Bedwetting in the Older Child: Punishable by Death

Nancy Muller Health Pro
  • In August of this year, the Dallas Morning News reported that a 10-year old Texas boy died in late July of dehydration after his parents deprived him of water to discipline him for wetting the bed. The boy's father, Michael Ray James, 42, and his wife, stepmother Tina Maria Alberson, also 42, were arrested afterwards and charged with injury to a child causing serious bodily injury. Depending on the outcome of trial, sentencing and punishment, they could be imprisoned for up to 99 years for the crime.

     

    The charge stems from the death of the boy after an autopsy revealed the child died from dehydration while being punished. Alberson's bond was set at $150,000; James' bond was $100,000. While the two had previously encountered problems with child custody authorities, nothing had been previously proven to warrant removal of their children from them, according to reports.

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    Their son, Johnathan James, died on July 25. He wasn't tied up or beaten as we often hear in child abuse stories. Instead, it seems the boy was forced to stand still for long periods of time, and not allowed anything to drink--not even a teaspoon of water, for five long days during the intense heat wave gripping Texas and The South throughout the summer. The James' home does not have central air conditioning. And the child was forced to eat peanut butter, found stuck in his throat upon his death because of insufficient beverages and in discovery by healthcare personnel upon autopsy.

     

    At the time of the boy's death, Alberson told police the boy had complained of being hot and she had tried to cool him by putting him into a tub of cold water. Authorities initially thought the boy had died from heat exhaustion, but his death went unexplained until his autopsy revealed foul play. The boy's grandmother is very concerned for the twin brother who saw his brother collapse and now wishes he had been able to sneak him a drink.

     

    It's not the first time we at NAFC have heard of a grandmother's concern. In fact, I have personally spoken to grandmothers who telephoned our headquarters expressing serious concern about the physical and emotional abuse their grandchildren were being subjected to because of bedwetting. I have even referred them to social service agencies and other local authorities including the police.

     

    Bedwetting happens to be the #1 search term that brings people to our web site, not for babies but for unresolved problems in older children and even young adults. Log in at NAFC's web site to read what we have to offer in the way of guidance and information. Most parents are ill-informed and react with frustration, anger, or acceptance, none of which are helpful to the child.


    Nocturnal enuresis, or bedwetting while sleeping at night, affects over 5 million children in the United States. In population-based cross-sectional studies on children between 6 and 12 years of age, a prevalence of 0.2-9.0% (daytime incontinence), 1.5-2.8% (combined daytime and nighttime incontinence), and 1.5-8.9% nocturnal enuresis, respectively, have been reported in published research. It is well known that nocturnal enuresis usually resolves over time. Every year 15% of those suffering from bedwetting become dry without treatment. But bedwetting also appears to run in families, and young people who suffer from bedwetting as children are more likely than others to have problems with overactive bladder and incontinence later in life as adults.

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    Before discussing the treatment of nocturnal enuresis, there are two important things to keep in mind. First, children do not wet the bed on purpose. They should never be punished. Second, most pediatricians do not consider bedwetting to be a problem until a child is at least six years of age. A recent study showed a significant communication breakdown between parents and doctors on this issue. While 80% of parents want healthcare providers to discuss bedwetting, most feel uncomfortable initiating the discussion themselves. Furthermore, 68% of parents said their children's doctor has never asked about bedwetting at routine visits. Therefore, parents need to be more proactive by asking for help if they have a child who is wet at night. And they MUST be involved in the remedy. The most successful intervention strategies, with or without sophisticated bed alarms, require the parent's involvement and positive reinforcement.


    Bedwetting by the older child is a common and embarrassing problem that can greatly affect children and families. