I noticed they have several different models of the Suprima plastic pants. Some of the models have a higher back,wider elastic, and wider crotch than others which also might help bed wetters. The S1212 is one such model. I would call  or email the owner of the company and discuss with  him  your specific needs and ask him what type of pants would best meet those needs. As a matter of fact it’s a good idea to do that with other companies that sell incontinence garments as well, in order to determine the products that will best suit your needs regarding absorbency,price,etc.

Some people have a favorite brand of plastic pants and diapers and stick with that particular brand,whereas other people use multiple brands because they could be happy with more than one brand. For example a person on an incontinence forum said he used both the Suprima plastic pants and the Comco plastic pants. One of the persons replying to this individual said that he also uses both brands. I’ve heard it’s a good idea to buy several pairs of plastic pants. Given this fact it might be a good idea to buy several different brands of pants and alternate using them, that way you save wear  and tear on the various pants.

On a related note some people have a favorite style of diaper such as pin-on and stick with that,whereas others are happy using both pin-on diapers and other types such as tape-on disposable diapers. Since people have different needs and preferences for managing their bed-wetting and since there are so many different types and brands of diapers available to meet these needs and preferences,it’s a good idea to be flexible in trying out different garments because even though you’re happy with one product to manage your bed-wetting, there might be a product out there which would better suit your needs. In addition new brands and products for managing bed-wetting are coming out all the time. Also people’s needs and preferences sometimes change over time. While there is  something to be said for sticking with what works, there’s also something to be said for trying different brands and products. Sometimes that’s the best way(and some people would argue the only way) to figure out what’s most effective for a particular person and  their circumstances. No two people are alike and nowhere is this more true than with choosing an appropriate diaper to manage one’s bed-wetting.

In terms of disposable diapers for bed-wetting there are several brands that have good reputations. Abriform X-Plus made by Abena,  Molicare,Unique brief(which I believe is also known as the Wellness brief),Tranquility All-Through-The-Night disposable briefs manufactured by Principle Business Enterprises, Eurobrief, Mega Careline, Ultraguards(website www.ultraguards.com),  Tenas ,and Secure X-Plus briefs .When shopping for disposable briefs it’s important to remember that some companies make two styles of disposable diapers-one with a  plastic outer cover and one with a cloth like outer covering. Some people feel that the diapers with the plastic outer covering offer better protection and are more comfortable whereas other swear by the diapers with the cloth like cover. Tena I believe just makes diapers with a cloth like outer cover. Abena make diapers with both a plastic outer covering and a cloth like outer cover. Molicare makes diapers with a plastic outer covering-I’m not sure if they also make a diaper with a cloth like outer cover. Molicare  make different lines of diapers. The most absorbent of these is the Super Plus Fitted Briefs. Out of all  the Molicare diapers these are presumably the best to use for heavy incontinence such as bed-wetting. They have a plastic outer cover and extra padding in both the front and rear wings for increased protection and comfort.

Regarding using disposable diapers with either a cloth like or plastic outer covering I would ask the company that sells both kinds to send you a sample of each in order to determine what works best for you. You can get the Tranquility from HDIS .You can get the Molicare Super Plus briefs from both XP Medical and ABAIP. In addition you can purchase Molicare briefs from HDIS  but they don’t appear to carry the Super Plus briefs-I was on their website recently and I just saw the  Molicare Super and the original Molicare. Although these are good from what I hear they’re not as absorbent as the Molicare Super Plus briefs. You might want to contact them and see if they can special order the Super Plus briefs from the manufacturer or if they plan on carrying the Super Plus briefs in the future.

Other brands of disposable briefs   include Wings by Kendall,Prevail by First Quality,Whitestone,Dignity,At Ease, Attends, and Depends but I’ve heard mixed reviews about some of these brands. It would be a good idea to contact the companies and see if they can provide samples. HDIS has a brief sample pack-I believe it’s $9.95 for the pack. In addition you can buy diaper doublers known as booster pads,liners,and diaper inserts to put in disposable diapers to make them more absorbent. They also make booster pads for cloth diapers and some people  purchase baby  cloth diapers from places such as Walmart and Target to put in their adult cloth diapers to increase absorbency. Diaper pins(which are referred to as safety pins) and diaper rash ointment can also be purchased from these stores.

I hope the last few sections have given parents a good overview of the wide variety of products available to manage their child, adolescent, or teens bed-wetting. It’s important for parents to have a wide variety of options to manage their youngster’s bed-wetting. Just as parents have different types and brands of diapers to choose from for their babies,they should have different diapers to choose from to manage their older child,teenager,or adolescent’s bed-wetting.

Too often in life we use a cookie-cutter approach to manage problems and bed-wetting is no exception. Just as a carpenter uses the most effective tools for a particular step in building a house or for a particular project,we must use the most effective diaper to manage bed-wetting and this might be different for each individual for a variety of reasons. Unfortunately due to the taboo nature of bed-wetting the problem is not discussed much and as a result most people are unaware of the full range of products available. Most parents I believe just know about products such as pull-ups and “Goodnites.” Hopefully as time goes on this problem will be less stigmatized and more people will feel comfortable discussing this problem. When this happens people will feel more inclined to talk about the different types of diapers out there to manage bed-wetting.

I think it’s good for the older child because it helps them be more supportive about these kinds of problems. Hopefully it will also make them more sympathetic about bed-wetting and the use of diapers to manage it. They in turn can carry these attitudes with them in later years. For example if they decide to have children themselves and if their children wet the bed,their experience helping their younger sibling deal with it will help them handle their own child’s bed-wetting in a gracious,gentle manner. That being said if the parents feel that the older child won’t have the maturity to deal with the situation in a tactful way or if the bed wetter will feel embarrassed about their siblings taking care of the diapers and plastic pants then the parents should not let them help with this particular chore.

Third,although the diapers might make the bed wetter feel more secure and comfortable it is still a hassle using diapers. Shelling out money for disposable diapers can be expensive,washing diapers and plastic pants is time consuming,it can be a hassle traveling with diapers because plastic pants,diapers,plastic sheets,and the skincare products required  take up more room in the suitcase,and since many people are reluctant to divulge the fact that they have to wear overnight diapers to friends they have to decline things such as sleepovers,going camping,etc. Adolescents,teenagers,and adults are especially vulnerable in this area. Most of them are reluctant to get involved in a relationship because they are afraid to tell the opposite sex they have to sleep in diapers every night.

Also if you’re an adult bed wetter who has to travel frequently for business it can be a hassle. trying to be discreet about your diaper use. There is always the risk your colleagues will find out. In fact I read about a case where that happened. Fortunately her colleague had the same problem and was real understanding but most people aren’t that lucky. These are just some of the reasons why most people are more than willing to give up their diapers if a cure is eventually found for their bed-wetting.

On a related note I would like to touch on the following point. As mentioned previously, with some individuals the cures and treatments available for the bed-wetting  might cause more harm than good. In  cases like this if it’s determined that there’s no serious underlying medical problem causing the bed-wetting that needs to be treated,if it’s determined that the youngster will eventually outgrow the bed-wetting,and if the bed-wetting is not causing the child or teen distress then it’s advisable to wait for the individual  to outgrow it and make him or her feel as comfortable as possible in the meantime. Sometimes we just need to follow the child’s natural growth process without interference. And while this might not be advisable in all circumstances,with some individuals and in some cases  this is the most prudent course of action to follow.

Some people might criticize this tact because they feel it causes the child unnecessary suffering .As with everything else in life we must take each case on an individual basis. As I have repeatedly stressed throughout this article there are situations in which people have tried many different methods to cure their  bed-wetting without success. That’s not to say they should give up-medical science is continually coming up with new treatments for various illnesses on virtually a daily basis. I’m just suggesting that due to the stigma surrounding nocturnal enuresis(and other forms of incontinence) there is tremendous pressure to cure it and sometimes that pressure can have a negative effect on people. It makes them feel they have to turn their life upside down to cure it.

With some people it can be more stressful going to countless doctors,having endless tests and procedures done, and trying many different treatments without success-imagine what it would be like to continually get your hopes up only to have them dashed? That’s when the person has to consider the quality of life issue I discussed earlier. If the child is more distressed about being shuttled around to different specialists  and trying multiple cures without success and if the child will eventually outgrow the bed-wetting, then it might be prudent to not put any more pressure on the child and to just follow their natural growth process.

I  would tell the child something along these lines: “We’ll do everything we can to support you with this problem. With some people it’s difficult finding a cure for their bed-wetting but that’s okay. Also with some people it takes a little while longer for them to be able to stay dry at night. You shouldn’t feel pressured to become dry at night-everyone’s body is different. We know you’re frustrated about going to countless doctors and trying different cures without success and that’s okay also. We’ll see how things go and if we find out about anything new that can help resolve the bed-wetting we’ll all sit down together and discuss it. I think it’s important for you to not feel discouraged about this. In the meantime we think it would make you feel more comfortable to wear diapers to bed.”

To me wearing diapers to bed should be viewed as more of an inconvenience as I suggested earlier in this section not as something  a person should be ashamed of. I wear glasses to manage my eyesight and while I might prefer not to wear them(like most people probably do) I certainly don’t feel ashamed about wearing them. If the inconvenience of using diapers is something the person can tolerate and if they  enable the user to feel more secure and have a better night’s sleep then they should use  them.

Teenagers can be very cruel when it comes to people being different. I think it’s important for teenagers to be able to talk to other people with similar problems. There are many online support groups for various health problems and teenagers suffering from bed-wetting should take advantage of the many online health resources.

You can also start an online support group if you want. Many older children,adolescents,teenagers,and adults deal with bed-wetting every night so there are a lot of people who would be interested if you do decide to start a bed-wetting support group.

I think it would help if teenage celebrities(as well as adult celebrities) started talking about subjects such as bed-wetting-it would make it less taboo.

