Sunday, December 28, 2008

Ways Parents Can Encourage Older Children and Teenagers to Wear Diapers for Bedwetting

After making the decision to have your child or teenager wear diapers to manage his or her bedwetting,and deciding what type and brand of diapers to have them wear to bed,the hard work for many parents has just begun. Although you might appreciate the benefits of wearing diapers at night the older child or teenager will very likely have different thoughts on the matter. However,with a little gentle persuasion and time,the youngster will eventually come to realize that the advantages of wearing nighttime diapers outweigh the disadvantages.

If the child, adolescent, or teenager is embarrassed about wearing the diapers and plastic pants to bed there are a number of different ways you can encourage them. First, you can stress how much more comfortable it will be waking up in a dry bed. Second,you can have them go to different chat rooms and online forums(with a younger child it's a good idea to supervise them while they are doing this) so they can talk to people in similar circumstances. There are many online forums and chat rooms dealing with bed-wetting and other incontinence issues. Sometimes it helps to have a sympathetic ear and to realize there are other people in the same boat.

Third, you should tell them that there are a large number of adults that wet the bed and many of them also wear night diapers. I would let the child know that many adult bed-wetters probably feel a bit self-conscious wearing diapers to bed also, but they understand that ultimately it's in their best interest to wear them. I've also read about cases where one or more parents have bed-wetting problems but their children don't. The parent might originally feel embarrassed about wearing diapers to bed(especially if their children are out of diapers) but many times the children are understanding and supportive of their parents. You can also mention that there are plenty of cases of adults who purchase diapers for other adults. An example of this is when a person buys diapers for their parent or parents that have medical problems that require them. For instance many people are caregivers for parents( or other relatives) that suffer from Alzheimer's disease. Incontinence is one of the symptoms of this disorder and the person has to purchase diapers for the individual who has Alzheimer's disease. Another example is if a married couple deals with bed-wetting. In this case the spouse of the bed-wetter encourages them to wear diapers to bed. Although they might feel embarrassed at the prospect of wearing diapers, they realize it's for their own good in addition to being considerate of the person sharing the bed with them. These are points that should be brought up to the older child,adolescent,or teenager that needs to wear overnight diapers but are reluctant to wear them.

A fourth strategy that you might want to consider is this. If your budget permits I would order 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 in a a size that is larger than what they would normally wear, it might help them feel better about wearing diapers to bed. By actually seeing an adult size it reinforces 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.

Fifth, 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. Also people can even experience the same types of incontinence differently. For example,some bed-wetters sleep on their sides and might experience problems with urine leakage in this area. With that in mind it would make sense to purchase a certain brand or style of diaper specifically designed to address this particular issue. Sixth, 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.

Another suggestion I have for helping an older child,adolescent,or teen adjust to the prospect of wearing nighttime diapers is to have the youngster see a mental health professional such as a child psychologist. Many psychologists have experience dealing with this issue and might be able to provide therapy specifically designed to help them deal with the emotional effects of the bed-wetting such as the feelings of shame they experience. If you have the financial means to try this option it would be worthwhile to consider this. You can talk to the mental health professional beforehand to see if they are able to offer counseling in this area. I talk about this in greater detail in my article "Bed-Wetting:When Cures Can Be Worse than the Disease."

Some people feel it's okay if an older child or teenager doesn't want to wear diapers to bed provided they take care of the wet sheets,clothing,and blankets. This brings me to another strategy for motivating an older child or teenager to sleep in diapers at night. I would tell them that it's much more time consuming washing bedding and clothing. By being aware of all the work involved in washing wet bedding and clothing it might make them more willing to wear diapers at night.

Another idea I have for helping parents encourage their older child or teenager to wear diapers for bed-wetting is to let them know that it's not healthy for their skin to sleep in urine soaked clothing and bedding. Urine can have detrimental effects on the skin. I talk about these effects in my article "Bed-Wetting and Maintaining Appropriate Hygiene. " I encourage both parents and children to read this article. I feel that this will help immensely in getting both children and teenagers to see the merits of wearing diapers for bed-wetting.

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."

