There are a number of reasons children may have little accidents during chemotherapy.
Overnight IV fluids, thirst and disturbed sleep increase the likelihood of bed wetting. However, bed-wetting stops when treatment ends.
Bed-wetting may be a sign of psychological distress. Children who are ill often regress to previously outgrown behaviours. Examples are play associated with younger age groups, baby talk, thumb sucking, fear of the dark, temper tantrums and shyness.
Prevention
Do not allow your child to drink for an hour before bedtime. Ensure a bathroom visit just before bed to empty the bladder.
Carry your child to the toilet/potty before you go to bed, and hold her steady on the seat (kneel in front and allow her to lean on you). She may still be asleep, but her system will have the opportunity to empty. Tell her where she is and it is safe to relieve herself.
Ask your child if she would like to be woken during the night for a bathroom visit. Set the alarm for a time agreed by her.
Promote Healthy Sleep
If your child is very distressed, consider letting her sleep with you, or sleep in her room. Your presence may calm her and enable her to sleep more peacefully, reducing the risk of an accident.
Bed-wetting is less likely if the child’s environment promotes sleep. Try to keep your child’s sleeping space a sacred haven from medical procedures, so she does not associate her bed with bad or frightening experiences.
Quiet music and soft lighting (night lights, fairy lights or a bubble lamp), may reduce night-time distress and enable your child to sleep more peacefully.
Reduce Emotional Stress
Many children believe illness is their fault, a punishment for being bad. Reassure your child this is not true, and that nothing will ever stop you loving her.
Encourage your child to share worries with you. Some children are reluctant to talk because they don’t want to cause their parents more distress. Let your child know it is ok to talk and ask questions, to cry and be afraid.
If your child is old enough to write or draw, introduce the concept of a diary (pictorial or prose). If she has a forum to express her feelings, she is less likely to bottle them up, and will be more at peace during the night.
When Accidents Happen
Do not punish your child. This only increases stress.
Reassure your child that bed wetting is “no big deal” by playing down the incident.
Address the practical necessities without fuss.
Bed-wetting usually occurs in the middle of the night when both parent and child are very tired. Have provisions ready so you can resolve the situation quickly.
Cover the wet patch with large towels. Save the more demanding sheet change for the morning when you are all awake.
When using a plastic sheet, place a thin towel or blanket between that and the linen. This will protect against overheating / sweating caused by plastic sheets.
