Bedwetting Institute

Bedwetting, also called nocturnal enuresis, has implications, which are often underestimated by both the community and those advising on its treatment.

It places a huge burden on the whole family, as any parent of a child who wets the bed will testify! Parents often become very distressed and might even suspect that their child is deliberately causing mischief. It is key to believe they are not!

Children can become anxious about their own ability to influence the outcome. Try as they may to help, they feel powerless to stop wetting the bed, and in time their self esteem may even suffer. Sleepovers with friends and school camps can become a source of considerable stress to the child. Many parents become resigned to the fact that they are unable to help their child. Doctors are often dismissive, offering only reassurance that the child will eventually outgrow the problem, when the family requires immediate help. Whilst bedwetting is a very common problem, it is often needlessly tolerated because of a certain stigma and reluctance to discuss what is an awkward and embarrassing subject for many people, yet totally possible to treat.

Don’t just wait for bedwetting to stop!
All children are different.  Just as most of the developmental milestones vary from child to child, so does continence at night. Two thirds of children will have stopped bedwetting completely by five years of age. One third are still wetting at five, with the frequency varying from occasional bedwetting to wetting every night. If your child is five and still wetting then it is time act. The parent must decide when they are ready to do something about the bed wetting rather than waiting for the child to be ready. The first three steps of our program can be used with children as young as four years of age, however, research has shown good results can be achieved with a bed wetting alarm from five years of age. No research has been done on younger children using alarms.

Young children (under 5’s) who are only wetting the bed occasionally are the most likely to outgrow the problem. Five and six year olds wetting most nights and all children seven years and over who are still bed wetting will generally stop bed wetting successfully with treatment. Only about 15% of children outgrow bed wetting naturally over the following 12 months. The older the child the less likely this is to happen. Most children and teenagers need treatment and then have a very good chance of being cured permanently.

Psychological Factors
Bedwetting is often attributed incorrectly to ‘psychological problems’.  In our experience, this is rarely the case. On the contrary, bedwetting, left untreated, may well lead to psychological problems. It may give rise to feelings of shame, guilt, isolation and loss of self–esteem, especially in older children. Following treatment, a child′s emotional health improves, as does self–esteem.

Occasionally when children are under an unusual amount of stress or very tired they may sleep more deeply. This could increase the likelihood of bedwetting but on many occasions children are more likely to wet in the comfort of their familiar bed at home when they are perfectly relaxed.

Physical Abnormalities
It is very unusual for a physical abnormality to be causing the bedwetting. Most children can be cured with the steps on the Bedwetting Cured DVD combined with using a bedwetting alarm.  If results have not been achieved within three months and all the steps on the DVD have been followed, then it is time to seek help from a continence professional or paediatrician.

Causes of bed wetting:

• Small bladder capacity
  This means the bladder is not large enough to hold all the urine produced overnight; this can be improved with our drinking program.
• Very deep sleep
  This is very common in children who wet the bed. During the night their bladder sends a message to their brain saying it is full. The child needs to wake up and get up to go the toilet, however, they sleep through this signal. Many children wet early in the night when they are in the deepest sleep.
• Large volumes of urine produced at night
  Some children produce double the normal amount of urine at night so that even if their bladder capacity is normal it will not be big enough to hold all the urine they produce. Overnight these children often have abnormally low levels of the hormone vasopressin, also called antidiuretic hormone. Vasopressin is a hormone, which helps to concentrate the urine at night i.e. it reduces the volume of urine. These hormone levels can return to normal with treatment.  The drinking program will help the child produce more urine in the daytime and less at night and their hormones will respond to this.
• Constipation
  This can lead to pressure building up in the area around the bladder reducing the amount of urine the bladder can comfortably hold. It can also lead to tight muscles, which stop the bladder from relaxing and emptying fully when it should whilst using the toilet. A bladder left half full will easily fill up again and soon need to be emptied.

Bed Wetting Treatment
What does a successful bedwetting program involve?
The Bedwetting Cured DVD explains how to treat the main causes of bedwetting with a step by step program.  It includes:

• a drinking program to improve the connection between the brain and the bladder and to gradually increase bladder capacity;
• information on foods and drinks which may be interfering with vasopressin, the hormone which concentrates the urine at night;
• information on the role of constipation;
• how to get the best results with a bedwetting alarm and
• information on medication (although medication is rarely needed).

Bed Wetting Enuresis Alarms
The alarm has a sensor which detects any moisture and sounds when urine is released. The Alarm sound helps the “I’m full” message get through from the bladder to the brain.  It is usually necessary to use the alarm for a duration of four to eight weeks in conjunction with the other steps of the program.
It is best to purchase rather than hire an alarm so if there are any relapses they can be treated immediately leading to a final cure.

All bedwetting alarms are battery operated so there is no chance of an electric shock. Alarms have various sounds. Most emit a siren sound or loud noise when triggered. There is an alarm, which has an alarm sound and can be recorded with the parent′s or child’s voice. This is a good option for young children who may be frightened by the alarm sound and may not want to use the alarm again. These alarms also have a flashing light and vibration.
The loudest alarms are the Pad and Bell alarms which are the best option for children who sleep very deeply.

Clip-on Body Worn
Clip-on alarms, attach to the pyjama top near the shoulder. A lead runs from the alarm to the sensor, which is placed between two pairs of underpants or underpants with pull-ups over the top. It will sound as soon as the sensor becomes wet, even with a few drops.

A waterproof mattress pad overlay can go under the child to keep the sheets dry. The overlay is optional and is not connected in any way to the use of the alarm, however, it will save on washing and changing the sheets.

Pad and Bell Alarm
The alarm pad goes on the bed and the alarm box is placed on the bedside table. A lead connects the two. Nothing is attached to the child. The alarm sounds once the wetness has reached the pad. Some of these alarms cost about $2000 making them too expensive for parents to purchase and so are usually rented. However, if a relapse occurs a hired alarm may not be available again for months. To stop the bedwetting in its tracks it is essential to purchase an alarm, keep it in the cupboard after the child has had 21 dry nights and use it the next night if the child has a relapse. We now have a relatively inexpensive Pad and Bell alarm. It is extremely loud and has a music option which is not as loud. The total cost of hiring an alarm is generally more than purchasing one outright.

Why Bedwetting enuresis alarms don’t always work...
Many people have tried alarms previously without success. The common reasons for failure are:

• Using an alarm alone without following the initial steps of the Bedwetting Cured DVD program.
• Not getting correct instruction.  It is necessary for the parent to go into the child’s room when the alarm sounds. They must wake the child if the child doesn’t wake independently and then the child must turn off the alarm.
• Hiring an alarm and having to return it before the child has stopped bedwetting completely. Some programs have time restrictions on keeping an alarm. It is necessary to keep the alarm for about 12 months because it is common for a child to have initial success and then have one or two relapses before remaining completely dry. The alarm must be available to use if the child has a relapse.

Is there any medication that can help? 
Doctors sometimes prescribe medication. The most common medication is a synthetic hormone and has similar actions to the hormone vasopressin, (antidiuretic hormone). It helps to reduce the volume of urine produced at night. This medication may reduce the number of wet nights in some children and even stop the bedwetting completely in a few. The main problem is it’s very common for the bedwetting to return as soon as the medication is stopped. The bedwetting alarm is more likely than medication to result in permanent success.

Does bedwetting run in families?
Yes, there is a tendency for bedwetting to run in families. This does not in any way alter the treatment used to stop bedwetting.

Is bedwetting more common in boys?
Yes, it is more common in boys but is just as much of an inconvenience whether it is happening to a girl or boy. The treatment is the same for both.

Will I need to purchase any equipment?
It may be necessary to purchase an alarm to eradicate bedwetting.   All our alarms come with a bonus Bedwetting Cured DVD. 

Washable waterproof mattress pads are also available which the child lies on top of to prevent the fitted sheet getting wet

Teenage and adult bedwetting
Our experience has shown treatment can be just as successful with teenagers and adults. Adults need to be aware that alcohol can contribute to bed wetting by suppressing the hormone vasopressin (antidiuretic hormone). This hormone helps to reduces the volume of urine produced at night. Following bedwetting treatment it should be possible to consume alcohol and not wet the bed.

Bedwetting – What not to do

• We have found measuring and charting urine output and fluid intake in a child is unnecessary, not to mention difficult. It is time consuming and messy and will only tell you what you will find out very quickly when you start the drinking program.

• Getting children up at night to go to the toilet will not solve bedwetting, even if it leads to a dry bed in the morning. You will still be doing this in a year’s time.

• We do not recommend asking children to ‘hold on’ as long as possible before going to the toilet (as children tend to leave it until the last possible moment to go anyway) and research has found children may then have difficulty fully emptying their bladder when they do go to the toilet.   It may also discourage them from drinking adequately and may lead to daytime wetting incidents.
• Reducing fluids in the evening without following a comprehensive drinking program will only lead to a thirsty and disgruntled child, not a dry bed.

Results
Many parents can hardly believe their child could soon be waking to a dry bed every morning, (especially after years of dealing with wet beds) BUT they can!  We strongly recommend starting with one of our bedwetting alarms.  All our alarms now come with a bonus Bedwetting Cured DVD to guide you through the step by step program. 

Parent's comment:  "We found the DVD extremely helpful. The program was easy to stick to and we have had tremendous results. Our son′s confidence has grown and he is a completely different child. We thank you from the bottom of our hearts."

What’s different about our drinking program? It is a common sense approach that busy parents can follow. It has no unnecessary steps. Many children and parents reduce fluid intake in the hope that this will help bedwetting. Unfortunately, this does not work and can often be part of the problem.

Before starting treatment many clinics request that parents measure the child’s urine output as well as fluid intake constantly for 48 hours. This means every time the child goes to the toilet the urine needs to be measured. Also, pull-ups need to be weighed before and after use. Fluid intake must also be measured.  Most parents find this extremely difficult and time consuming.

Another request is that parents are asked to chart the bedwetting for several weeks so the nurse or doctor knows exactly how often the child wets the bed.  Although this can sometimes be revealing we find that parents know how often their child wets the bed and they will know if our drinking program varies from what they have been doing, which is very likely.

One extra question that needs to be asked is “if you did not get your child up at night, how often would your child wet the bed” as people sometimes say their child wets the bed twice a week when in fact if the parent did not get their child up during the night the child would wet every night.

The first step in our program is a structured drinking program. Left to themselves children are often rushing in the morning, running around in the school breaks and forgetting to drink. Once they relax at home after school they have a bit more to drink, sometimes a lot more. Poor drinking habits can lead to several factors including small bladder capacity, meaning the child can’t hold much urine in their bladder at night. Some children’s habits lead to them making too much urine at night and not making enough during the day. Also the hormone which concentrates the urine at night, works more effectively with a structured drinking program.

The easy to follow drinking steps are outlined in detail on the thirty minute 'Bedwetting Cured' DVD. The steps are suitable for children from 5 years of age. They should also be followed by older children, teenagers and adults.

Younger children may respond as well but the medical research on bedwetting treatment is mainly with children who are at least five years of age so that is the age we suggest parents start a bed wetting program.

Parents often think very deep sleep is the only factor contributing to bedwetting. Before rushing into starting a bed wetting alarm to address the deep sleep, it is best to prepare your child to respond to the alarm by removing the other possible causes of bedwetting first.

All children who wet the bed have some degree of deep sleep.

One major advantage of the Bedwetting Cured DVD is helping your child to become agreeable to trying a bedwetting program and following the steps without having to attend lots of clinic appointments.

