It would be interesting to see how developmental psychologists feel about this issue. We tend to have certain preconceived notions about our child’s growth process and if they deviate from that in the slightest we become alarmed. For example children should talk by a certain age,they should read by a certain age,they should walk by a certain age,etc. And while it is true that we should have reasonable parameters established for these situations in order to rule out the possibility of cognitive and/or physical problems,the same reasoning shouldn’t be applied in my opinion to the use of diapers and plastic pants for the management of bed-wetting in older children,adolescents,teenagers,and adults.
Frequently we feel pressured to use socially accepted methods to resolve various medical issues but in some cases it’s a good idea to consider alternative approaches and this may entail using methods that a large majority consider unorthodox or not accepted by the mainstream. A case in point is the following. In the May-June 2007 issue of AARP magazine there was an article on Naomi Judd. It talked about how the traditional treatments that were used by her doctors to treat her hepatitis were not working so she tried various non traditional methods which are not fully accepted by western medicine such as biofeedback,aromatherapy,and meditation. It turns out that these methods worked.
I think that the use of diapers to manage bed-wetting in older children,adolescents,teenagers,and adults is another example of a management technique that is not fully accepted by most medical professionals and the public. Just like Naomi Judd had the courage to try alternative approaches to manage her disease people must have the courage to use alternative methods to manage bed-wetting.
I think we need to reevaluate our attitudes on diaper use for older bed wetters for two reasons. As mentioned previously in some cases the pull-ups and “Goodnites” aren’t as effective at protecting both the youngster and the bed. The second reason is that it makes the person who has no other option but to wear diapers to bed feel they are somehow inadequate. This in turn can lead to feelings of low self-esteem,low self-worth,and subsequent depression.
In going over the literature and opinions of many professionals regarding diaper use in older bed wetters one thing sticks out in my mind-the status quo has a negative opinion of diaper use. The literature and opinions are very consistent regarding this issue-most people believe you shouldn’t keep a bed wetter in diapers past the age of 4 or 5.After that the majority of people feel you should use pull-ups or “Goodnites” only.
It’s my firm opinion that we have a double standard regarding this particular form of incontinence. For instance we seem to have no problem with the use of diapers for developmentally disabled children,the elderly with incontinence,and people suffering from disorders such as cerebral palsy,multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,or other ailments, but if you suggest putting an older child,adolescent,teen,or adult with a bed-wetting problem in a diaper people think you’re barbaric and should be driven out of town on a rail. What difference does it make who suffers from incontinence or why-it’s still the same problem and it still needs to be managed. In some cases the best way to manage it is by using diapers.
There is a saying that goes something like this- “Nothing is good or bad but thinking makes it so.” While this is not the case for everything-torture,murder,rape,and stealing are inherently bad-there is nothing intrinsically shameful about wearing diapers to bed. Wearing diapers to bed after the age of 4 or 5 is considered shameful because we have been conditioned to think this way for years. It would be interesting to see how other cultures feel about this issue but unfortunately I suspect they feel the same way we do. From what I understand the Japanese,British,and most Europeans are even more uptight about this issue.
Custom and fashion dictate a lot of our behaviors. For example there is a custom that says it’s not appropriate to wear white shoes and pants after labor day. The author Stanley Schmidt talks about the influence of custom and fashion on our behavior in some of his writings. In one editorial of his he discussed something he calls “phantom tyrants”. According to Schmidt: “These are impersonal forces that presumably originate with identifiable actions by individual people but then take on a life of their own and continue to dictate people’s behavior whether or not any individual would independently choose them. We commonly know them by such names as “custom” or “fashion.” ” The example he discusses in an editorial of his called “Signs of Respect” is the custom of men taking off their hats upon entering a building. I feel that the expectation that people are supposed to stop wearing diapers for bed-wetting after the age of 4 or 5 is a perfect example of a “phantom tyrant.”
Even though there is a great deal of stigma attached to older children,adolescents,teenagers, wearing diapers for bed-wetting, and the majority of people use garments that most people consider less stigmatizing and embarrassing such as pull-ups or “Goodnites”, there are still probably a significant number of individuals who do wear diapers to bed for their bed-wetting. With that said, the people who do use diapers to manage their bed-wetting go to great lengths to keep their diaper wearing secret. The same can be said for adult bed-wetters who have to wear diapers.
The renowned pediatrician T. Berry Brazleton pointed out in one of his newspaper columns from several years ago that he’s come across many bed-wetters in his practice who’ve had to wear diapers to bed. This also leads me to believe that more bed-wetters might use these garments than we suspect,but because of ridicule by other people they keep it a secret,thereby giving us an inaccurate judgment of the actual number of people who have to use diapers to manage their bed-wetting.
There are many different reasons I feel most parents don’t use diapers to manage bed-wetting with both teenagers and older children. The next few sections discuss this. I believe that one of the reasons for our negative reactions toward older children being in diapers at night stems from attitudes left over from potty training. Many parents try to motivate their child during this stage with praise such as “we’re so proud of you,you’re becoming a big kid now!” While these parents might have good intentions(of course we all know the road to hell is paved with good intentions),unfortunately they use the same approach with an older child or teenager who still needs diapers at night .Children and teens still in diapers at night see the commercials for Huggies pull-ups and might remember what their parents told them about diapers during their potty training years and then feel ashamed about using diapers for their bed-wetting. In addition many parents try to motivate their child to achieve night dryness by claiming that only babies wear diapers. I think this puts a lot of pressure on a child and most likely will exacerbate the situation .If a child’s body is not developed enough where it is ready to stay dry at night no amount of yelling or shaming will make them stop. There’s no point yelling at them or shaming them for a condition they can’t help .It would be like yelling at them or making them feel ashamed for having a certain eye color-no matter how much you yell at them or degrade them it’s not going to change it.
