Emily developed night time dryness at around age 4 years. Despite being dry for many years, following the birth of her baby brother, she regularly wet the bed at night (this is known as secondary enuresis). Her parents felt very stressed and angry about this, and viewed this behaviour as being lazy, attention seeking and defiant. They responded by shouting and criticising her and enforcing consequences. In response, Emily tried to cover up her bedclothes being wet and seemed more withdrawn and quieter than normal.
Physical causes were ruled out. The parents were told that a setback in normal development when previously dry was more likely a reaction to psychological (or in some cases physical) stress i.e. the arrival of a new baby rather than being caused by laziness, attention seeking or defiance.
The family limited Emily’s intake of fluids before bedtime, particularly fizzy and caffeinated drinks. She was encouraged to have a routine regarding going to the toilet before bedtime.
To help reinforce bladder control, she was encouraged to change her own nightwear and bedding following episodes of wetting. Praise and encouragement were given to Emily by her parents for steps taken towards dry nights. A reward system was set up for her. She could earn rewards for performing activities, such as going to the toilet before bedtime each night and taking responsibility for changing her wet nightwear and bedding.
To help Emily adjust to having a new brother, her parents also spent time with her each day engaged in some positive activities, such as playing and talking. To help her feel more involved, she was also given some specific jobs to help with the care of the baby.