After researching the medical literature and adding in years of clinical experience the recommendations on the DVD give you the best chance of stopping the bed wetting.

The DVD can be watched by parents as well as the child. This leaves the parent out of the job of making recommendations.

Many children especially older ones are embarrassed about wetting the bed and are sick of going to appointments. We recommend trying our program for up to three months. If you have followed all the steps most children will be cured. If not then it is time to make an appointment at a Children’s Hospital, Continence Clinic or ask your G.P. for a referral to a Paediatrician.

Many older children have tried various things before but usually one at a time leading to disappointment. From the feedback we have had just adding our drinking program, which is different from others, can make all the difference. It is important to try all the steps together. Some children need to keep up the drinking program long term while others just start to wake up when necessary during the night if their bladder is full.

If you start using an alarm straight away you may find it is going off three or four times a night, your child is not waking up to the alarm sound and you will all get exhausted and give up. The child is not ready for an alarm if it is sounding this often. The child probably has more than one of the causes leading to the bedwetting. Read more about causes.

Remember, for most children it is important to follow the initial steps on the DVD for a about three weeks and then add in a bedwetting alarm. If the child is only wetting a few nights a week or less frequently then start the alarm at the same time as the DVD steps.

When you start an alarm keep up the other steps. If you keep going with the initial steps and don’t start an alarm and your child is still wetting the bed then the child will start to believe nothing will work and they will be less co-operative when you finally do try an alarm in six month’s time.

Once you start a bedwetting alarm you need to continue until your child has achieved 21 dry nights in a row. Some people recommend 14 dry nights, however, with a longer dry period before stopping use you are more sure you have the bedwetting under control.  You can then put the alarm away in a cupboard. Do not give it away. Have it ready to use in case your child has a relapse, which can happen even months later, possibly after exhaustion, illness or just the start of winter.  If your child has a relapse start the alarm again straight away and you should get it under control quickly. Restart the steps on the DVD if these have been relaxed. Some children will need to maintain these healthy habits long term.

To buy the DVD and one of our clip-on or Pad and bell alarm go to All Bedwetting Alarms and DVD Kits.

Read more about choosing an alarm and DVD Kit.

All our Bedwetting Alarms come with a bonus Bedwetting Cured DVD. In the past we have found that customers who purchased the DVD with their alarm were more likely to be successful with the alarm and also less likely to end up with a broken alarm!

Pad and Bell Alarms  
These alarms are the loudest.

The child cannot wear pull-ups this type of alarm. We have two alarms which can be used as a Pad and Bell or as a clip-on alarm, the iDry which is very loud and the Malem Deluxe which is not as loud but has special features. It is possible to use pull-ups with these two alarms when they are used as clip-on alarms but not when they are used as pad and bell alarms.  View both here.

Pin on & Clip on Alarms - also called Body Worn
If your child is wearing pull-ups the easiest system to use is a pin-on or clip on bedwetting alarm.

The alarm sound box attaches to the pyjama top near the shoulder.

A lead then goes down to the underpants. either over the top or between two singlets or T-shirts.

The sensor at the end of the lead  goes between two pairs of underpants with a clip holding the lead in place.

It is also possible to use one pair of underpants and put pull-ups over the top with the sensor in between.

The pull-ups allow the sensor to still get wet and so the alarm sounds but the sheets stay dry making your workload less, which will help you continue with the program.

Some people are lucky and their child is cured within two weeks however it can take a couple of months but usually the child starts to improve by starting to have more and more dry nights.

Wireless Alarms
With the Malem Alarm a Transmitter attaches to the underpants and the Receiver with a sound box sits on the bedside table. 

1.  What does my child need so that the bedwetting will stop?
Most children need to follow the steps on the DVD for three weeks and then start a bedwetting alarm while continuing the DVD steps.

2.  What is a bedwetting enuresis alarm?
The alarm has a moisture sensor that sounds as soon as the child wets the bed. This sound eventually helps to get the message from the bladder to the brain and helps the child wake at night instead of wetting the bed.