I  also think it’s important to be able to confide in people about this problem-whether a family member or relative,a teacher,or friend. Sometimes talking to people helps a great deal.. It’s important to be able to gauge  the depth and quality of a person’s friendship. There are some people who are real compassionate and understanding. These people are very accepting of other people’s problems and they’re easy to confide in. If  you feel you have friends of this nature and  if you’re having difficulty coming to terms with wearing diapers to bed then you might want to consider discussing this with them. It’s important to remember one thing-there are plenty  of people of all ages who wet the bed so the next time you’re getting ready for bed and putting on your diapers and plastic pants keep this in mind!

I can certainly see Guest’s point of view however he said several things in his reply that just proved my point .One of them was “Kids do have difficulty “seeing two feet beyond their noses” to understand the consequences of their decisions. They also tend to have a somewhat distorted view of the priorities” and “Where the parents come in is in the fact that because they are older,can often have a more realistic view of the “big picture.”

The big picture as I (and I believe most people) see it is to be able to manage the bed-wetting in a manner that both makes the youngster comfortable and helps them maintain hygiene. If a youngster doesn’t wear protective garments and lays all night in urine soaked sheets or wears a product that leaks how is this helping them with hygiene or making them feel comfortable?

I think requiring a youngster to wear some type of diaper to bed strikes most people as being punitive due primarily to the fact that diapers conjure up an image of being a baby. Due to the negative image of diapers, people associate requiring an older child,adolescent,or teen to wear diapers to bed as something degrading and therefore punitive. People are very symbol oriented-flags,national anthems,art,medals,and clothing are just some of the symbols we impart certain meanings and value to. To many individuals a diaper is a symbol too-a symbol of being a baby. But we must remember that the meaning and value we impart to a symbol is not intrinsic-we are the ones to give it meaning and value. There is nothing intrinsically babyish about  diapers-they’re just an absorbent material folded  and placed between the legs then fastened around the waist of an individual to help manage incontinence. It would help a great deal if dictionaries define a diaper in this way instead of  being a garment worn by babies. By not acknowledging that incontinent individuals and bed-wetters also need diapers it demonstrates the implicit assumptions people have regarding diapers which in turn  perpetuates  the image of diapers being babyish. If I was responsible for writing the entry for diaper in the dictionary I would define it this way: “An absorbent garment folded and placed between the legs of an individual then fastened around the waist designed to protect individuals with bed-wetting problems,incontinence,and as a basic garment for infants before they are potty trained.”

In my opinion it’s all about the parent’s attitude. If the parents are putting the child,adolescent,or teenager in diapers to humiliate or degrade them then it is wrong. If however the parents are using the diapers as a tool to deal with the bed-wetting then this is acceptable in my opinion.

Another thing Guest mentions is that my comparison between wearing a cast and wearing a diaper is “comparing apples and oranges.” He said-”A child won’t necessarily get sick or have a detrimental consequence of not wearing protection for bed-wetting as long as hygiene is maintained” But “not wearing protection for bed-wetting” can have a negative effect on hygiene. Frequent exposure to urine can cause skin breakdown, ulceration, and infection.

I was reading that normal urine pH is between 6.0 and 6.5 whereas the urine pH of incontinent people is between 8.0 and 9.0 which means it’s more alkaline. This in turn can irritate the skin. To quote one article-”Prolonged exposure to urine is known to chemically irritate the skin and impair its function. Although wearing certain types of diapers can also cause skin problems,these problems can be minimized or eliminated by using the appropriate skin care products such as lotions and creams. Without wearing diapers you’re just exposing more areas of the skin to negative effects.

I’ll reiterate the following point-I do believe that parents should be understanding in terms of having the youngster wear diapers. That’s the reason I suggested implementing the reward system to encourage them to try the diapers and plastic pants out. It’s important to use this system for at least 6 months-some youngsters might need a year. It’s my contention that the older child, adolescent, or teenager will be motivated to wear them because of the rewards. By using a reward system to encourage them to wear diapers to bed they’ll associate wearing diapers with something pleasant-getting a reward. After a suitable time period they’ll probably be so comfortable waking up in a dry bed they won’t need the rewards anymore and will wear the diapers and plastic pants to bed of their own accord.

One of the most important aspects of dealing with an illness whether mental or physical is the sense of having some level of control over it. Having this feeling of control improves a person’s self-esteem. This is a recurring theme in discussions and debates about using diapers to manage bed-wetting with older children,adolescents,and teenagers. I touch on this issue frequently in my posts and I thought I would touch on it more in the present one.

The prevailing view among most people whether medical professionals or not is that older children,adolescents,and teenagers should be granted autonomy in their decisions about what type of protection to wear to bed. The reasoning behind this is that by forcing them to wear diapers to bed you’re making them feel babyish. Independence is very important as children get older but in this context the main issue is the following: if the child,adolescent,or teen chooses a product that doesn’t offer adequate protection or chooses to wear no protection at all should the parents judgement about what the most appropriate form of protection to wear to bed trump the youngster’s need for independence? I personally feel it should but everybody’s  different.

In terms of self-esteem one of the issues I haven’t seen addressed is this: a big part of self-esteem is having a sense of control over one’s circumstances. In order to have this control  we must make decisions about the best course of action to follow given our particular circumstances,and since everybody’s circumstances are different people will make different choices. The way we make these decisions is by evaluating all available options and then choose the best one from all the alternatives. In some cases this might not be the most pleasant one but over time we learn to adjust. Adults do this all the time and the ability to do this must be instilled in youngsters at an early age.

How this ties in with bed-wetting and wearing diapers to manage it is in the following manner: by not wearing the most effective protection (or not wearing any protection at all) they’re in effect demonstrating that they’re not acting in a responsible manner which to me is being childish. I would tell them that to a certain extent it’s more babyish not wearing diapers to bed. I would also tell them that part of being an adult is choosing the best way to manage a problem not necessarily the most pleasant one. Most adults are also reluctant to wear diapers but they realize it’s in their own best interest to do so and although it might take them considerable time and effort to make this adjustment,in the end the majority are able to get used to wearing the diapers.

The qualities of being responsible and choosing the best course of action given the circumstances are some of the hallmarks of being an adult. In addition it makes an individual feel in control of the situation thereby improving the individual’s self-esteem.

How is lying all night in wet clothes and bedding or wearing a diaper that leaks being in control of the situation? On the contrary, by lying all night in wet clothes it reminds the person that they’re not in control. As mentioned previously people have different levels of incontinence. In addition the incontinence might effect them in different ways-some people sleep on their sides and have problems with side leakage,some people wet more than others at night,etc. Due to these differences people require certain types and brands of diapers otherwise they wouldn’t manufacture such a wide variety of products. Wearing the most effective type of diapers to bed whether pin-on diapers and plastic pants,tape-on disposables,or other products makes the user feel more in control of the situation and helps the person feel more self-confident. This in turn will improve the bed-wetter’s self-esteem.

I wanted to clarify where I stood on this issue. I was under the impression that some people might think I’m some kind of ogre because of my stance on this issue. Nothing could be further from the truth. I look forward to any comments regarding this or any of my other posts. It’s good to have constructive dialogues regarding this issue. Many people have preconceived ideas about this issue and I hope my posts might make some reconsider some of their basic preconceptions on this topic. We as a society have overcome many of our prejudices and have matured where many issues are concerned. For example there is less stigma surrounding mental illness and other diseases. Hopefully in time there will be less of a stigma surrounding using diapers to manage bed-wetting with older children,adolescents,teenagers,and adults.

According to a Mayo Clinic article a large number of children become interested in potty training at age 2 but some don’t show an interest until 2 and ½ years or older. As mentioned there should be reasonable parameters established for these situations to rule out physical and/or cognitive problems but we also need to take into consideration the fact that people’s bodies develop at different rates. Also some people do have physical and/or cognitive reasons for being delayed in this area. The reason for mentioning people’s attitudes regarding toilet training is that many persons extrapolate their ideas from this area onto matters of bed-wetting and diaper use. I n my opinion this extrapolation is not warranted.

Continence and people’s conceptions of maturity have been inextricably linked in many person’s minds for a long time. I firmly believe it’s time to rethink this. People who are delayed in their ability to be continent including bed wetters may have physical and/or cognitive reasons for this and the fact that they have these problems and might need diapers to manage the problems is not a reflection on their “maturity.” People have ailments effecting different parts of their body-their heart,liver,eyes,ears,etc. and use whatever means necessary to correct or manage the problem why should it be any different with a problem like bed-wetting?

People reading this article might come to the conclusion that I believe a person should just use diapers for their bed-wetting due to the emphasis on diapers. Nothing could be further from the truth. As mentioned earlier I don’t believe that people should just rely on diapers and not seek out various cures for their bed-wetting. It’s very important that a person seek medical advice in order to rule out a potentially serious condition. However,if after seeing a doctor and serious conditions have been ruled out,if all avenues at curing the bed-wetting have proven unsuccessful, are not viable,or not desirable for whatever reason,and if the pull-ups or “Goodnites” are ineffective at protecting the youngster,then the parents need to consider other diapering options such as pin-on diapers covered with plastic pants or disposable tape-on diapers. Although it might take the child or teen some adjustment wearing the diapers,I think in the long run it’s better for the child-after all it’s unhealthy and unsanitary(not to mention uncomfortable) lying all night in wet sheets and clothing.

One of the hallmarks of independence is the ability to take care of one’s self-this includes managing health problems. I feel that by wearing diapers to bed the youngster is taking responsibility for the situation which is a very mature thing to do and is what adults do. In fact it could be argued that the youngster is acting more like a baby by not wearing diapers to bed. By not wearing the appropriate protection to bed they are absolving themselves of responsibility and they are in effect saying they are helpless to control the situation.

We all know what the function of wearing a diaper is,so it shouldn’t make a difference whether you’re 2 or 102 the purpose is still the same. Unfortunately when you mention the word diaper to most people the image that  immediately comes to mind is that of a baby. Most people think that a diaper and plastic pants are something to be outgrown like a high chair or a bib(of course they make bibs for adults also so even this image is wrong).