It's my contention 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. In my opinion, 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 that period of time they'll most likely realize how comfortable it is to wake up nice and dry. At this point many parents are probably asking the following question- "Suppose we try this reward system for 6 months and they're still resistant about wearing the diapers to bed?" This is a judgment call but in this situation the parents can say the following to the youngster: "So you still don't feel comfortable with the idea of wearing diapers at night.? We understand that it's difficult getting used to them but just remember what we told you-plenty of adults wear them also. There are millions of people all over the world of all age groups who have to wear diapers for various reasons. Some of them have to wear them during the day and night and some have to wear them only at night. There are also many types and levels of incontinence and some products are more effective at managing certain forms of incontinence. That's why there are so many different types and brands of diapers available. We appreciate you trying these out. How would you feel about wearing them to bed for a few more months? We thought it might be a good idea if you continue to wear them for another 3 to 6 months. An important thing to keep in mind is that even with adults it can take them a while to get used to wearing the diapers." There is no guarantee that this will work but it's worth a try. A second thing the parents might be wondering about is the following-suppose the child gets used to the diapers but pretends they haven't to see if the parents might be willing to extend the reward system? While many people might say this is being somewhat cynical, the possibility of this occurring(at least with some children) should be considered. I'm not a parent but I do work with children in the school system so I know that kids can be manipulative. I think that in a situation such as this the parent has to make a judgment based on what they know about the personality and temperament of the child and their previous actions in different situations. In this case the parents intuition should serve as a fairly reliable guide. A third possibility is that the rewards might eventually become a crutch. The parents need to make it clear to the child upfront that the purpose of the reward system is to encourage them to wear the diapers to bed, to help them adjust to putting on the protection every night,and to get them to understand that even though they might be a little embarrassed about wearing diapers, it's more embarrassing sleeping in wet sheets and clothing(not to mention more uncomfortable). The child needs to accept the fact that this is not a permanent solution .After a suitable period of time the parents have to wean the child off the reward system and this can vary with different children.

In combination with using a reward system there are certain scripts(as the mental health professionals say) that an older child, adolescent, teen, or adult can say to themselves in order to feel more comfortable with the idea of wearing 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."

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.

Another tactic that a parent might want to try is to mention to the older child or teenager that many celebrities dealt with bed-wetting when they were younger. As mentioned in my article “Reasons for the Stigma Surrounding Diaper Use With Older Children,Adolescents,and Teenagers that Wet the Bed and Ways to Reduce this Stigma” there are many famous people who experienced this problem when they were younger. Among the famous individuals that suffered with this problem growing up were Johnny Carson,Suzanne Somers,Michael Landon,Mark McGwire,Vince Vaughn,and Sarah Silverman. In fact Sarah Silverman's recent book “The Bedwetter: Stories of Courage,Redemption,and Pee” recounts her experiences dealing with this problem when she was younger. Sarah dealt with this problem until she was 16.Sarah mentioned that she had to wear diapers to bed for a while. In one part of the book she talks about going on a camping trip when she was 12 and how her mother prepared Sarah for the trip by putting Pampers in the sleeping bag so she could be discreet about the issue.

Right now I'd like to talk about one other factor that should be considered about approaching your youngster about wearing diapers to bed. In some cases the child or teen might be closer to one parent and as a result they feel more comfortable discussing personal matters with them. In a situation such as this, both parents should get together with each other before talking to the child to make sure they're on the same page in terms of the best way to approach the youngster about wearing protection. When you've both mapped out the best strategy and the parent is ready to talk to the child, I would say something along these lines: "We realize you might feel embarrassed about your bed-wetting. We just want you to know that there's nothing to be ashamed of. People of all ages(including many adults) have this problem also. Both your father(or mother depending on who is talking to the child)and I came up with a plan to help you manage the problem. We both came up with a reward system designed to encourage and motivate you to try wearing diapers to bed for a while. I'd like to talk to you about it now." In my opinion it's a good idea to stress to the youngster that both of you decided that it would be best for the child or teen to wear diapers to bed so he or she doesn't think it's some arbitrary decision. I think in general it might make a youngster feel better if both parents are in agreement because it shows the youth that there was more thought put into the decision, which in turn will most likely make he or she feel more comfortable with the idea of wearing diapers to bed.

