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Examining the effectiveness of parental strategies to overcome bedwetting: an observational cohort study
  1. Mariusz T Grzeda1,
  2. Jon Heron1,
  3. Kate Tilling1,
  4. Anne Wright2,
  5. Carol Joinson1
  1. 1 School of Social and Community Medicine, University of Bristol, Bristol, UK
  2. 2 Evelina London Children’s Hospital, St Thomas’ Hospital, London, UK
  1. Correspondence to Dr Carol Joinson; carol.joinson{at}bristol.ac.uk

Abstract

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 1258 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 to 0.202), ie, there is a 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 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 9½ 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 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.

  • bedwetting
  • prevention
  • child
  • cohort study
  • ALSPAC

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors CJ, JH, MTG, KT and AW conceptualised and designed the study. MTG carried out the statistical analysis and drafted the Results section. JH, CJ and KT supervised the statistical analysis and interpreted the results. All authors were involved in drafting the manuscript and approved the final manuscript as submitted.

  • Funding This work was supported by the Medical Research Council grant number MR/L007231/1. The UK Medical Research Council, the Wellcome Trust (grant reference: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval ALSPAC Law and Ethics committee and local research ethics committees.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This is a secondary data analysis based on data from the ALSPAC cohort. The ALSPAC Executive encourages and facilitates data sharing with all ‘bona fide’ researchers. The access policy for the ALSPAC data can be found at http://www.bristol.ac.uk/media-library/sites/alspac/documents/ALSPAC_access_policy.pdf.

  • Collaborators Dr Penny Dobson provided advice on the strategies used by parents to overcome bedwetting and on the current NICE guidelines.

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