Due to the stigma surrounding diaper use in older children,teenagers,adolescents, and adults the diaper manufacturers seem to be placing a stronger emphasis in many cases on the appearance of the garments rather than functionality or as  artists might say they’re emphasizing form over functionality. Tying in with this concept is the emphasis on discretion. Some of the ways the manufacturers seem to be doing this are by the introduction of underwear like products,garments that are less bulky so they can’t be noticed under  clothes, and the design of diapers with a cloth like(also known as a nonwoven) outer layer.

Since a significant number of people suffer from daytime incontinence I can certainly understand this but there are a large number of people who suffer from bed-wetting as well, and in these particular cases we should use whatever type of garments are necessary and not be concerned with how a product looks or its image since it’s only worn at night anyway. Granted there are companies that manufacture diapers for both daytime and nighttime use but I think that the stigma surrounding diapers has colored the diaper manufacturers in a negative way and this might prevent them from manufacturing,marketing, and selling products that truly meet the customers needs.

As far as the introduction of the underwear like products are concerned I think these serve more of a psychological than a protective function for the bed wetter because for all intents and purposes they’re diapers. Because they pull on like underwear as opposed to taping on this seems to help a person more psychologically. While this may be the case  in many situations they don’t work as well as diapers.

The same with the introduction of diapers with a cloth like outer covering. Again this is an example of a product that is more underwear like as opposed to diapers with a plastic outer covering. Of course there is the possibility that these types of diapers could have been introduced because they’re more cost effective for the manufacturers to produce,they’re more breathable and therefore presumably more comfortable to wear,and they’re theoretically healthier for the individual’s skin,or it could be for all these reasons. However considering that there are companies that make both styles of diapers I suspect that the introduction of this style is due more to aesthetic reasons and that the diaper manufacturers feel these will be less embarrassing to wear. Furthermore some people have commented that the diapers with a cloth like outer layer are actually more uncomfortable to wear and in fact provide less effective protection than the disposable diapers with a plastic outer covering.

I’ve heard of cases where people have used the disposable diapers with  a cloth like outer cover  for bed-wetting and leaked right through them. While this doesn’t happen with everybody, people should have the option of buying diapers with a plastic outer covering if that’s what they prefer and if that’s what works best for them. A number of people seem to be disappointed with the fact that most diaper manufacturers are moving away from making diapers with a plastic outer covering. Perhaps customers should write or call the diaper companies and complain about this. In many cases companies do respond to consumer criticism.

As I said before people should have a wide variety of products to choose from due the fact that people have different needs and preferences in this area and I’m not against people using pull-ups,disposable diapers with a cloth like outer covering, or other products of a similar nature if that’s what they prefer and if they offer adequate protection for the user however as mentioned previously this isn’t always the case. What  I am against is this emphasis on discretion and image at all costs as opposed to manufacturing,marketing, and selling products that will most effectively manage a person’s bed-wetting.

The trade-off between image and protection is made by large amount of people unfortunately and I believe that many of these people will suffer as a result. To me I would think it would be much more satisfying to use a product that might be considered “babyish” by most people but offers better protection than  to use a  product that is considered more “dignified” but that leaves the wearer and bedding drenched. In a situation such as this a person has to ask him or herself how much is it worth to them to wear  a product that has a better image versus a product that will offer more effective protection and therefore provide more comfort.

People who are reluctant to wear diapers to bed because most people feel they are strictly for babies need to keep in mind the old saw “what is popular is not always right,what is right is not always popular.” There was a time when most people thought the earth was flat,slavery was an acceptable practice,and the sun revolved around the earth but we now know these views are incorrect. I believe that in time we’ll become more informed(and as a result more enlightened) about this issue also. Furthermore there are plenty of companies that manufacture and sell plastic pants,pin-on cloth diapers,and disposable tape-on diapers for older children,adolescents,teenagers,and adults that wet the bed so this is a very common problem. This is another thing that people need to consider.

Most pediatricians,child psychologists,and other medical professionals advise against using diapers in older bed wetters because they feel it might hurt the youngster’s self-esteem and self-image. In fact one book I read said the following- “I’ve known parents that have kept their children in diapers at night as late as 7,8,9,and even 12 years of age but wearing diapers makes a child feel like a baby” and “diapers are a symbol of babyishness.”  Maybe there are some children and teenagers who actually want to wear diapers to bed but they feel that their parents will look down on them for requesting this because the youngster realizes that most people feel diapers are for babies only. And since many books and other sources suggest that only babies wear diapers that’s probably why there is such reluctance to use them for bed-wetting. In other words  it’s possible that many people feel ashamed about wearing diapers to bed not because they  actually feel that way but because the professionals do and they believe that they should feel this way also.

This wouldn’t be the first time we are cowed by what the experts say as Stanley Milgram’s  experiment and other psychology experiments so vividly demonstrate. Parents could feel the same way also-they might want to use diapers for their bed wetter or want to grant the child’s request to wear diapers to bed but they too might be influenced by what the authorities say.

This raises an interesting question-is the fact that diapers have such a negative image by most of society the result of assimilating the opinions of most medical professionals,or is the negative opinion of diapers by most medical professionals influenced by how the public feels-the proverbial chicken or egg debate. How much of our attitudes regarding diaper use by older bed wetters is influenced by cultural attitudes,parents and other relatives,medical professionals,and other factors?How and to what degree do these factors interact with each other?I think it would be interesting to study this issue in depth.

By gaining better insight into how these ideas developed we might have a deeper understanding of why we have such negative attitudes regarding this issue which in turn might significantly reduce the stigma associated with using diapers to manage bed-wetting in older children,adolescents,teenagers,and adults.

To get back to self-image older children and teenagers are particularly sensitive and concerned with self-image and the image that diapers conjure up in most peoples minds are babies. Commercials also stress this. For example the ad for Huggies pull-ups has the following motto-”I’m a big kid now!” the implication being that only babies wear diapers. I have  heard urologists,pediatricians,and other medical professionals(who in my opinion should be more sensitive and also should know better  regarding this issue) claim that putting an older child,teen,or adult in diapers at night makes them feel undignified but to me it’s more undignified waking up in pee soaked sheets and clothing!

It would be interesting to see how developmental psychologists feel about this issue. We tend to have certain preconceived ideas about our child’s growth process and if they deviate from that in the slightest we become alarmed. For example children should talk by a certain age,they should read by a certain age,they should walk by a certain age,etc. And while it is true that we should have reasonable parameters established for theses situations in order to rule out the possibility of cognitive and/or physical problems,the same reasoning shouldn’t be applied in my opinion to the use of diapers and plastic pants for the management of bed-wetting in older children,adolescents,teenagers,and adults.

Frequently we feel pressured to use socially accepted methods to resolve various medical issues but in some cases it’s a good idea to consider alternative approaches and this may entail using methods that a large majority consider unorthodox or not accepted by the mainstream. A case in point is the following. In the May-June 2007 issue of AARP magazine there was an article on Naomi Judd. It talked about how the traditional treatments that were used by her doctors to treat he hepatitis were not working so she tried various non traditional methods which are not fully accepted by western medicine such as biofeedback,aromatherapy,and meditation. It turns out that these methods worked.

I think that the use of diapers to manage bed-wetting in older children,adolescents,teenagers,and adults is another example of a management technique that is not fully accepted by most medical professionals and the public. Just like Naomi Judd had the courage to try alternative approaches to manage her disease people must have the courage to use alternative methods to manage bed-wetting.

I think we need to reevaluate our attitudes on diaper use for older bed wetters for two reasons. As mentioned previously in some cases the pull-ups and “Goodnites” aren’t as effective at protecting both the youngster and the bed. The second reason is that it makes the person who has no other option but to wear diapers to bed feel they are somehow inadequate. This in turn can lead to feelings of low self-esteem,low self-worth,and subsequent depression.

In going over the literature and opinions of many professionals regarding diaper use in older bed wetters one thing sticks out in my mind-the status quo has a negative opinion of diaper use. The literature and opinions are very consistent regarding this issue-most people believe you shouldn’t keep a bed wetter in diapers past the age of 4 or 5.After that the majority of people feel you should use pull-ups or “Goodnites” only.

It’s my firm opinion that we have a double standard regarding this particular form of incontinence. For instance we seem to have no problem with the use of diapers for developmentally disabled children,the elderly with incontinence,and people suffering from disorders such as cerebral palsy,multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,or other ailments, but if you suggest putting an older child,adolescent,teen,or adult with a bed-wetting problem in a diaper people think you’re barbaric and should be driven out of town on a rail.

There is a saying that goes something like this- “Nothing is good or bad but thinking makes it so.” While this is not the case for everything-torture,murder,rape,and stealing are inherently bad-there is nothing intrinsically shameful  about wearing diapers to bed. Wearing diapers to bed after the age of 4 or 5 is considered shameful because we have been conditioned to think this way for years. It would be interesting to see how other cultures feel about this issue but unfortunately I suspect they feel the same way we do. From what I understand the Japanese,British,and most Europeans are even more uptight about this issue.

There are many different reasons I feel most parents don’t use diapers to manage bed-wetting with both teenagers and older children. The next few sections discuss this. I believe that one of the reasons for our negative reactions toward older children being in diapers at night stems from attitudes left over from potty training. Many parents try to motivate their child during this stage with praise such as  “we’re so proud of you,you’re becoming a big kid now!” While  these parents might have good intentions(of course we all know the road to hell is paved with good intentions),unfortunately they use the same approach with an older child or teenager who still needs diapers at night .Children and teens still in diapers at night see the commercials for Huggies  pull-ups and might remember what their parents told them about diapers during their potty training years and then feel ashamed about using diapers for their bed-wetting. In addition many parents try to motivate their child to achieve night dryness by claiming that only babies wear diapers. I think this puts a lot of pressure on a child and most likely will exacerbate the situation.

