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

Objective: To examine whether a range of common strategies used by parents to overcome bedwetting in 7½-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 9½ years.
Design: Prospective cohort study.
Setting: General community.
Participants: The starting sample included 1,258 children (66.7% boys and 33.2% girls) who were still bedwetting at 7½ years.
Outcome measure: Risk of bedwetting at 9½ years.
Results: Using propensity score based methods we found that two of the parental strategies used at 7½ years were associated with an increased risk of bedwetting at 9½ years, after adjusting the model for child and family variables and other parental strategies: lifting (risk difference= 0.106 [95% CI= 0.009–0.202] i.e. there is an 10.6% (0.9% to 20.2%) increase in risk of bedwetting at 9½ years among children whose parents used lifting compared with children whose parents did not use this strategy) and restricting drinks before bedtime (0.123 [0.021–0.226]). The effect of using the other parental strategies was in either direction (an increase or decrease in the risk of bedwetting at 9½ years) e.g. 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 7½ year olds are not effective in reducing the risk of bedwetting at 9½ years. Parents should be encouraged to seek professional advice for their child’s bedwetting rather than persisting with strategies that may be ineffective.