The following section talks about how bed-wetting and diaper use can effect teenagers. Teenagers can be particularly sensitive about this issue. This section talks about one teenager's feelings regarding wearing pin-on diapers and plastic pants to bed. 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 pants in a negative way,the person can view them in a positive light-they make 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 and plastic pants make when he or she moves around in bed, that concern can be addressed beforehand by the parents. 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. My article "Teens and Bed-Wetting:Dealing With Diapers and Plastic Pants" talks about this issue in greater depth. If you have a teenager who is reluctant to wear diapers for bed-wetting I encourage you to have them read this article.

There are people with bed-wetting problems who buy disposable briefs to manage their bed-wetting. Disposable briefs are the term used for disposable diapers for older children, adolescents, teenagers, and adults. They have the same fit, style, and design as baby diapers. Disposable diapers can make a crinkling sound when the user moves around which makes some people feel self-conscious about wearing these types of garments. This generally happens with disposable briefs with a plastic outer cover, although it can also happen to a certain extent with some brands of disposable briefs with a cloth like outer layer. The same strategies designed to make a person feel more comfortable with the idea of wearing pin-on diapers covered with plastic pants can also be used with disposable briefs. Again the parents can tell the child or teenager that the tapes should be looked at the same way as other methods for fastening clothing such as zippers, buttons, or snaps. As far as the rustling sound the plastic makes, it should be mentioned that since the diapers are worn only at night this shouldn't be a concern. Finally, the parents need to point out that the plastic is an important part of the diapers because it makes the diapers waterproof. This in turn provides more comfort and security for the person wearing the diapers. At this point I'd like to mention that there are instances of bed-wetters using both pin-on cloth diapers covered with plastic pants and disposable briefs to manage their bed-wetting. For instance, there are cases of people who alternate using both types of diapers. On some nights they wear the pin-on diapers and plastic pants and on other nights they wear the disposable diapers. Also there are cases of people who find the cloth diapers and plastic pants too hot to wear during the summer months and switch to disposable diapers during this time. The reason for mentioning this is that it's good for people to consider different options for managing bed-wetting. It's not at all uncommon for people to use both reusable and disposable diapers. By being open to experimenting with different styles and brands of diapers, it makes it more likely you'll find the best type of diapers(or combination of diapers) to manage your youngster's bed-wetting. Also there are parents who use both pin-on diapers covered by plastic pants and disposable diapers for their babies so it might be a good idea to consider the possibility of trying this combination out to see what works best for you. I emphasize this point in many of my articles discussing the different types and brands of plastic pants,cloth diapers,and disposable diapers available to manage bed-wetting with older children, adolescents, teenagers, and adults.

I strongly feel that it's a good idea to combine the methods discussed in this article. By doing this,you're more likely to have success in motivating your youngster to wear the diapers at night. How you do this will have to be tailored to the individual needs of the child-everyone is different and some of the ideas discussed in this article will have different rates of success with different individuals,but I believe that with the right methods(and combination of methods) and persistence,you'll have luck with even the most stubborn and resistant youngster.

If you haven't decided what type or brand of diapers you want to buy for your older child,adolescent,or teenager please see my articles “Disposable Diapers for Older Children and Teenagers With Bedwetting Problems”,"Information Regarding Pin-On Diapers for Older Children and Teenagers with Bed-Wetting Problems", and "Brands of Plastic Pants for Older Children and Teenagers with Bed-Wetting Problems." One of the reasons some older children might be anxious about wearing diapers at night is that they might believe that their parents are going to diaper them before they go to bed. I think it's important that parents talk to their child about this and let them know that they're going to be responsible for putting on their own protection. After deciding what type of diapers to purchase for your bed-wetter I encourage you to read my article "Older Children, Bed-Wetting,and Self Diapering." This article talks about why I feel it's important to let an older child be responsible for putting on their own diapers.

Whatever you do it's important to not get frustrated or discouraged if the youngster is having difficulty adjusting to wearing the diapers to bed. This will not happen overnight but with the right amount of support and encouragement they will eventually get used to putting them on. With many medical issues it can take some effort getting used to the particular treatment. For instance when a person gets glasses or braces it feels a little awkward and unnatural at first but the individual gets used to them over time. As I mentioned before I would remind the youngster that plenty of adults also wear diapers for their bed-wetting and although they might be embarrassed by having to put them on before going to bed they realize it's for their own good.