3.  What is the difference between a Pad and Bell alarm and a clip-on alarm?
The Pad and Bell Alarm has a mat which sits on the bed. The child lies on this and the mat connects to the alarm box on the bedside table. 
The clip-on body worn alarm attaches to the child's pyjamas and a lead goes from it to the sensor which goes between two pairs of underpants or underpants and pull-ups. 

4.  Can my child wear pull-ups while the bed wetting is being treated?
Yes, it's OK while following the steps on the DVD and also while using a clip-on or body worn alarm. 
They cannot be worn with a pad and bell alarm. 

5.  What alarm is best for a young child aged 5, 6 or 7?
Young children can use either type of alarm. The clip on alarm is easier to set up and reset at night especially if your child is wetting multiple times each night.

6.  What is best for older children and teenagers?
We usually recommend the loudest alarm. The iDry model is the loudest and can be used as a clip-on or pad and bell alarm. Once the bedwetting is cured place the alarm mat under the fitted sheet and leave it there for six months.

7.  What is the best alarm for children who wet occasionally?
The pad and bell is best as it can be set up under the fitted sheet. It is there "just in case". It can be disconnected and the alarm put away and the leads tucked under the sheet when visitors come. It does not need to be set up every night.
 
8.  We tried an alarm before and it didn't work. Why should we try again?
By “didn't work” some parents mean the child did not wake when the alarm sounded. This is common and it is essential that the parent hears the alarm, goes in and helps the child wake up. 
By following the steps on the DVD first the child is more likely to wet later in the night and this is more likely to be when they are not in a state of super deep sleep.

9.  Should we see a Paediatrician?
Many children can be cured within three months using our program. We suggest if you intend to see a Paediatrician you make an appointment for three months in advance and follow our program during the three months leading up to the appointment. If your child is cured then you can cancel the appointment. If your child is not cured then you have something to report to the Paediatrician. Usually the first step a Paediatrician will recommend is to use a bedwetting alarm.

10.  What about psychological issues?
Some children are under an increased amount of stress at certain times. They may sleep less deeply in certain situations and not wet, then relax and go into a very deep sleep once home again. The aim is to help children, even those living in stressful situations to stop wetting the bed. 

Founders:  Margaret, O’Donovan Dip Physio; MMAPA (Physiotherapist), Dr Mark Condon MBBS (Syd.) (General Practitioner) and Louise Kenny BPharm GradDipHPharm(Syd.) (Pharmacist).

Margaret O’Donovan, Physiotherapist, successfully started treating bedwetting 20 years ago in her Canberra physiotherapy practice.  10 years ago, following requests from parents struggling with bed wetting issues, who were not located in Canberra, the revolutionary Bedwetting Institute DVD programme was launched, allowing the Bedwetting program to be followed wherever someone is based.

Prior to making the DVD we scoured medical literature on enuresis (AKA bedwetting) to ascertain what past research had revealed.  We then combined our years of experience as a G.P. , Physiotherapist and Pharmacist to design an easy to follow, practical guide to help eliminate bedwetting issues using a caring and medication free approach.

Margaret O’Donovan, Physiotherapist, has experience in Australia and the UK in large teaching hospitals, private hospitals and private practice and currently treats patients in her Canberra practice for continence issues as well as musculoskeletal problems.

Dr Mark Condon (2009 Illawarra GP of the Year) has worked in both hospital, university and general practice settings, establishing his current practice at Albion Park, Wollongong in 1992.  Mark has held an appointment with the University of Wollongong Graduate School of Medicine since 2006 and has been teaching medical students and post graduate doctors for over ten years. Mark’s previous Tongarra Medical Practice was recognised in the 2012 Practice of The Year Awards.