Children grow at different rates-just as some children walk sooner than others,talk sooner than others,and learn to read sooner than others,some need diapers at night later than others. In my opinion a different approach is warranted. The parents need to encourage their children by letting them know that peoples bodies develop at different rates and there is no shame in using diapers to manage the bed-wetting. I would remind the child that people of all ages have problems with wetting the bed and many of them also wear diapers during the night.

A second reason for peoples negative feelings toward older children still being in diapers could be the fact that parents used to use cloth diapers and rubber pants for their babies. This meant lots  of work for parents especially before the advent of washing machines. In this circumstance parents felt compelled to get their children out of diapers as soon as possible. If an older child had to wear diapers to bed for bed-wetting the parents might have been upset about the prospect of having to spend years washing diapers and rubber pants. Subsequently many parents used the shaming approach to try to get them out of diapers.

Over the years we’ve become more enlightened about this issue(although we still have a long way to go in my opinion) and most people realize that this approach doesn’t work and in many cases can make the situation worse. That being said the people who had the bed-wetting problem when they were younger remember their parents using this approach with them and they might use this technique with their children also.

A third reason for our negative attitudes regarding this stems from our attitudes toward various milestones in a person’s life. Most cultures have certain expectations of when we’re supposed to achieve certain things-we’re supposed to get a driver’s license by a certain age(I know a woman who is 24 who still does not have a driver’s license),we’re supposed to graduate from high school by a certain age,etc. Nowhere are our cultural expectations more deep-seated than with bed-wetting and diaper use and if a person needs diapers past the age that is considered socially acceptable by most people we instill in them the idea that they should feel ashamed.

To get back to parental attitudes toward diaper use I wonder if one of the reasons most parents are so adamant about getting their child or teenager out of night diapers is that a part of them feels ashamed about it. It’s a very competitive world out there and every flaw a child might have is looked at as something that must be hidden or fixed at all costs. The prevailing attitude among many parents is that their kids must be perfect at everything because any sign of imperfection is viewed by society as a sign of weakness. There is immense pressure for parents to make sure their children go to the best schools,to participate in numerous after school activities because it looks good on their records,play sports,etc. Imagine if it got out that 18 year old Susan is still in diapers and plastic pants at night? So much for going to Harvard!

Parents are also competitive with one another and unfortunately some hyper competitive parents use their children as pawns either consciously or subconsciously in this competition. They feel that any flaw the kids might have is a reflection on their parenting skills and might make them look bad. “What would our friends and neighbors think if they found out our 15 year old son still wears diapers and plastic pants at night? How embarrassing!” We need to grow up! Everybody has some flaws-that’s what makes us human! The only thing we can do is accentuate our strengths and do the best we can to work on our flaws and try to improve ourselves but we shouldn’t obsess about our weaknesses.

A fourth reason for our negative feelings concerning using diapers to manage  bed-wetting  has to do with our emphasis on self-image. Although this is a universal concept this concept is especially important in the U.S. Most of our ideas of self-image unfortunately tend to be rather superficial. We’re very concerned with status,power,image,and success and these four things are inextricably linked in many people’s minds with having a strong self-image. A large number of people believe that wearing diapers represents the opposite of all four of the qualities in which people feel a strong self-image consists of .In particular a significant number of   people believe  wearing diapers represents a feeling of being powerless,no doubt due to the fact that most people associate diapers with babies. Many people of course view babies as the paragon of powerlessness. Because of this view a large number of people develop a negative self-image if they have to use diapers for bed-wetting.

A fifth reason is that some people believe that by putting the child in diapers for bed-wetting you in essence “are giving them permission to wet the bed” or that “it’s okay to wet the bed.” Believe it or not I’ve heard some people say this and I think it’s one of the most ridiculous things I’ve ever heard. Since the purpose of having the child or teenager wear diapers at night is to keep the bed dry I think it sends the opposite message-that it’s not okay to wet the bed. In no way can putting a child or teenager in a diaper for a problem they can’t control be construed as “it’s okay to wet the bed.” I think it sends the message that the parents are going to make their children as comfortable as possible until a cure is found. Or if the treatment options currently available don’t work or are not viable for some reason, they’re going to have them wear diapers because it’s more healthy for the child and it makes them more comfortable.

Diapers should not be the  first option used for bed-wetting, but by the same token they should be used if all alternatives have been exhausted or are not desirable or feasible. To me diapers should be viewed no differently than sanitary napkins for women.

A sixth reason why most  people are so against older bed wetters remaining in diapers at night is group think. People in general want to conform and with that tendency comes the fact that people go along with the prevailing wisdom without questioning its validity. They internalize it and it becomes so ingrained in their thinking that they can’t imagine anything else. We’re like fish in water-it becomes so much a part of their life and environment that they don’t even notice it. The fact that the majority believe in something is no guarantee that it’s right. History shows that in many cases it is the minority or a sole visionary who is right and the majority wrong.

Finally we tend to put too much credence in what experts say without questioning its validity. I ‘m not suggesting that we shouldn’t listen to anything the experts say but we should keep the following points in mind: experts frequently have conflicting opinions which could mean either that they in fact have opposite opinions on certain issues or that the issue is complex and they need to undertake more research in order to make a definitive conclusion or come to a consensus.

Second, there have been many situations where the experts were later shown to be wrong. Childcare is no exception. For example it was originally thought that playing Mozart would have a positive effect on an unborn child’s brain development. This theory known as the “Mozart Effect” was later shown to be false(who knows-after further research and an improved understanding of cognition they might change their minds again-this has also happened with certain things) With this in mind it’s conceivable that our current opinions about using diapers to manage bed-wetting are wrong also( I strongly believe that this is the case and that our thinking on this issue is completely misguided) although with how entrenched our attitudes our regarding this issue it might take a generation or more to overcome this inertia and reconsider our current attitudes concerning this situation.

A seventh reason  why most parents use pull-ups or “Goodnites” instead of diapers for their youngster’s bed-wetting  may be that they’re not aware of the different brands and types of products out there to manage bed-wetting. As mentioned previously there are many choices available to manage one’s bed-wetting. Also some styles might not be used as much because of generational differences. For example,although some younger parents  use pin-on diapers and plastic pants for their babies, most younger parents are probably not familiar with pin-on diapers and plastic pants since they’re not as popular as they once were. The parents who do use pin-on cloth diapers and plastic pants for their babies might continue to use them  if their child or children who wet the bed since the parents are  familiar with them but parents who don’t use them or are not familiar with them might not use them unless their friends,relatives,or other  people  recommend them. Second,even if parents are aware of the different choices out there to manage their child or teenager’s bed-wetting it’s very time consuming sorting through all this information in order to make an informed decision about the best type of product to buy. There’s a bewildering array of products out there to deal with bed-wetting and it can be quite  daunting learning about all the different products out there.

That’s where the role of medical professionals comes in to play. I think  urologists, pediatricians,and other medical professionals should have some basic knowledge of the different types of diapers available to manage bed-wetting and the advantages and disadvantages of each. While they obviously can’t have an encyclopedic knowledge of this they can apprise their patients of the basic styles of cloth diapers such as as pin-on diapers,pull-ons,snap-ons,and Velcro; and disposable diapers such as tape-on diapers and pull-ons.

They can also inform them about the different types of waterproof pants such as plastic pants and the different types of waterproof sheets. If possible they should  also have a list of several companies that sell both  kinds of diapers and a list of websites(such as bed-wetting forums, incontinence organizations,and other resources) .These organizations can provide further information not listed in the physicians office such as additional companies that manufacture and sell incontinence products,information about bed-wetting support groups,etc.

I was reading that in the U.S. and other countries they have wound,ostomy,and continence nurses. From what I understand wound,ostomy,and continence nurses(abbreviated wocn nurses)perform the following functions: they  inform patients of the different types and brands of products available to manage incontinence;the different ways some products may effect the skin such as causing diaper rash and/or other problems; what types and brands of skincare products to use if this is the case-  Desitin,A&D ointment,powder,petroleum jelly such as the Vaseline brand,lotions,etc.;the pros and cons of different absorbent products;in addition to the different companies that sell incontinence products in order to help guide the patient in making a decision about what type of products to purchase based on their current needs.

I think this is a good thing that we have these types of specialists-after all it’s very time consuming trying to find out this information on your own whereas a nurse or other medical professional specializing in bed-wetting and other incontinence issues can find the information more rapidly and efficiently due to the resources they have at their disposal. It’s my belief that if more people become aware of the different diapering methods out there to manage bed-wetting more people might use these products thereby decreasing the stigma associated with older children,teenagers,adolescents,and adults wearing overnight diapers. The medical community can play a big role in the reduction of this stigma  by  informing both parents and patients of these options.

A second way to reduce the stigma associated with using diapers to manage bed-wetting in older children,adolescents,teenagers,and adults is to have  talk show hosts discuss this on their shows. I think this would be a perfect topic to discuss on Oprah. Due to the nature and depth of the material she could make it a two or more part series on her show. She could invite experts on bed-wetting to discuss what it is,the age groups effected,adult bed-wetting,different cures and treatments for it and the advantages and disadvantages of each,the best ways to cope psychologically if it can’t be cured,and the different types of protection to manage bed-wetting.

As far as protection is concerned the experts would  discuss the different diapering options available to manage bed-wetting and the advantage and disadvantages of each. Some of the options discussed on this segment would be cloth diapers such as pin-on,pull-on,and other types, disposable diapers such as tape-on and pull-on,the various types of waterproof pants such as plastic pants,and the various types of waterproof sheets. I think it’s important to mention all these options for two reasons. One, it’ll make parents aware of options to manage their youngter’s  bed-wetting they might not have known about or if they did know about them they might not have considered them before. Two,by doing this more people might consider using these different types of garments thereby decreasing the stigma surrounding them.