Children grow at different rates-just as some children walk sooner than others,talk sooner than others,and learn to read sooner than others,some need diapers at night later than others. In my opinion a different approach is warranted. The parents need to encourage their children by letting them know that peoples bodies develop at different rates and there is no shame in using diapers to manage the bed-wetting. I would remind the child that people of all ages have problems with wetting the bed and many of them also wear diapers during the night.
A second reason for peoples negative feelings toward older children still being in diapers could be the fact that parents used to use cloth diapers and rubber pants for their babies. This meant lots of work for parents especially before the advent of washing machines. In this circumstance parents felt compelled to get their children out of diapers as soon as possible. If an older child had to wear diapers to bed for bed-wetting the parents might have been upset about the prospect of having to spend years washing diapers and rubber pants. Subsequently many parents used the shaming approach to try to get them out of diapers.
Over the years we’ve become more enlightened about this issue(although we still have a long way to go in my opinion) and most people realize that this approach doesn’t work and in many cases can make the situation worse. That being said the people who had the bed-wetting problem when they were younger remember their parents using this approach with them and they might use this technique with their children also.
A third reason for our negative attitudes regarding this stems from our attitudes toward various milestones in a person’s life. Most cultures have certain expectations of when we’re supposed to achieve certain things-we’re supposed to get a driver’s license by a certain age(I know a woman who is 24 who still does not have a driver’s license),we’re supposed to graduate from high school by a certain age,etc. Nowhere are our cultural expectations more deep-seated than with bed-wetting and diaper use and if a person needs diapers past the age that is considered socially acceptable by most people we instill in them the idea that they should feel ashamed.
To get back to parental attitudes toward diaper use I wonder if one of the reasons most parents are so adamant about getting their child or teenager out of night diapers is that a part of them feels ashamed about it. It’s a very competitive world out there and every flaw a child might have is looked at as something that must be hidden or fixed at all costs. The prevailing attitude among many parents is that their kids must be perfect at everything because any sign of imperfection is viewed by society as a sign of weakness. There is immense pressure for parents to make sure their children go to the best schools,to participate in numerous after school activities because it looks good on their records,play sports,etc. Imagine if it got out that 18 year old Susan is still in diapers and plastic pants at night? So much for going to Harvard!
Parents are also competitive with one another and unfortunately some hyper competitive parents use their children as pawns either consciously or subconsciously in this competition. They feel that any flaw the kids might have is a reflection on their parenting skills and might make them look bad. “What would our friends and neighbors think if they found out our 15 year old son still wears diapers and plastic pants to bed? How embarrassing!” We need to grow up! Everybody has some flaws-that’s what makes us human! The only thing we can do is accentuate our strengths and do the best we can to work on our flaws and try to improve ourselves but we shouldn’t obsess about our weaknesses.
A fourth reason for our negative feelings concerning using diapers to manage bed-wetting has to do with our emphasis on self-image. Although this is a universal concept this concept is especially important in the U.S. Most of our ideas of self-image unfortunately tend to be rather superficial. We’re very concerned with status,power,image,and success and these four things are inextricably linked in many people’s minds with having a strong self-image. A large number of people believe that wearing diapers represents the opposite of all four of the qualities in which people feel a strong self-image consists of .In particular a significant number of people believe wearing diapers represents a feeling of being powerless,no doubt due to the fact that most people associate diapers with babies. Many people of course view babies as the paragon of powerlessness. Because of this view a large number of people develop a negative self-image if they have to use diapers for bed-wetting.
A fifth reason is that some people believe that by putting the child in diapers for bed-wetting you in essence “are giving them permission to wet the bed” or that “it’s okay to wet the bed.” Believe it or not I’ve heard some people say this and I think it’s one of the most ridiculous things I’ve ever heard. Since the purpose of having the child or teenager wear diapers at night is to keep the bed dry I think it sends the opposite message-that it’s not okay to wet the bed. In no way can putting a child or teenager in a diaper for a problem they can’t control be construed as “it’s okay to wet the bed.” I think it sends the message that the parents are going to make their children as comfortable as possible until a cure is found. Or if the treatment options currently available don’t work or are not viable for some reason, they’re going to have them wear diapers because it’s more healthy for the child and it makes them more comfortable.
Diapers should not be the first option used for bed-wetting, but by the same token they should be used if all alternatives have been exhausted or are not desirable or feasible. To me diapers should be viewed no differently than sanitary napkins for women.
A sixth reason why most people are so against older bed wetters remaining in diapers at night is group think. People in general want to conform and with that tendency comes the fact that people go along with the prevailing wisdom without questioning its validity. They internalize it and it becomes so ingrained in their thinking that they can’t imagine anything else. We’re like fish in water-it becomes so much a part of their life and environment that they don’t even notice it. The fact that the majority believe in something is no guarantee that it’s right. History shows that in many cases it is the minority or a sole visionary who is right and the majority wrong.