Louise Kenny is a Pharmacist who has worked in community pharmacy, teaching hospitals in both the UK and Australia, as well as country NSW. Realising remote communities faced logistical challenges in accessing help for specialist conditions, Louise knew the Bedwetting Cured DVD offered a solution.  (The Bedwetting Institute also offers back up by phone for additional help).

Our team attends the CFA (Continence Foundation of Australia) NSW State Conference and the National Conference on Incontinence annually and well as relevant workshops to keep up to date with the latest research and information and we’re confident we can help you eliminate bedwetting.

We recommend you purchase the alarm which will most suit you and your child.  Follow all the strategies on the Bedwetting Cured DVD then start the alarm to have the best chance of a permanent cure.

Alarm + DVD Kit

Number of sounds

Rotating sounds

Select favourite sound

Vibrates

Wear with pull-ups

Volume

Battery

Clip type

Reliability

Warranty

iDry Clip on or Pad and Bell Recommended

2 alarm

2 settings Extremely loud

9V

clip-on or pad and bell

99%

12 months

Malem Bedside Pad and Bell

8 sounds Recordable

yes

yes

optional extra

no

Very loud

4 x AA

pad and bell

95%

MO3 Standard Clip

1

loud

3x A76 button

clip-on

95%

6 months

Malem Deluxe Recordable standard clip

8 sounds recordable

very loud

2x AAA

clip-on + optional alarm mat for pad and bell

97%

6 months

Malem Gold

8

loud

2x AAA

clip-on

97%

6 months

0

Bedwetting Enuresis Alarm Information
The aim of a bedwetting, enuresis alarm, is for the loud sound to start straight after the child begins to wet. The sound of the bed wetting alarm is supposed to wake the child and help the message get through from the bladder to the brain. Over time the aim is that the child will stop wetting as soon as the alarm sounds. They will then stop wetting altogether.

Unfortunately, many children wet early in the night and they don’t wake to the alarm. The parent thinks the alarm does not work and they give up. The child is often in their deepest phase of sleep early in the night so is less likely to realise their bladder is full. They are also less likely to wake to the alarm.

We recommend starting with a drinking program, treating any bowel sluggishness and checking any foods and drinks which may be causing problems before starting the alarm.  This often gives you a quicker result with the alarm. 

Alarms have various sounds. Some emit a siren sound or loud noise when triggered. Others can be recorded with the parent′s voice. Others, including the Pad and Bell variety are generally very loud. All bedwetting alarms are battery operated so there is no chance of an electric shock. They operate by giving off a loud sound, or a recorded message of the parent′s or child’s voice, as soon as the sensor gets wet. Some alarms also have a flashing light and a vibration option.

One type of enuresis alarm, the clip-on or body worn alarm is a small plastic box which is attached to the pyjama top. A lead connects the box to a sensor which is placed between two pairs of underpants. The lead can be threaded between two T-shirts to hold it in place. This type of alarm can be used while the child is still wearing pull-ups. The sensor goes between underpants and pull-ups. If this system helps the parents to persist with the program then that is what will achieve results in the end. Once the child stars to improve the pull-ups can be removed.

Another type of alarm is a pad and bell. The child lies on a special alarm mat which has a moisture sensor in it. A sheet goes over the alarm mat to hold it in place, make it comfortable and stop perspiration setting it off accidentally. The alarm box sits on the bedside table. A lead connects the pad to the alarm box.

There is also a wireless alarm, whereby a transmitter attaches to the underpants which then transmits the sound to the alarm box on the bedside table. We have found that this type of alarm is not as reliable as the other types of alarm. It may be that the transmitter gets moisture inside as it sits on the underpants or the wireless function interferes with other household wireless products. We no longer stock this type of alarm.

See our range of bedwetting alarms here

Remove the insulation tag from the battery compartment. Remove the plastic from the battery. If using the alarm mat then remove the plastic from the mat. Test the alarm is working by wetting the sensor tip with water. Press the ”Reset” button to stop the alarm from sounding.

