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 www.dy-dee.com 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 mentioned there should be reasonable parameters established for these situations to rule out physical and/or cognitive problems but we also need to take into consideration the fact that people's bodies develop at different rates. Also some people do have physical and/or cognitive reasons for being delayed in this area. The reason for mentioning people's attitudes regarding toilet training is that many persons extrapolate their ideas from this area onto matters of bed-wetting and diaper use. I n my opinion this extrapolation is not warranted.

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 still 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 person's 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 bed-wetting 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 bed-wetting?

Parents like to tell the 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. However,the fact that a child has to wear diapers for bed-wetting has nothing at all to do with this. A situation such as this is solely about the person having the ability to control certain bodily functions. A person can be the most highly intelligent, skilled,and competent person in the world yet not have the capability to stay dry at night for whatever reason.

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