Oprah has a lot of clout and influence and I believe that people such as her(and other celebrities) could help lessen the negative image of bed-wetting and diaper use. I guarantee after this episode of Oprah diapers would sell like hot cakes- department stores such as Walmart and Target and food stores such as Giant couldn’t keep them on the shelf .By both doctors and celebrities recommending diapers this might have a snowball effect. For instance someone who uses diapers for their bed wetter because doctors or celebrities  recommended them might in turn recommend using diapers to  their friend/friends who have children with bed-wetting problems thereby increasing the number of people who use diapers to manage bed-wetting.  The subsequent increase in the number of people using diapers to manage bed-wetting  will do more to decrease the stigma associated with using diapers for bed-wetting.

We as a society have matured as far as many medical issues are concerned. For example there is less stigma surrounding mental illness and other medical problems,but unfortunately bed-wetting and the use of  diapers to manage it is an issue that remains taboo. We are very stubborn regarding this issue. Most people for a variety of reasons do not want to budge regarding this issue. I suspect that in the future we will loosen up about this issue to a certain extent,but I also  think there will always be people who view this in a negative light no matter how persuasively we argue the merits of wearing diapers for bed-wetting.

One of the major reasons for the stigma of diaper use in older bed wetters has to do with our thoughts and feelings on the issue of dignity. Many older children,adolescents,and teenagers feel undignified about wearing diapers to bed.  To a large extent our concept of dignity is shaped either consciously or subconsciously by people we admire such as sports figures,entertainers,and heroes. We have this idealized image of them and we tend to extrapolate that image to all aspects of their personal lives. Because of this perfect image we have of them we couldn’t imagine them having a problem like bed-wetting. Of course we must remember that these individuals are human also and are subject to the various health problems that everyone else has. In fact many famous stars such as Suzanne Sommers, Johnny Carson,and Michael Landon(to name a few) experienced bed-wetting when they were growing up.

I also feel that are ideas about dignity go hand in hand to a large degree with our feelings about independence-being able to take care of yourself and run your own life. As mentioned earlier diapers represent to many people a return(at least symbolically) to a state when their parents took care of them which is a blow to a child or teenager’s ego. Adults who have to wear diapers to bed also feel this shame. Many people find it very difficult to get past this feeling of shame and unfortunately some people can never get past it. Although most people find it undignified wearing diapers and plastic pants for bed-wetting,personally I think it would make a person feel more undignified laying all night in pee soaked bedding and pajamas!

Dignity also relates to a feeling of control which in turn relates to are sense of self-esteem and how self-confident we feel about ourselves. When we are self-confident we have a feeling that we are in control of our lives and that in turn makes us feel more dignified. Again by wearing diapers to bed we feel a lack of control which in turn makes us feel less self-confident. This in turn erodes our feeling of dignity. This is the case with many other medical problems as well. For example a person who has to wear a cast for a broken leg or a person who has to take insulin shots for diabetes might feel either consciously or subconsciously that he or she doesn’t have control. The cast or needle represents the feeling of a lack of control. The same is true for wearing diapers and plastic pants to bed. Of course every person is different in the degree in which they have these feelings and their ability to overcome these feelings.

One thing that we must realize however is that we should not be defined by our illness. The fact that a person has to wear diapers to bed is only a part of who that person is. A person’s dignity should be measured by the fortitude they exhibit in dealing with life’s adversities and  how well they treat other people. If a person has to wear diapers to bed and they deal with it with a sense of grace and humor then the fact that he or she needs diapers at night should not detract one iota from their dignity.

Third,you might consider ordering a large or extra large,adult size pair of plastic pants and/or diapers. By showing the youngster an actual adult size pair of plastic pants or diapers which is a size that is larger than what they would wear,it might help them feel better about wearing diapers to bed. By actually seeing an adult size it emphasizes the fact that adults wear them to bed also. This will help them more psychologically as opposed to just seeing something on a web site.

Fourth,you can explain to them that people have different needs in terms of managing their incontinence-that’s why they have so many different styles of incontinence garments. There are different levels of incontinence-some wet more than others. You need to stress to the youngster that what works for one person might not be as effective for another. Fifth,emphasize to the child or teen that they are only wearing the diapers at night. Unlike during the day it is much easier to conceal the use of diapers at night.

In some circumstances however it might be difficult to be discreet about the use of diapers particularly if the parents are using cloth diapers and plastic pants to manage the bed-wetting. I would like to digress for a moment and discuss this briefly. If the bed wetter has siblings it’s inevitable that they’re going to notice either diapers in the laundry or plastic pants hanging up to dry on the clothesline. Or if the bed wetter shares a room with a sibling it’s impossible to hide the diaper use from their brother or sister. If this is the case it’s imperative that the parents let the other children of the household  know that any teasing about the bed-wetting or diapers and plastic pants will not be tolerated and will result in punishment.

On a related note there is also the possibility of friends of either the bed wetter or sibling finding out about the bed-wetting when they come over to visit. There are some precautions that you can take to prevent this from happening. If the youngster uses cloth diapers and plastic pants you can put the diaper pail in the laundry room before the friends come over. And if you’re worried about them accidentally discovering the diapers and plastic pants you can put them in a special bin(which you can purchase from Target or Walmart) and either label the bin “school papers”(or something similar) or take the bin out of the room before the friends come over and put it back after they leave. Plastic sheets can also be a concern due to the fact that some of them make a crinkling or rustling sound which can be discovered if friends sit on the bed. I have read and heard about this happening in some cases,however this can also be remedied. You can take the waterproof sheet off before the friends come over and put it back on again before going to bed or put extra cloth sheets over the protective sheet to muffle the sound of the plastic. It should be mentioned that while this is a possibility with some plastic sheets if the youngster has the bed covered with a rubber sheet this won’t be a concern.

At this point I would like to get back to suggestions on how to motivate an older child or teenager who is reluctant to wear diapers to bed. The last idea I have is to implement a reward system designed to encourage the child or teen to wear diapers to bed. You can offer to increase their allowance by a certain amount. You could also say that if they agree to wear the diapers to bed for at least 6 months they can earn a certain amount of money per month such as $20.00(or whatever amount the parents can afford and are willing to pay them).If they  don’t wear the diapers and plastic pants to bed you can deduct a dollar for each night they don’t wear them. In addition to having a specific amount they can earn per month,if financially feasible it might be a good idea to purchase a present for them which you can give them after the 6 month trial period. Or they can earn a specified number of gold stars or points per month which they can cash in for presents. Again they will be deducted a gold star or point each night they did not wear the diapers to bed.

I think that verbal praise is an important part of the reward system. There is always the possibility that some older children and teens might get discouraged and not put on the diapers some nights. If this is the case it’s very important to encourage them. Remind them of how proud you are for trying them out and also remind them of the reward system. I would say something along these lines: “We’re real proud of you for trying the diapers and plastic pants out. I  realize that it’s no fun wearing them but just keep in mind the advantages of wearing them-you’ll wake up nice and dry. Also remember that the more nights you wear them to bed the more money you’ll make. I know it’s hard but try to hang in there.”

I think that in order to motivate them to wear the diapers to bed for the long term it’s important to have some small rewards they can earn along the way while waiting for the big reward at the end. It’s my contention that after the 6 months is up they’ll feel so accustomed to wearing them and so comfortable wearing them that they will want to wear the diapers to bed of their own volition and not need rewards anymore. After 6 months they’ll most likely realize how comfortable it is to wake up nice and dry.

In combination with using a reward system there are certain scripts(as the mental health professionals say) that a child,teen,or adult can say to themselves in order to feel more comfortable with the idea of wearing the diapers and plastic pants to bed. For example he or she could say something like this to themselves: “This is just a garment designed to absorb urine and prevent it from getting myself and my bed wet. Wearing this is no reflection on my maturity. In fact by taking the appropriate precautions in dealing with the situation I am acting more mature. It doesn’t matter what most people think. I am doing what’s best for me in my particular situation and circumstances” or “I’m just wearing these at night-no one but myself and my family know I have them on. I’m asleep while I have them on so it’s not like I’m going to notice them much anyway except when I put them on at night and take them off in the morning. It’s like having a tooth pulled under anesthesia-I won’t even notice it.”

Finally another thing a person could say is the following: “Everyone’s body develops at different rates-some people are potty trained later than others and some wet the bed later than others. My bladder has just not developed enough where I can stay dry at night unlike during the day. I wore diapers during both the day and night to protect me when I was a baby so why should it be any different now-I still have the problem of wetting. Just because I’m older doesn’t mean I still don’t need them. Besides they make diapers and plastic pants in my size so there must be a need for them-I am not the only one who wears them for bed-wetting.”

If the child is younger you can tell them to play a little game. You can tell them to imagine that the diapers and plastic pants are a like dam and the bed is like a city. The dam(in this case the diapers and plastic pants) keeps the city(in this case the bed)  from being flooded. Or they can pretend they’re a superhero and the diapers and plastic pants give them special powers-in this case the power to prevent  their bed from getting wet. Finally they can look at the diapers and plastic pants in the same way as a raincoat.

I’d like to wrap this section up with an example of how concerns over both the issues of maintaining discretion when using diapers and the negative image of diapers can adversely effect a person’s self-esteem. In this part I’d like to mention the difficulties faced by the individual with coming to terms with wearing diapers to bed and what a person could tell him or herself(what the professionals call positive self talk) to overcome the distress associated with these difficulties or at the very least minimize the distress. Although the person in question was talking specifically about his objections to wearing cloth diapers and plastic pants to bed I feel my suggestions are applicable to the use of disposable diapers also.

When reading about the teen’s difficulties I was struck by how poignant it was and how sad it is that other children and teenagers feel the same way. The teen feels that certain aspects of the diapers make him feel like a baby. The pins,the bulk of the diapers between the legs,and the sound of the plastic as he moved around were triggers in his mind that made him feel this way. As mentioned many older children and teens probably feel the same way but instead of viewing these aspects in a negative light it is conceivable to put a positive spin on the situation-instead of seeing the glass as half empty with the right attitude one can see the glass as half full. For instance the bulk of the diapers can be looked at as an advantage-it provides more absorbency and therefore better protection. Regarding a teen’s embarrassment about the rustling of the plastic pants as they move around it’s important to remember that since the diapers are worn only at night this shouldn’t be a concern. The parents should let him or her know that it’s not unusual for a certain degree of noise to be associated with some diapers. Instead of viewing the plastic as negative the person can view it in a positive light-it makes the diapers waterproof  which keeps the user dry and comfortable. If however the bed wetter shares a room with a sibling and is concerned that the sibling will notice the crinkling sound the diapers make when he or she moves around in bed that concern can be addressed beforehand by the parents.