Sound – slide the sound selection switch on the side of the alarm to change the sound - 2 sounds available. 


Volume – choose high or low setting.

Setting up the Alarm at night

Clip-on method
To keep the lead out of the way it is best for the child to wear two layers on top e.g. two singlets or T-shirts or a singlet and pyjama top. Attach the Alarm sound box near the shoulder. The lead can be threaded between the two tops and at the end of the lead the sensor goes between two pairs of underpants. Pull-ups can be worn over the underpants if you want to stop the urine getting onto the sheets. Using pull-ups may help you continue with the program as you will have less work to do.

Once the child starts to improve take the pull-ups off and use one of the waterproof bedwetting pads under the child. 

To stop the alarm from sounding when bedwetting occurs:

Remove the sensor. from the wet underpants. Shake if necessary to remove any excess urine. Press the “Reset” button on the alarm. 


Pad and Bell method

Place a waterproof bedwetting pad on the bed if you want to keep the sheet dry. The alarm mat goes on top of the fitted sheet or on top of the pad. A folded sheet goes on top of the alarm mat as is tucked in on both sides to make the bed comfortable, hold the alarm mat in place and stop perspiration setting off the alarm. 

Cleaning

Clip on sensor
Detach the sensor from the alarm before cleaning. Rinse the underpants sensor at night when the alarm sounds before setting it up again. Wash the underpants sensor with soapy water every few days, rinse and dry.

Alarm Mat

The alarm mat must be washed immediately at night by the parent. Leave a wash cloth in the bathroom with some liquid soap. Wipe over the mat with the soapy cloth. Rinse with clean water and pat the mat dry.  If any urine is left on the mat overnight it will gradually build up and the mat will stop working in three or four weeks. Spare mats are available for purchase. Normally one mat should last three months or long enough to cure most children. 

Getting the best results
For best results if your child is wetting every night, follow the steps on the Bedwetting Cured DVD before starting the alarm. The DVD also demonstrates how to get the best results with an alarm. It also helps to get your child on side with the program and shows you what to do at night.  By following all the steps you are more likely to achieve a permanent cure.

The Malem Bedside Alarm can only be used with the alarm sound box on the bedside table. The alarm mat goes on the bed and attaches to the sound box on the bedside table with a lead. Pull-ups cannot be worn with this alarm. 

This alarm mat plugs in on top of the alarm box. The other plug is used for an optional vibration attachment. If using the vibration attachment make sure the lead is held securely in place and cannot twist around the child at night.

Method

Place a waterproof bedwetting pad on the bed if you want to keep the fitted sheet dry. The alarm mat goes on top of the fitted sheet or on top of the pad. A sheet folded in four goes on top of the alarm mat. It is tucked in on both sides to make the bed comfortable, hold the alarm mat in place and stop perspiration setting off the alarm. 

Cleaning

Alarm Mat

The alarm mat must be washed immediately at night by the parent. Leave a wash cloth in the bathroom with some liquid soap. Wipe over the mat with the soapy cloth. Rinse with clean water and pat the mat dry.  If any urine is left on the mat overnight it will gradually build up and the mat will stop working in three or four weeks. Spare mats are available for purchase. Normally one mat should last three months or long enough to cure most children. 

Parent's job

The parent must be able to hear the alarm at night and go in and wake the child if necessary. The child turns off the alarm. The parent changes the bedding, washes the alarm mat and sets up the alarm again. 

Getting the best results
For best results if your child is wetting every night, follow the steps on the Bedwetting Cured DVD before starting the alarm. The DVD also demonstrates how to get the best results with an alarm. It helps to get your child on side with the program.   By following all the steps you are more likely to achieve a permanent cure.

Malem Bedwetting Alarm Gold MO4 Instructions    

If your child is wetting the bed every night we recommend following the steps on the Bedwetting Institute® DVD for three weeks before starting the alarm.