Should Parents Involve Older Siblings in Taking Care of the Bed-Wetter's Diapers and Plastic Pants?

Many parents have their older children be responsible for helping their younger siblings in various aspects of their lives and they might want to involve their older children in taking care of the bed-wetter's wet garments. This is a delicate issue because it has the potential to embarrass the bed wetter. Each situation is different. As mentioned previously if a parent uses diapers and plastic pants to deal with the youngster's bed-wetting it's inevitable that the other children of the house are going to discover this. They're going to notice plastic pants hanging to dry on the clothesline,see their mother washing wet diapers and plastic pants,and folding up the diapers and pants after they're laundered. With that in mind it might be a good idea to talk to the older child and ask them if they would be comfortable helping out with these chores.

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.

The first step is to talk to the youngster and tell them that you're considering involving their brother or sister in taking care of the diapers and plastic pants. How they feel about this is depends to a large extent on how close they are to their siblings. Another thing that needs to be considered is the following. Girls might be more receptive to doing this type of chore due to the fact that they tend to be more mature than boys and because of their innate maternal instinct. If you have a son that wets the bed and he has both boy and girl siblings he might feel more comfortable with his sister or sisters handling this. On the other hand it could go the other way. The same thing applies if you have a girl bed-wetter. Girls tend to be sensitive regarding this and there's always the possibility that they could feel self-conscious about a boy taking care of their laundry(whether regular laundry or diapers and plastic pants) In a situation such as this the parent has to ask them who they would prefer to deal with this. Once this is known, the parents can then make a decision based on what they know about the character and maturity level of the sibling or siblings in addition to how responsible they are. At this point the parents can talk to the sibling or siblings and tell them what their particular task will be-one sister will be responsible for washing the diapers and plastic pants,one will be responsible for folding them up and putting them in the laundry basket,etc A second option would be to have the siblings alternate-one weekend one sister will take care of the wet garments,the next weekend the other sister will,etc. As parents know there are many different ways to assign responsibilities and this situation is no exception. If the bed-wetter has only one sibling this obviously changes the equation somewhat but the same reasoning applies-the parent has to get the bed-wetter's opinion about this and then make a judgment call about whether to involve them.

Bedwetting can be very stressful for a child particularly if the bed-wetter has siblings. As we all know brothers and sisters can be very cruel particularly where this is concerned.. Whatever decision you make in this matter the most important thing to impress upon them is this-any teasing about the bed-wetting and diapers and plastic pants will not be tolerated. It's important for the bed-wetter to have a nurturing and supportive environment. This more than anything else will help them through this difficult time.

Will Wearing Diapers for Bedwetting Decrease the Motivation to Achieve Dryness?

A number of people claim that if you use diapers for bed-wetting there's no incentive to become dry-that the child,adolescent,or teenager become so accustomed to using the diapers they'll eventually become a crutch or security blanket. The reasoning behind this is that people will become complacent about seeking a cure for their bed-wetting. While I suppose this is a possibility for a small number of individuals(although I believe it is highly unlikely) I can think of a number of reasons why this probably wouldn't be the case. This article addresses this concern. First of all I believe that the premise behind this thinking is flawed. It assumes that the reason the youngster or adult wets the bed is purely psychological. The cause of the bed-wetting could be physical in which case no amount of motivation will get them to achieve night control. The bed-wetter might be motivated to experiment with different treatments so from that standpoint they're "motivated" but this is a completely different issue than what is normally meant by most people who talk about bed-wetting and the concept of motivation. To say that a person who wears diapers for bed-wetting will be less likely to have the motivation to cure their bed-wetting is like saying that a diabetic who has to use insulin for their diabetes or a person who uses an inhaler to manage their asthma won't be motivated to seek cures for their diseases. In fact in could be argued that the people who wear diapers for their bed-wetting have more of an incentive to cure their enuresis than those who don't because of the stigma associated with diapers.

