You’re at the pediatrician’s office, and the conversation about your child’s bedwetting is wrapping up.
The doctor hands you a prescription, or suggests an alarm, or recommends fluid restriction.
And you nod, say thank you, and head home to try yet another approach.
But wait.
Before you start ANY bedwetting treatment—whether it’s medication, an alarm, our program, or anything else—I want you to pause and ask three critical questions.
These questions will help you become an informed consumer of bedwetting treatments and increase your chances of finding an approach that actually works for your family.
Question #1: is this treatment teaching a skill or managing a symptom?
This is the most important question you can ask.
Let me break down the difference:
Symptom Management
Symptom management approaches reduce or work around the bedwetting, but they don’t teach your child’s brain and bladder to communicate.
Examples include:
Medications (like DDAVP) – Is supposed to reduce urine production at night, so there’s less in the bladder. But it only helps 1/3 of patients, has no effect on 1/3, and is in between for the other 1/3. And, when you stop the medication, bedwetting usually returns because the brain-bladder connection hasn’t been taught.
Fluid restriction – Limiting drinks after dinner means less urine to manage. But again, it doesn’t teach the skill. And it makes your child uncomfortable and thirsty.
Pull-ups or waterproof sheets – These manage the consequences of not being dry yet, but they don’t address the cause.
Waking your child during the night – This prevents not being dry by emptying the bladder on a schedule, but it doesn’t teach your child’s brain to recognize when the bladder is full and respond appropriately. But this is usually not effective as it is virtually impossible to time this just right.
These approaches can be helpful in the short term or for specific situations (like an upcoming camping trip). But they’re not long-term solutions.
Skill-Building
Skill-building approaches teach your child’s brain and bladder to communicate effectively so that your child can recognize fullness during sleep and either wake up to use the bathroom or send signals to hold the urine until morning.
Examples include:
Medical hypnosis and cognitive behavioral techniques – These teach the brain-bladder connection directly. When your child learns this skill, they don’t need medication or alarms or fluid restriction. The skill stays with them.
Bedwetting alarms – These can be considered a hybrid approach. The alarm is used to manage the symptom by waking your child when they’re not dry yet, and over time, it can condition a response. However, they usually take months to work, success rates vary widely, and relapse rates are high because the skill isn’t always fully internalized.
Why This Distinction Matters
When you’re evaluating a bedwetting treatment, ask yourself:
“If we stop doing this, will my child still be dry?”
If the answer is no—if your child will likely not be dry again once you stop the medication, remove the alarm, or stop waking them at night—then you’re looking at symptom management, not skill-building.
And that’s fine if you understand what you’re signing up for.
But if you want a lasting solution that doesn’t require ongoing intervention, you need an approach that teaches the skill.
Question #2: What’s the Success Rate—and How Is “Success” Defined?
This seems like an obvious question, but it’s surprising how rarely it gets asked.
When someone recommends a treatment for bedwetting, ask:
“What percentage of children have success with this approach?”
But here’s where it gets tricky: How is “success” being defined?
Different Definitions of Success
Some treatments define success as:
- Any reduction in wet nights – So even if your child goes from not being dry 7 nights a week to 5 nights a week, that counts as “success.”
- 50% reduction in nights that aren’t dry – Your child is still not dry multiple times per week, but it’s better than before.
- Dry nights for two consecutive weeks – This sounds better, but what happens after those two weeks? If the bedwetting returns, was it really successful?
- Complete dryness for 6 months or more – This is a more meaningful measure of success, but it’s often not the standard used in studies.
Questions to Dig Deeper
When you’re evaluating success rates, ask:
“What does ‘success’ mean in this context?”
“How long do the results typically last?”
“What percentage of children relapse after treatment ends?”
“What happens if it doesn’t work—is there a next step?”
These questions help you understand what you’re really signing up for.
Real Success Rates
Let me be honest with you about what research shows:
Medications (DDAVP): Success rates while taking the medication range from 30-70%, but relapse rates after stopping are high (50-70%). So only about 25-30% of children remain dry long-term after stopping.
Bedwetting alarms: Success rates range from 30-70%, depending on the study and how success is defined. Relapse rates are 50%, and many families stop using the alarm before it has a chance to work because of the disruption and frustration.
Medical hypnosis and cognitive behavioral approaches: Research shows success rates of 60-80% for complete or near-complete dryness, with low relapse rates because the skill has been internalized.
“Wait and see” approach: About 15% of children spontaneously stop wetting the bed each year. So, by age 10, most will have outgrown it. But the emotional and social costs of waiting can be significant.
I’m not sharing these numbers to promote one approach over another—I’m sharing them so you can make an informed decision.
Question #3: What Happens When We Stop This Treatment?
This is the question that reveals whether you’re building a skill or just managing a problem.