Problems with clip:

Lift the clip carefully up and down and view from the side.  Check where the material of the pyjamas or T-shirt must be inserted. If you insert too much thick material or put it in the wrong place the clip will break.

The standard sensor attaches to the underpants at the level of the elastic. The metal sensor extends lower down and is held in place with another pair of underpants or pull-ups or can be inserted into a stick on pad. 

The MO4 Gold has eight different sounds and vibration. The alarm automatically changes to a different sound each time it sounds. Vibration can be turned on or off. Vibration can be used alone without any sound.

See the diagram in the green instruction book to choose both sound and vibration or sound or vibration.

Remove any white plastic from the battery compartment.

At night:

Test the alarm by moistening the sensor so the child can hear what will happen during the night. The child presses the button on the side to stop the sound.

The parent will need to go into the child’s room when the alarm sounds so it is essential that the parent can hear the alarm when it starts, as it is common for the child to sleep straight through the alarm initially. If necessary move the child’s mattress into the parent’s room or use a baby monitor.

To turn the alarm off, the parent removes the sensor from the wet underpants and the child presses the button on the side of the alarm.  The parent dries the sensor if the alarm continues to sound. The parent then changes the waterproof mattress overlay and helps the child change underpants.

A small number of children wake to the alarm but are frightened by the noise. In this case put the alarm on after the child goes to bed. These children may respond quite quickly to the alarm if you persist despite the initial distress.

Be sure to remove the alarm from the pyjamas before putting the pyjamas into the washing machine!

Once your child has achieved 21 day nights remove the batteries and put the alarm away. Keep it on hand in case of a relapse and restart it if necessary the next night.

• This alarm has several options. eight rotating alarm sounds
• choose your preferred sound
• alternating alarm sound and voice recording, five seconds or each repeating
• a vibration option. 

Remove back cover. Remove white plastic (if there) and place 2 x AAA batteries inside. Test the alarm is working by attaching the lead and wetting the sensor. 

Set-up
Clip the alarm near the shoulder. Thread the lead between two T shirts or singlets so the lead stays in place. The sensor goes between two pairs of underpants or underpants and pull-ups. We also offer the option of using this alarm with an alarm mat. If the alarm mat is used then the alarm sound box sits on the bedside table. 

With batteries in and cover off gently press the recording button. A light will come on. The message could be  "Wake up, Emma, stop wetting the bed. Emma, wake up"

Research with smoke detectors has found that young children sleep through a piercing beep 50% of the time; however, they are more likely to wake to a parent’s voice mentioning their name. Any sound can be used.  

The parent must be able to hear the alarm:
The parents will still need to go into the child’s room, as shown on the DVD, so it is essential that the parent can hear the alarm when it starts. The recordable function will be harder for the parent to hear. If necessary put a baby monitor in the child’s room or sleep in the same room as the child.

At night:
Test the alarm by putting a moist finger onto the sensor so the child can hear what will happen during the night. Explain to the child that they should wake up, stop wetting, turn off the alarm, get up and go to the toilet.

What to wear:
At night the child wears two pairs of underpants (or one pair of underpants and pull–ups over the top). The sensor is placed between the two pairs of underpants. The clip is attached to the underpants.

To turn the alarm off, the parent removes the sensor from the wet underpants until the child can manage this and the child presses the button on the side of the alarm. Dry the sensor if the alarm continues to sound.

The parent then changes the waterproof bed pad and sheets if necessary and helps the child change into dry clothes. The alarm should be reset.

If you have purchased an alarm mat in addition to the alarm then it goes on top of the fitted sheet. A waterproof bed pad can be placed under the alarm mat. On top of the alarm mat place a sheet folded in four and tuck the sheet in on both sides. This will hold the alarm mat in place, make it comfortable for the child and stop perspiration setting off the alarm accidentally. If the alarm mat is used then the alarm sound box goes on the bedside table. 

If your chid is wetting every night then start with the steps on the Bedwetting Institute® DVD. Follow these steps for three weeks and then start the alarm. 

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