Right now I'd like to talk about the reasons why I feel that diapers won't have any effect on a person's desire and motivation to achieve nighttime control. In the first place wearing diapers to bed does not preclude the person from trying to find out information about new treatments that might become available for the bed-wetting. Second, most children and teens want to fit in and be like everybody else and they realize most people their age are out of diapers.

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 inconvenient 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's difficult 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 in my article " Bed-Wetting:When Cures Are Worse Than the Disease", 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 shown 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 tack because they feel it causes the child or teen unnecessary suffering .As with everything else in life we must take each situation on an individual basis. As I have repeatedly stressed throughout many of my writings there are instances 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) people feel compelled to cure it and many times that pressure can have a negative effect . It makes them feel they have to turn their life upside down to cure it.

With some individuals 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 youngster is more distressed about being shuttled around to different specialists and trying multiple cures without success and if they'll will eventually outgrow the bed-wetting, then it might be prudent to not put any more pressure on them and 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 for bed-wetting should be viewed as more of an inconvenience as I suggested in another article 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.

Parental Decisions Regarding Bed-Wetting and Diapers

I had originally published the article “Should Parents Require Their Older Child,Adolescent,or Teenager to Wear Diapers to Bed?” on the incontinence section of the Health Central Network.One of the readers had some objections to my reasoning regarding why I felt parents should require their youngster to wear diapers to bed if all methods to cure the bed-wetting were unsuccessful and garments like pull-ups and “Goodnites” did not adequately protect the youngster and this article is a response to these objections. I realize what I've said is very controversial and goes against the grain of most people's thinking(both professional and non-professional) on this subject. The point of my original sharepost was to get people to see this issue in a whole new light.

  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.

Reasons for the Stigma Surrounding Diaper Use in Older Children,Adolescents,and Teenagers that Wet the Bed and Ways to Reduce the Stigma

Unfortunately there is tremendous stigma associated with diapers. Most people view diapers as babyish. This is the main reason most older children,adolescents,teenagers,and adults are reluctant to wear them to bed. In fact most of them wouldn't be caught dead in a diaper. Older children,adolescents,and teenagers are at a point in their lives where they want to become more independent and in their minds diapers represent a stage in their lives when they were more dependent on their parents. In their view wearing diapers to bed is regressing. Although I sympathize with this view,to a large extent I think it misses the mark.

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.

Teens and Bed-Wetting:Dealing With Diapers and Plastic Pants

Being a teenager can be a stressful time in life. There's the pressure of fitting in,preparing to get into college,going to prom,learning to drive. Now imagine if you also had to tell someone of the opposite sex that you have to wear diapers and plastic pants because you still wet the bed?

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. On a related note,if you don't personally feel like starting an online support group for teenagers suffering from bed-wetting you can do a Google search for incontinence support groups and forums. Bed-wetting is a very common problem so it shouldn't be difficult finding a person you can talk to about this issue. There are also organizations that specialize in disseminating information about incontinence. Two of the major organizations that deal with incontinence are the Simon Foundation for Continence and the National Association for Continence. These organizations should be able to provide you with information about support groups for incontinence.

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.

Right now I'd like to talk about one teen's experience with wearing cloth diapers and plastic pants. This person felt extremely self-conscious about wearing the garments. I talked about this in my article "Ways Parents Can Encourage Older Children and Teenagers to Wear Diapers for Bed-Wetting" but I thought I'd revisit this issue for those of you who might not have read this article. There are several aspects that made him feel babyish-the bulk of the diapers between the legs,the safety pins,and the crinkling sounds of the plastic pants. I thought I'd talk a little bit about because it's possible that many teenagers have similar feelings regarding wearing diapers and plastic pants for bed-wetting. I believe in this particular case it's possible to see the glass as half full. For example instead of viewing these attributes in a negative manner one can see them in a positive way. Instead of viewing the bulk of the diapers as a bad thing a person could see them in a positive way-thicker diapers are more absorbent and therefore they provide better protection. This in turn will make the wearer feel more comfortable and secure. As far as the plastic pants are concerned it should be stressed to the teen that some plastic pants and disposable diapers make a rustling sound. Although many people are self conscious about this crackling sound the teenager should be reassured that since the product is only worn at night this shouldn't be a concern. However if the child or teen is sharing a bedroom with another sibling they might have some misgivings about this. If they do share a room with another sibling the parents need to tell the sibling in no uncertain terms that if they make fun of the bed-wetting or diapers and plastic pants they'll be punished. Finally, as far as the pins are concerned,these should be viewed no differently than other methods of fastening clothing such as buttons, zippers,or snaps. I hope this helps other teenagers who might be feeling embarrassed about wearing the diapers and plastic pants at night.

