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Q: My eight-year-old daughter is still wetting her bed. We have been using DDAVP on and off for over a year. How long do children usually stay on this medication? My daughter has had ultrasounds to check her bladder and no physical reason is apparent. She is very concerned about this.
A: Wetting the bed is not uncommon in 8-year-olds. Most children will outgrow the problem as they get older, with the majority being dry by 12 years of age. The medication you describe, DDAVP, works by telling the kidney to concentrate the urine so that less is produced. The medication is taken as a nasal spray and works very quickly. While this medication does work, it is only a temporary solution, as it doesn't actually fix the problem that most bedwetters have.
Most children who wet the bed are deep sleepers who don't sense the usual signals that the bladder gives the brain to tell it to wake up and go. Other children have small bladders and can't hold the whole night's urine in. DDAVP works temporarily because it causes less urine to be produced overnight. But as soon as the child stops taking it, the kidney goes right back to making a less-concentrated urine in the usual amounts. Thus, I usually don't recommend using DDAVP for long periods of time. It is best used when there is an important night or couple of nights when you don't want the child to wet the bed (sleepovers, overnight camp, vacations, or outdoor camping). It's not a true cure for bedwetting.
If you and your child would like to try to resolve her bedwetting permanently, you should try one of the commercially available bedwetting alarms. The have a very high success rate, and only a small relapse rate once you stop using it. They cost about $60 to $90, and are available through most medical supply companies.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.