As mentioned the parents should let all siblings of the bed wetter know that any teasing regarding the bed-wetting  and diapers will not be tolerated and the parents will punish those involved. As far as the safety pins are concerned these should be viewed no differently than other tools for fastening clothes such as snaps,buttons,or zippers.

In terms of siblings and bed-wetting there is one other point I’d like to bring up. There are cases where an older child might wet the bed and the younger sibling or siblings don’t have this problem. This can be a blow to the child’s ego and if the parents have the child wear diapers to bed it can make him or her feel more self-conscious and embarrassed. If the child expresses concerns about this it’s important for the parents to have a discussion with the child. The parents can stress to him or her that it frequently happens that children develop at different rates and this type of situation happens all the time. If the child doesn’t seem concerned  about it I wouldn’t even bring it up-it’s very possible that he or she hasn’t even thought about this but if you bring it up then they will be concerned. In terms of the siblings of the bed wetter and how they react to the fact that he or she still wears diapers to bed I’ll reiterate what I’ve said before-the parents should have a discussion with the siblings of the bed wetter (both older and younger) and tell them in no uncertain terms that any teasing about the bed-wetting and/or diapers will not be tolerated.

Finally I would tell the child who wets the bed  that plenty of adults also  have problems with bed-wetting and they  wear diapers at night too. Many of them probably feel the same way. I’ve read about cases where one or more parents have bed-wetting problems but their children don’t. The parent originally feels embarrassed about wearing diapers to bed but many times the children are supportive of their parents. This is another point that should be brought up to the older child,adolescent,or teenager that needs to wear overnight diapers.

At this point I would like to discuss the following. I feel this particular topic dovetails in with the concept of self-esteem. Although this is not a common occurrence I felt it needed to be addressed. As mentioned I have done a fair amount of reading on both bed-wetting and the use of diapers to manage it and in my readings I’ve ran across situations in which babysitters and parents of children that wet the bed had to get the children ready for bed. A friend of mine years ago told me of a situation where she had to babysit a 6 year old boy and she had to diaper him before he went to bed. I figured at that age he was potty trained and just needed the diapers for a bed-wetting problem. This was the days before pull-ups and “Goodnites” so she had to use tape-on disposable diapers. The child threw a fit and refused to let her put the diapers on him which I can’t say as I blame him. I don’t think the child had any cognitive and/or physical impairments that prevented him from putting on his own diapers so I was kind of puzzled why it would be necessary for her to be involved in getting him ready for bed. Most older children are very self-conscious about this issue and by diapering them you might embarrass them.

I’m not a pediatrician or developmental psychologist so I’m not an expert on this,but there are certain cognitive and physical tasks-such as putting on pants,tying shoes,etc. that can be accomplished  at a certain age by children that are not developmentally disabled. Putting on one’s own diapers would seem to fit into this category also. My intuition tells me that above the age of 3 or 4 a child should be taught how to diaper themselves. If the child incorrectly fastens the diapers and it causes the diapers to leak the parents can teach them the correct way to put on the diapers. They can do this by laying the diaper on the bed,have the child sit in the diaper,and once the child is correctly positioned in the diaper explain to them how to draw the diaper up between the legs,how to place it around the waist,and how to fasten the tapes. After the child puts the diapers on the parents or babysitter can check to see if the child fastened them correctly. If not the child should do the refastening not the parents or babysitter. The child will eventually get the hang of this and in time will not need the parents or babysitter  in the room to supervise them.

At this age children are starting to get very self-conscious about these issues and you don’t want to embarrass the child. With that in mind it’s good to teach them to be self-sufficient in this area as soon as possible. Disposable diapers are pretty simple to put on. Pin-on diapers might be a little trickier for some children but I believe that they can also be mastered. Many parents might be worried that a younger child might accidentally stick themselves with the pins. I spoke to a woman from a company that manufactured and sold pin-on diapers for older children to get her take on the situation and she told me that for a child of 7 or younger they might need help from their parents whereas if the child was older than 7 it might depend on their development. As in the case of the disposable diapers the parents should lay the diaper on the bed,show the child how to fold it correctly,have them sit in the diaper,make sure they’re correctly positioned in the diaper,show the child how to fasten it around him or her,and how to safely pin the diapers on. As before the parents or babysitter can check to make sure the child put the diapers on correctly and if not have them do the diapering again. As far as the plastic pants are concerned they can also put them on by themselves.

It’s very important for parents to teach their child to be independent in this area otherwise they’ll feel ashamed and this will adversely effect their self-esteem,perhaps for a long time. I’ve read about a case where the parents diapered their older child who wet the bed in front of the whole family in an attempt to shame him into stopping. There are many other things I’ve heard parents do to shame their child into stopping bed-wetting but out of sensitivity to my readers I won’t mention them. These practices are despicable and a form of child abuse. In terms of  diapering older children that wet the bed,it seems that the situations described above are atypical but even though this is the case, my friend’s experience concerned me and it made me feel that this issue needed to be addressed.

There are a couple other points regarding discretion that I’d like to talk about. The first has to do with various caretakers of the bed wetter. These include babysitters,relatives,friends of the parents, and other people along these lines. Many children who wet the bed and have to wear diapers for the problem dread when their parents go out for the evening. If the parents have a good relationship with the caretakers and they feel comfortable discussing the issue of the bed-wetting and diaper use with them and they feel the caretakers will be understanding about it,this shouldn’t be a concern. If however they don’t feel comfortable discussing this issue with the babysitter or other caretakers and the parents feel they won’t be understanding about it,then it’s advisable to make sure the protective garments are laundered(if the parents are using garments such as cloth diapers and plastic pants) and made available to the child beforehand;that way if the child wakes up wet in the middle of the night and has to change,he or she can be discreet about it.

If the parents are considering hiring a nanny to take care of their child or children and one of them has to wear diapers for a bed-wetting problem,the parents might want to discuss this with the agency and perhaps during the interview with the nanny also. Most nannies have dealt with these types of problems in the past therefore they should be very professional regarding this issue. The second point has to do with spending the night at other peoples houses(such as a friend’s house) and going away to camp. Again if the parents have a good relationship with the parents of the friend and feel comfortable discussing this problem with them this shouldn’t be a concern. There might be a place that the child can use to change into their garments before going to bed and after waking up in the morning.

As far as camps are concerned there are a couple of  programs geared toward individuals that suffer from nocturnal enuresis and other incontinence related issues. One of them is called Camp Brandon for Boys in New York state,the other is Camp Kirk in Canada. There might be other camps out there of a similar nature. In order to find out you can do a Google search. You can try using the following key words-(or key words of a similar nature) “ camps with programs for disabled/special needs youth” or “ camps with programs for bed wetters.” The contact information for Camp Brandon for Boys is-14 Jerry Drive, Plattsburgh, NY  12901,Phone:(518)570-5184. The contact info for Camp Kirk is 1083 Portage Rd., Kirkfield, Ontario KOM  2BO. Phone:(705)438-1353.They also have an off season address and phone number- 115 Howden Rd.,Scarborough,Ontario M1R 3C7. Phone: (416)782-3310 These  might not be an option for many people so in this case the parents need to talk to the head of the camp program and find out what types of provisions are available for youth that wet the bed. For example if the parents use diapers and plastic pants for their bed wetter are there facilities available to wash the diapers and plastic pants?

In terms of the youngster staying away from home there is one other scenario that I’d like to discuss and that’s concerning boarding school. The advice I gave for parents sending their child to camp applies here also-the parents need to talk someone at the school beforehand and ask them what type of provisions are available for the bed wetter.

The bottom line is that people do not like getting wet and take the appropriate precautions to prevent that from happening.Setting aside concerns of being unsanitary for the moment,even if the child or teen did offer to wash their own sheets or garments it should be mentioned to them that it is much more time consuming and a lot more work to wash a whole bunch of wet sheets,blankets,and pajamas than to wash the wet diapers and plastic pants.

Right now I’d like to touch on the following.Many parents might be wondering if they should require their older child,adolescent,or teen to wear diapers to bed if all methods to cure the bed-wetting have failed and they leak through the pull-ups or “Goodnites.” The consensus seems to be that the child or teen should be involved in the selection of what type of garments to wear to bed. While I agree with this theory in principle,in practice it might not work out all the time.The reasoning behind this theory is that by letting the child or teen be involved in the decision making process they will feel more in control of the situation thereby improving their self-esteem which in turn will make them feel less embarrassed.

Many children,adolescents,and teenagers feel babyish about bed-wetting and a large number of people feel that by forcing them to wear diapers to bed you are taking the decision about how to deal with the bed-wetting out of their hands thereby making them feel even more like a baby. I can certainly understand this point of view but in many situations parents make decisions for their older child or teenager that are in their best interests but they don’t like.Wearing glasses or braces are two things that come to mind.If it were up to the youngster they wouldn’t wear glasses or braces at all. Is it such a stretch to apply the same reasoning to the use of diapers to manage bed-wetting? Besides I would think it would be less embarrassing and stressful for the child or teenager to wear diapers to bed than wear glasses or braces-after all since the diapers are worn only at night their friends won’t notice them whereas with the glasses or braces they will.