Another idea I have for helping teenagers adjust to wearing diapers to bed is to talk to a child psychologist or other mental health professional. I talk about this in greater detail in my article "Ways Parents Can Encourage Older Children,Adolescents,and Teenagers to Wear Diapers to Bed for Bed-Wetting" and "Bed-Wetting:When Cures Can Be Worse Than the Disease." I would encourage all teenagers suffering from this problem to read these articles because I feel they have some valuable information in them.

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!  

Thoughts on the Development of Our Ideas Regarding Diapers and Bed-Wetting

It seems that most of our ideas regarding continence related issues such as potty training and bed-wetting are passed down from our parents. Some parents take a more relaxed view of these matters whereas others are more stringent. This is also the case with pediatricians and other medical professionals. For example I saw an ad some years ago by a famous pediatrician(I believe it was T.Berry Brazleton) saying in essence that in terms of potty training parents should let nature take its course and follow the child's natural growth process-when the child is ready the parents should then begin a training regimen.

There are differences of opinion about when a child is ready for potty training. The psychologist John Rosemond disagrees with what is called the child-centered approach espoused by Dr. Brazleton and feels that children should be out of diapers as soon as possible. According to the website Rosemond believes it is “a slap to the intelligence of a human being that one should allow a baby to continue soiling and wetting himself past age 2.”

A Mayo Clinic article states that 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 I have talked about in an earlier article 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 bedwetting and diaper use. In my opinion this extrapolation is unwarranted.

For some reason our notions about potty training and when our children should attain night dryness have been linked-we feel that if the child is “mature” enough to use the toilet they should be mature enough to be able to sleep through the night without wetting themselves. It follows from this that if they are grown up enough to not need diapers because they have learned to use the potty,they should be grown up enough to not need diapers during the night. But we must realize that there is not necessarily a correlation between when a child is potty trained and their ability to stay dry at night. Some children might be able to be potty trained at an early age and not achieve night dryness for many years(in some cases never-there are plenty of adults who wet the bed and have this problem their whole lives). Physical and mental capabilities of all sorts sometimes develop at different rates.

Continence and people's conceptions of maturity have been inextricably linked in many persons' minds for a long time. I firmly believe it's time to rethink this. There may be physical or cognitive components(or both) that can be responsible for a person being delayed in their ability to achieve continence including those with bedwetting problems. The fact that they have these problems and might need diapers to manage them 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 bedwetting?

Parents like to tell their child how much of a “big kid” they are for not having to wear diapers any more. I realize that parents have good intentions with this approach because children are motivated to act and behave more like adults and the parents and other relatives of the child feel this method will help in this regard. I can also understand why children are proud of each accomplishment whether physical or cognitive that moves them closer to adulthood and independence such as learning to tie one's shoes, learning to swim without products such as “water wings”,being able to take the training wheels off their bike,etc. These are examples of things that demonstrate a child's competency and their ability to learn a new skill which to the child is a great source of pride because they feel more mature. This in turn bolsters their self-esteem. Not having to wear diapers anymore is universally acknowledged as another one of the milestones on the path to becoming an adult similar to the ones mentioned earlier in this section. Many people(including both the general public and the person suffering from incontinence) feel that wearing diapers is a sign of regressing which tends to lower the individual's self-esteem and subsequently damages their self-concept. However,the fact that a child,teenager,or adult has to wear diapers for bedwetting has nothing at all to do with their value as a human being, their competency,or level of maturity. A situation such as this is solely about the person having the ability to control certain bodily functions. A person can be the most intelligent, skilled,mature,independent,and competent person in the world yet not have the capability to stay dry at night for whatever reason.