Let’s play out a few scenarios:
Scenario A: Your Child is on DDAVP
Your child takes the medication every night and experiences significant reduction in bedwetting. Great!
But then you ask: “What happens when we stop the medication?”
Typically, the bedwetting returns because the medication was reducing urine production, not teaching the brain-bladder connection.
So, you have a few options:
- Keep your child on medication indefinitely (which has cost and potential side effects)
- Try to wean off slowly and hope the skill developed naturally in the meantime
- Accept that the bedwetting will likely return when you stop
Scenario B: Your Child Uses a Bedwetting Alarm
Your child uses the alarm for several months and eventually starts waking up before the alarm goes off. Excellent!
But then you ask: “What happens when we remove the alarm?”
For 50% of children, the conditioning sticks and they remain dry. For the other half, bedwetting returns because they were relying on the external alarm rather than their own internal signals.
Scenario C: Your Child Learns the Brain-Bladder Connection
Your child completes a program that teaches medical hypnosis and cognitive behavioral techniques to strengthen the brain-bladder communication.
Then you ask: “What happens when we finish the program?”
The skill stays with them. They’ve learned how to recognize fullness, how to send signals to the bladder to hold urine until morning, and how to wake up if needed.
They own the skill. It’s theirs to keep.
The Long-Term View
When you’re considering any bedwetting treatment, think long-term:
- Will this still be working a year from now?
- Will my child be dependent on this treatment indefinitely?
- Are we solving the problem or just managing it?
- What investment of time, money, and energy is required—and is it sustainable long-term?
Bonus Question: How Does This Treatment Affect My Child’s Self-Esteem?
This isn’t one of the three main questions, but it’s equally important.
Some bedwetting treatments can inadvertently reinforce shame, dependence, or a sense of being “broken.”
Ask yourself:
Does this treatment empower my child, or does it make them feel dependent on external interventions?
For example:
- Medications: Can be convenient, but they don’t teach your child that they have control over their own body.
- Alarms: Can work, but the disruption and repeated alarm notifications each night can make bedwetting feel like an even bigger problem than it is.
- Skill-building approaches: Empower children by teaching them that they can learn this skill, that their body is capable, and that they’re in control.
The psychological impact of treatment matters just as much as the physical outcome.
Putting It All Together
Before you start any bedwetting treatment, I want you to feel confident in your decision.
That means asking:
- Is this teaching a skill or managing a symptom?
- What’s the success rate, and how is success defined?
- What happens when we stop this treatment?
If you’re satisfied with the answers—if the treatment aligns with your goals and values—then move forward with confidence.
But if you’re left with questions, or if the approach doesn’t feel like a true solution, keep looking.
How Our Program Answers These Questions
Since I’ve spent this entire post encouraging you to ask tough questions, let me answer them for our program:
Is this teaching a skill or managing a symptom?
Skill-building. We teach your child’s brain and bladder to communicate using medical hypnosis, cognitive behavioral techniques, and motivational tools. When your child completes the program, they own the skill—no ongoing medication, no alarm, no dependence on external interventions.
What’s the success rate?
Research on medical hypnosis and cognitive behavioral approaches shows 60-80% of children achieve complete or near-complete dryness, with low relapse rates. In our program, most families see significant improvement within 1-3 months.
Success means: More dry nights, improved confidence, and a skill that lasts long after the program ends.
What happens when we stop treatment?
The skill stays with them. They’ve learned how their brain and bladder work together. That’s not something that goes away when you stop a medication or remove an alarm—it’s a lifelong skill.
You Deserve Clear Answers
If someone is recommending a bedwetting treatment and can’t clearly answer these three questions, that’s a red flag.
You deserve to understand exactly what you’re signing up for:
- What the treatment is actually doing
- What results you can reasonably expect
- What happens when the treatment ends
Ask the questions. Push for clear answers. Make informed decisions.
Your child’s wellbeing is worth it.
Jeff Lazarus, MD, FAAP
Keeping the Bed Dry®
About Dr. Jeffrey Lazarus, MD, FAAP
Dr. Jeffrey Lazarus is a board-certified pediatrician who combines over 25 years of medical experience with expertise in medical hypnosis and cognitive behavioral therapy. He is one of only 8 pediatricians in the United States certified as an Approved Consultant by The American Society of Clinical Hypnosis.
After completing his pediatric residency at Stanford University Medical Center, Dr. Lazarus specialized in using medical hypnosis to address conditions that traditional medicine doesn’t treat effectively. He created Keeping the Bed Dry®, an at-home video program that teaches children’s brains and bladders to communicate effectively—proven successful in independent research published in Clinical Pediatrics.
Dr. Lazarus practices in Menlo Park, California, and works with families nationwide via telemedicine.