While it is good to grant children and teenagers more autonomy as they get older in order for them to be a more confident and responsible adult there are certain types of knowledge that only come with experience.Choosing an appropriate incontinence product is one of them-there’s a lot of trial and error involved in choosing an incontinence product that works well.There are many factors involved in choosing an appropriate incontinence product: the type and level of incontinence,whether your incontinence is during the day,night,or both;how absorbent the product is and how effectively it protects the individual;how durable a product is;a person’s budget;how discreet the products are;how certain products effect an individual’s skin;whether or not a person has the time and/or desire to wash diapers and plastic pants;etc. While adults have the capability to weigh these decisions and are able to make a sound choice in the matter,many children and teens don’t have the maturity,knowledge,experience,and ability to make an informed choice in this situation.Their decision about what type of incontinence product to wear to bed will be influenced by what they perceive the image of diapers to be rather than how well the product keeps them dry at night.

Parents are in a better position to judge what type of product will be best at managing their youngster’s bed-wetting.They know how much the youngster wets at night and have experience in dealing with diapers when the youngster was a baby so they’re familiar with how absorbent and effective various diapers are.This puts them in a better position to evaluate how well a particular product will work in protecting both the youngster and the bed.If a child or teenager’s current bed-wetting product is not offering adequate protection and if after weighing all options the parents come to the conclusion that pin-on diapers and plastic pants,tape-on disposables,or other garments will be better at keeping the youngster dry at night then the parents should have the final say in the matter.

The same is true with any medical issue.If the youngster is being treated for a certain illness and the method currently being used is not solving or adequately managing the problem then it’s time to consider alternative courses of action,and ultimately the adult,due to their life experience is best qualified to make that decision.A diaper should be viewed no differently than other medical equipment for managing various medical problems such as an inhaler for asthma,a wheelchair for paralysis, a hearing aid,a cast for a broken arm,etc.

One of the other things that puzzles me is this-children wore diapers when they were babies to protect themselves from wetness why should that change when they get older? The parents are in effect saying-” well you’re still wetting yourself but you’re getting too old to protect yourself” Although the parents should have the final say in the matter I don’t think they should be cruel or callous about it.Also there are cases where parents have used diapers to shame the child or teen into stopping the bed-wetting or as a form of punishment.I find this practice reprehensible and a form of child abuse.

To get back to how to approach the older child or teenager about wearing diapers to bed I think the parents should be gentle but firm. Some parents are from the “my way or the highway” school of parenting and while that approach might be necessary with some youngsters and in some situations and circumstance I feel that it’s not warranted in this case.The parents should put themselves in the youngster’s place-they should be empathetic and help them realize that it’s in the youngster’s best interests to wear the diapers to bed.As I said you need to emphasize to them that people of all ages wet the bed and many of them use diapers at night otherwise they wouldn’t manufacture so many different sizes.If the youngster is having difficulty accepting a certain style of diaper I would again mention to them that since there are so many different styles of diapers-tape-on,pull-on,pin-on,etc.,that must mean that there are advantages to some of these diapers with certain people and in certain circumstances.I would stress to them that although wearing diapers might be unpleasant,the alternative,waking up in cold,soaking wet sheets is worse.

I would tell them the reasoning behind why you chose one type of diaper over another.You can talk to them about the different types of diapers available to manage bed-wetting and the advantages and disadvantages of each.For example some people have problems with side leakage because they move around a lot at night and/or they sleep on their sides,some people urinate more profusely than others at night,etc. and some brands and types of diapers are more effective than others at dealing with these particular problems.In addition some styles of diapers are more durable than others.

Finally parents might choose a particular brand or style of diaper due to financial reasons.For instance I read about a parent who had an older child with a bed-wetting problem and he was a very heavy wetter.Originally he used pull-ups to protect the child but due to the level of incontinence he had to use three or more per night.The parent had limited financial means and couldn’t afford to spend the money on the amount of pull-ups required so he switched to plastic pants and pin-on diapers. These are just some of the reasons for choosing one type and brand of diaper over another.With any type of consumer purchase there are some brands and products that are more effective than others for various problems and situations,more adequately meet a consumer’s needs,etc. and diapers are no exception.

I think it’s important to discuss why you chose a particular style of diaper to manage the youngster’s bed-wetting for the following reasons: it shows that you’re sympathetic because you’re taking the youngster’s feelings about wearing the diapers into consideration,it shows that it’s not some arbitrary decision designed to belittle or degrade the child or teenager, and it shows that you have the youngster’s best interests at heart.As one book on adolescent psychology put it: “As the adolescent pushes for autonomy,the wise adult relinquishes control in those areas in which the adolescent can make reasonable decisions and continues to guide the adolescent in areas where the adolescent’s knowledge is more limited.” In my opinion the choosing of an appropriate product to manage bed-wetting would fall into the second category. Adults have more life experience. This life experience makes them more effective at controlling their emotions and not letting them get in the way of making major decisions particularly regarding health care.

Bed-wetting is a very touchy issue with most older children,teenagers,and adolescents and as a result they probably won’t be as objective as parents in choosing the most effective product to manage their enuresis.Due to the youngster’s concerns with self-image their choice of what type of product to wear to bed will be dictated more by this criteria than on how well the product protects them at night.

As mentioned earlier it’s good for the parents to talk to them about all the different products out there to manage bed-wetting and the advantages and disadvantages of each,that way if there is a disagreement about what type of product to wear to bed the parents can go over why they are requring the child or teen to wear one product versus another. For example,it might be the case that the child or teen wants to wear one kind of product(say pull-on cloth diapers) whereas the parents feel that pin-on cloth diapers and plastic pants would be the best option. If that’s the case the parents can say something along these lines : “I know you would prefer to wear the pull-on diapers instead of the pin-on diapers but there are several advantages with the pin-on diapers. You move around a lot at night and are a very heavy wetter. Also you tend to sleep on your side.The pin-on diapers are more effective at dealing with these specific problems because they’re thicker than the pull-on diapers and you’re able to customize the material in the pin-on diapers whereas with a pull-on diaper by putting more material in the pull-on diaper it causes it to bunch up.It might take some time getting used to the pin-on diapers but in the long run you’ll be much happier because these will protect you much better than the pull-on diapers which in turn will make you feel more comfortable.You’re mother and I came up with a reward system to encourage you to try these out for a while.We think you’ll be happy with this idea and we’d like to discuss it now. Again by doing this it make the child or teen feel much better about the situation as opposed to the parents saying “you’re wearing pin-on diapers and plastic pants to bed because we say so!”

If the older child,adolescent,or teen is reluctant to wear a certain type of product to bed the parents should definitely hear them out and then work with them in trying to overcome their anxiety.This requires patience,warmth,and encouragement. I would also say something along these lines: “I realize you’re getting older and you might feel that by us making the final decision in this matter we’re treating you like a baby or little child but we have a lot of experience in these matters and the products we chose for you to wear to bed offer the best protection.These will make you feel a lot more comfortable than the other products you wore.” To get back to my earlier analogies about wearing a cast,glasses,or braces,it’s kind of awkward and unpleasant at first,but eventually the person gets used to them and realizes they’re for his or her own good.The same is true for wearing diapers and plastic pants for a bed-wetting problem.

By discussing the reasons behind your decision about what type of diapers to wear for bed-wetting you are helping them in a very significant way-you are saying that you acknowledge their concerns about wearing the diapers and this makes it more likely they will not feel you’re treating them like a baby because you respect them enough to discuss why you are having them wear a a specific type of diaper at night. It’s my feeling that this discussion with the child or teen along with the reward system previously discussed will help them feel less apprehensive about the prospect of wearing diapers to bed.

I would also mention that there are situations where parents purchase diapers for their parents with incontinence issues such as with a parent suffering from Alzherimer’s disease and there are instances of couples who deal with bed-wetting and the spouse of the bed-wetter suggests that he or she wears diapers to bed.In the case of the bed-wetting spouse,while there might be some initial embarrassment at the thought of wearing night diapers,the bed-wetter realizes that it’s only fair to the person sharing the bed with them and eventually gets used to them.By mentioning these scenarios to the child or teen it helps them realize they are not alone and will help them feel less emabarrassed about their parents putting them in diapers at night. They’ll be able to say to themselves -”If parents purchase diapers for their parents and the husband or wife of a bed-wetter suggest they wear diapers to bed then I guess it’s not so bad that my parents are encouraging me to wear diapers to bed also.”

The last thing I’d like to mention with regard to the older child,adolescent,or teenager who might be having a hard time accepting diapers for bed-wetting is the following.The parents should let him or her know that it is not uncommon to feel this way.Many incontinent adults have difficulty accepting diapers also but over time they come to terms with this. As mentioned before it would be a good idea for the child or teen to talk to other people in a similar situation.

In conjunction with the techniques previously mentioned to help the youngster accept the diapers it might be neccessary for the youngster to speak to a mental health professional(if financially feasible) to help them adapt to wearing the diapers to bed.It’s my contention that by using all these approaches together-the reward system,discussing your reasoning behind your choice of a particular type of diaper,the positive self-talk,parental encouragement when the child gets distressed and/or discouraged about the diapers,speaking to a mental health professional,and mentioning the fact that adults get other adults to wear diapers to bed,they’ll be able to internalize the positive psychological aspects of these strategies.This in turn will help them cope with the thought of wearing diapers,it will help them by dispelling the negative self-image they might have of themselves due to wearing diapers to bed,and they’ll feel more confident about themselves because they’ll be protecting themselves more effectively which will help them improve their self-esteem.

I realize that what I’ve just said goes against the prevailing wisdom espoused by most pediatricians,child psychologists,and other professionals,but I think it’s time we reevaluate our current attitudes toward the management of nocturnal enuresis and look at this issue in a whole new light.

How one copes with wearing diapers to deal with bed-wetting is a very personal issue.Some people don’t have any problem whatsoever wearing diapers to bed and are even glad to wear them because of the security and comfort they provide,whereas others need a significant amount of coaxing and encouragement to use them. Parents should not get discouraged if this is the case. It could take several months or more(depending on the individual) for the youngster to feel completely comfortable wearing nighttime diapers.