People reading this article and other articles I've written about this topic might come to the conclusion that I believe a person should just use diapers for their bedwetting and not seek medical attention for the problem or look into new treatments should they become available. I feel this is in large part due to the fact that my articles tend to be about protection as opposed to treatments. Nothing could be further from the truth. As mentioned in other articles, I do believe that people should explore various cures for their bedwetting. 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,and if all avenues at curing the bedwetting have proven unsuccessful, are not viable,or are not desirable for whatever reason, then the parents should have the youngster sleep in diapers. As I have indicated in my article “Bedwetting:When Cures Can Be Worse than the Disease” in some cases the treatments available for the bedwetting might be unpleasant or unfeasible for the particular individual. My articles are geared specifically toward those individuals who have tried different methods of treating their bedwetting without success or have found the treatments available unsatisfactory for whatever reason. The people in this group feel that wearing protection to bed is the best option at this point in time and I've written articles specifically for this audience due to the fact that there seems to be a dearth of articles for this particular group. In my opinion this group is unduly stigmatized and I wanted to address these individuals . A person who wets the bed(or suffers from any other form of incontinence) should not be denigrated for choosing to wear diapers either by medical professionals or the public if they feel that's the best course of action. I also feel that a person should not feel pressured to try a treatment that they find objectionable or not suitable for them just because diapers have a negative image.

Regarding using garments such as pull-ups or “Goodnites” it seems in general that diapers provide more effective protection for the management of heavy incontinence such as bedwetting which I discuss in my article “Choosing the Right Diaper to Manage Bedwetting With Older Children and Teenagers.” That being said some parents might opt to use the pull-on type disposable products. Products such as “Goodnites” were introduced into the market several years ago due to their underwear like design. It was thought that these types of garments would be less stigmatizing for an older child or teenager to wear. There are reusable style pull-on garments as well which also look like regular underwear. Again this style of garment is supposed to be less embarrassing for an older child or teen to wear. If however the parents decide to try these products and find they are ineffective at protecting the youngster then the parents need to consider other forms of protection such as pin-on diapers covered with plastic pants or disposable tape-on diapers(known as disposable briefs)Or the parents can use both styles of diapers to handle the child or teenager's bedwetting. As I mention in my article on the different types and brands of diapers available to deal with this problem, some people use both styles of diapers to cope with their bedwetting. For instance there are people who wear pin-on diapers and plastic pants on some nights and disposable diapers with the tape fasteners on other nights. There are also people who wear both types of diapers to bed but find it uncomfortable wearing pin-on cloth diapers covered by plastic pants during the warmer seasons such as spring and summer and switch to disposable diapers with tape tabs during those times of year. As this example shows and as I've pointed out in other articles there is a lot of flexibility in how to deal with the bedwetting.

As far as pin-on cloth diapers are concerned,there are a number of characteristics of these diapers which make them particularly well suited for the management of heavy incontinence such as bedwetting. Some of these properties include absorbency and wicking. Cloth diapers have superior absorbency and wicking ability. Wicking refers to how well liquid is dispersed throughout the diaper. Since bedwetters generally lose a large volume of urine during the night and many wet multiple times throughout the night,the use of cloth diapers is an option that should be considered. The better a diaper is at wicking and absorbency the better it will be at protecting the person and bed. If the parents are concerned about the amount of laundry and the time involved in taking care of cloth diapers and plastic pants, the parents can use disposable briefs instead. There are a number of disposable briefs that are considered good for managing bedwetting. If the parents do decide to use cloth diapers and plastic pants but want to cut down the time involved in taking care of these items,the parents can alternate using disposable and cloth diapers as I've recommended in previous articles. I go into more detail about the wicking and absorbency qualities of cloth diapers in my article “Information Regarding Pin-On Diapers for Older Children and Teenagers With Bedwetting Problems.” This article also talks about the different types and brands of pin-on diapers. If you decide to use pin-on diapers you must cover the diapers with waterproof pants. Plastic pants(which many people refer to as rubber pants even though this is a misnomer) are the most widely used pants to put over cloth diapers. For a discussion of the different brands of plastic pants available for this problem see my article “Brands of Plastic Pants for Older Children and Teenagers With Bedwetting Problems” The brands mentioned in these articles are highly regarded by many people in the incontinence community particularly for managing heavy incontinence such as bedwetting.

