Examining the effectiveness of parental strategies to overcome bedwetting: An observational cohort study

Abstract

Objective: To examine whether a range of common strategies used by parents to overcome bedwetting in 7 1/2-year-old children (including lifting, restricting drinks before bedtime, regular daytime toilet trips, rewards, showing displeasure and using protection pants) are effective in reducing the risk of bedwetting at 9 1/2 years. Design: Prospective cohort study. Setting: General community. Participants: The starting sample included 1258 children (66.7% boys and 33.2% girls) who were still bedwetting at 7 1/2 years. Outcome measure: Risk of bedwetting at 9 1/2 years. Results: Using propensity score-based methods, we found that two of the parental strategies used at 7 1/2 years were associated with an increased risk of bedwetting at 9 1/2 years, after adjusting the model for child and family variables and other parental strategies: lifting (risk difference=0.106 (95% CI 0.009 to 0.202), ie, there is a 10.6% (0.9% to 20.2%) increase in risk of bedwetting at 9 1/2 years among children whose parents used lifting compared with children whose parents did not use this strategy) and restricting drinks before bedtime (0.123 (0.021 to 0.226)). The effect of using the other parental strategies was in either direction (an increase or decrease in the risk of bedwetting at 9 1/2 years), for example, showing displeasure (-0.052 (-0.214 to 0.110)). When we re-analysed the data using multivariable regression analysis, the results were mostly consistent with the propensity score-based methods. Conclusion: These findings provide evidence that common strategies used to overcome bedwetting in 7 1/2-year-olds are not effective in reducing the risk of bedwetting at 9 1/2 years. Parents should be encouraged to seek professional advice for their child's bedwetting rather than persisting with strategies that may be ineffective.