Although it might take awhile for the youngster to get used to wearing diapers to bed,over time the child or teen will realize how much more comfortable and secure they’ll make he or she feel.At this stage they won’t have any problem putting the diapers on before going to bed. It’ll be second nature to them. Like brushing their teeth they’ll view wearing the diapers as just another part of their nighttime routine.

Although many cases of bed-wetting  can be cured using medicines,alarms,and other methods there are cases of  bed-wetting persisting into adult years. In fact many adults suffer from bed-wetting their whole lives. The statistics vary but anywhere from 2 to 3% of adults wet the bed. Due to the negative image associated with enuresis we should consider the possibility that these figures might be significantly higher. Just as some rape victims are reluctant to report their rape because they feel ashamed,many adult bed wetters could be reluctant to see a doctor because of the shame they are experiencing. The reason for this shame is the perception shared by a large number of people of bed-wetting as a child’s disorder. The adult bed wetter realizes the negative public perception of bed-wetting and as a result, many adults don’t seek treatment and resign themselves to wearing diapers at night.

Bed-wetting  it seems carries more of a stigma than other forms of incontinence. Why this is so is puzzling to me. While younger children are not immune from feeling embarrassed about this condition it seems that the older one gets the more embarrassed one feels.

Due to the stigma associated with nocturnal enuresis there is tremendous pressure with most people to cure it,and while I believe that a person should consider different methods to cure their bed-wetting and be open to trying new treatments when they become available, there are a number of  factors that should be kept in mind. First of all,it can sometimes be more distressing and embarrassing going to countless doctors and specialists and having endless tests and procedures done without success. Second, there are many instances of people trying a wide variety of treatments to cure their bed-wetting without success and unfortunately there may always be circumstances in which the bed-wetting can’t be resolved for whatever reason.

Third,some people might not be happy with  the options available to treat their bed-wetting and prefer to wear diapers instead-as hard as it is for most people to believe there are people that prefer to use diapers to manage their bed-wetting! The reason for this is that in some cases the cure can be worse than the disease and bed-wetting and the various techniques used to cure it is no exception. For example,I have heard and read that bed-wetting alarms can disrupt a child’s sleep patterns and as a result the child has difficulty both staying awake and being able to focus  in class. While I am not aware of any studies corroborating this, the possibility that this might occur with some individuals  should be considered. If the parents choose to use a bed-wetting alarm they should monitor the youngster’s sleep patterns and if the youngster reports any difficulties  then the parents should discuss these problems with the physician. If it looks like these symptoms might be a result of using the alarm and if these problems persist or get worse over time they should consider discontinuing use of the alarm.

In addition some children and teenagers are very deep sleepers and sleep right through the alarm. In fact I’ve heard of cases where the alarm wakes up everybody else in the house except the bed wetter. That’s another reason why alarms might not be a viable option in some cases-it might wake up the other members of the household and they might not be able to get back to sleep.

Furthermore,sometimes the alarms create false positives-i.e.  false alarms. This can occur  if the child or teen sweats a lot at night. Finally some children are frightened or embarrassed by the alarm. The reason the alarm  might embarrass the child is that as mentioned it might wake up other members of the household and as a result it draws attention to the fact that the child or teenager had an accident,therefore it’s difficult for the youngster to be discreet about the bed-wetting.

Medicines are another method used to treat bed-wetting but these can have unpleasant side effects with some people and there are also instances of people who in general don’t like taking medicines whether due to the side effects,their fear of long term effects on the body,or both. I was also reading that there have been cases of children dying from using some medicines for bed-wetting. For example there was an article published on December 4,2007 which discussed an FDA warning about the drug DDAVP. The article mentioned that 61 seizures were reported and of these 36 were connected with the intranasal form of the drug. In addition there was a report of 2 people dying from the drug. There have also been cases of children dying from the drug Tofranil or Imipramine. It should be mentioned that these cases appear to be rare but nevertheless it’s important for parents to be informed about all potential risks involved with using medicines to treat their child’s bed-wetting. Surgery is also another option to treat some cases of bed-wetting but again this can be an unpleasant choice for most people.

There’s an old saying- “if all you have is a hammer,every problem looks like a nail” The people who sell bed-wetting alarms are naturally going to view their method as the best way to treat  bed-wetting, the pharmaceutical company marketing a particular drug for bed-wetting is going to be biased about their method of treating  bed-wetting, etc. It’s important to realize this when evaluating various treatment methods. I’m not suggesting that any of these methods are bad or don’t work for people. The fact is that they are successful with many cases of bed-wetting, but it’s important to keep in mind that with some people they don’t work for whatever reason-everybody is different.

The main point of this section(and I can’t stress this enough) is to help people realize that if they’re given a choice between several options to treat their  bed-wetting  they need to  evaluate the pros and cons of each in a calm,objective way and not feel  pressured to find a cure just because they feel embarrassed and/or pressured by what others think. It’s important to realize that all of these methods have their advantages and disadvantages and with some people the disadvantages might far outweigh the advantages. The same is true with most medical decisions in addition to other choices we make in life. A person has to weigh all these options and then ask themselves what are the best choices given their particular circumstances. For example if it comes down to two options to deal with the bed-wetting-say wearing diapers or taking medicine and the medicine causes unpleasant side effects then the user has to ask him or herself the following question-which is worse wearing diapers to bed or taking the medicine? Personally I would think taking the medicine is worse but everyone is different. Or what if the only option to treat the bed-wetting was surgery but the risks and/or complications from the surgery were unacceptable to the person or what if the expense of the surgery was too great? Or perhaps all three?

Sometimes in life we have multiple options to choose from but unfortunately there are situations in which there are only two alternatives neither of which is pleasant. In cases such as this we must choose  the lesser of two evils. In the cases mentioned above the lesser of two evils would be wearing diapers to bed. If this was any other medical problem the person’s decision to not take the medicine or undergo surgery would be respected but with incontinence(particularly bed-wetting) we have a double standard.

With any medical problem we must choose the most appropriate tools and equipment to manage it and since everybody has different needs they’ll require different tools for their particular situation and circumstances. An example that comes to mind  are   mental health disorders. Although people might have similar symptoms,the symptoms might manifest themselves in different ways therefore people experience these diseases differently. This means they might need different medicines or treatments.

The same is true for problems like bed-wetting. People might wet more at night than others and require a product with more absorbency,they might have problems with side leakage due to the fact that they tend to sleep on their side and require products that are more effective at dealing with that issue,they might prefer cloth diapers because they are more cost effective than disposables etc. With this in mind people must wear products that best suit their needs and be less concerned about whether or not the products have a good “image”(which is a euphemism for being less “babyish.”)

One of the key issues that seems to be forgotten when discussing bed-wetting  is quality of life. While bed-wetting is unpleasant it is not as bad as having daytime incontinence since it is much easier to be discreet about it and in terms of medical issues there are many disorders and medical issues that are far worse to live with-multiple sclerosis,chronic pain,cerebral palsy,diabetes,cancer,schizophrenia,etc. That’s not to say that life is peaches and cream for the bed wetter but it’s good to be able to put things in perspective.

Although most bed wetters want to seek a cure for their enuresis(due I suspect primarily because of the stigma associated with it and  as a result of that stigma societal pressure) there are a significant number of them who have tried multiple cures without success and while some of this group might be depressed about it there are also a number of them who take a more stoic approach to the situation. With these people they feel that their quality of life is not that significantly effected by the bed-wetting and don’t have any problem putting on a diaper before going to bed.

This could be because they have friends,relatives,or a spouse who are supportive of them and aren’t concerned about the bed-wetting and diapers,because they  have a strong self-image,or they have both a strong self-image and supportive friends and family,etc. The people who have tried different methods of curing their bed-wetting without success and who feel that their quality of life is not significantly diminished should not be pressured to find a cure if they can live with it and should not be stigmatized for using diapers to manage the bed-wetting.

Why people are stigmatized for wearing diapers for bed-wetting is a mystery to me. Just about every other medical aid is accepted by people-canes, glasses, hearing aids,wheelchairs and walkers,pacemakers,insulin for diabetics,inhalers for asthma,etc. Everything except night diapers. For example people don’t say to a person using a hearing aid or a cane- “ you should feel ashamed of yourself-you need to find a cure!” People are more pressured to cure incontinence(especially bed-wetting)  than any other disease.

Individuals are different in their ability and propensity to tolerate different things in life-one man’s backache is another man’s headache. Some people feel real upset about their bed-wetting whereas others are not that concerned about it. Some people might find it puzzling that a person can take a relaxed view of a problem such as this-after all most people believe that only babies or small children wet the bed. But it’s important that we face life’s challenges with grace and dignity and in the overall scheme of things the fact that a person has to wear diapers to bed is not that bad.

Finally with some individuals it is difficult to ascertain the cause or causes of the bed-wetting. We must not forget that while medical science has made tremendous strides in dealing with different diseases there are times when even the professionals are stumped and cannot provide answers or cures with some individuals. In situations such as this we must use whatever means necessary to manage the problem in order to live a fuller and richer life. Diapers enable many bed wetters to do this. As mentioned there are people who wet the bed their whole lives and many of these people sleep in diapers their whole lives. If this is the case a person shouldn’t feel discouraged or depressed. It’s okay to be a bed wetter and it’s okay to wear diapers to bed no matter how old you are!

There are many online support groups in which you can talk to individuals dealing with the same problems. In addition many psychologists,counselors,and other mental health professionals deal with this issue and can provide therapy for the individual having difficulty coming to terms with wearing diapers to bed. If the parents decide to go this route they should talk to child or teen beforehand and ask them if they would prefer to talk to a male or female therapist. They should also tell the child the reasons for going to therapy and how you feel it will help the child. The parents should talk to the therapist before the session and discuss the goals they have.

They  should let the therapist know that they’ve tried many different methods to cure the bed-wetting to no avail and tell him or her that they prefer to use diapers to manage the bed-wetting but the child or teen is having difficulty adjusting to wearing the diapers to bed. The parents should ask the therapist if it would be a good idea for them to meet with the therapist and if he or she wants to meet with both them and the child at some future point.