One of the key things I have pointed out in my articles and a point I feel bears repeating is this-don't be concerned with the image of a product. Even though there is a lot of stigma attached to wearing diapers and despite the fact that they have a negative image it's better to focus on the following criteria when choosing absorbent products to manage the bedwetting: how comfortable the garments are and how effective they are at keeping both the person and bed dry. Unfortunately the stigma associated with diapers has prompted many manufacturers to focus on products which are more “underwear” like in appearance. Although there's no doubt these items work for some individuals(primarily those with lighter forms of incontinence), diapers appear to be the products most suited to deal with heavier forms of incontinence such as bedwetting. I believe this emphasis on the appearance and image of the incontinence garment hurts those individuals who might require diapers because they'll feel pressured to buy garments that might not be as effective at managing their particular form of incontinence. By wearing a garment that does not provide adequate protection a person will feel less comfortable,less secure,and as I mention in my article on bedwetting and hygiene,there is the potential for the person to develop skin problems. I talk more about the stigma surrounding older children,adolescents,and teenagers wearing diapers to manage their bedwetting and the different ways we as a society can overcome this stigma in the article “Reasons for the Stigma Surrounding Diaper Use With Older Bedwetters and Ways to Reduce this Stigma.”

Although the child or teen might be reluctant to wear diapers to bed and it might take them a while to make this adjustment,I think in the long run it's better for the youngster-after all it's unsanitary(not to mention uncomfortable) lying all night in wet bedding and clothing. My article “Bedwetting and Maintaining Appropriate Hygiene” discusses this issue in greater depth and talks about why I feel that diapers are an essential component in helping the bedwetter prevent any possible skin problems that may arise from the incontinence. If you feel that it would be best for the child or teenager to wear diapers at night but they resist wearing them, I encourage you to read my article “Ways Parents Can Encourage Older Children and Teenagers to Wear Diapers for Bedwetting.” This article offers several strategies a parent can use to encourage and motivate an older child or teenager who might feel embarrassed and ashamed about wearing nighttime diapers. Finally, I would tell the older child,adolescent,or teenager that is having difficulty coming to terms with wearing diapers to bed that there are plenty of adults who wet the bed and have to wear diapers at night their entire life.

Should Parents Require Their Older Child,Adolescent,or Teenager to Wear Diapers to Bed?

I've heard parents say that it's okay if an older child,adolescent,or teenager doesn't want to wear diapers to bed provided they take care of the wet clothes and bedding but I think that sends the wrong message. I think it sends the message that it's okay to be unsanitary. As mentioned previously it's unsanitary and unhealthy(not to mention uncomfortable) to lie all night in wet sheets and clothing. The following analogy might help. If a youngster has a cut you would have them put on a band-aid in order to prevent blood from getting on their clothes and on other stuff in the house in addition for sanitary reasons. Wearing a diaper to bed should be viewed no differently-the diaper is a band-aid for a bladder control problem. Or if the youngster was going to go out in the rain the parents would see to it that they wear a raincoat or use an umbrella to keep the child from getting wet. All of them are waterproof and all of them serve the function of keeping the individual from getting wet.

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 and uncomfortable for the moment,even if the child or teen did offer to wash their own sheets and 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 and braces are just two things that come to mind. If it were up to the youngster they wouldn't wear glasses and 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 still 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 try 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 teen 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 circumstances 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 interest 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. Again I would tell them that since there are so many different styles of diapers-tape-on,pin-on,pull-on,etc that must mean that there are advantages to some of them 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 a lot 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,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 just about 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 youngsters 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 requiring 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 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 diaper it causes it to bunch up. It might take some time to get 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 more comfortable. Your mother and I came up with a reward system to encourage you to try these out for awhile. We think you'll be real happy with this idea and we'd like to discuss it now.” Again by doing this it makes 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 child 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 at night then 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 a person gets used to them and the person 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 the 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 specific type of diaper at night. It's my feeling that this discussion with the child or teen in conjunction with using 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 Alzheimer's disease and there are instances of married couples who deal with bed-wetting and the spouse of the bed wetter suggests that they wear diapers to bed. In the case of the bed-wetting spouse,while there may 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 embarrassed 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 necessary 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 of these approaches together-the reward system,discussing the 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 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 the 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.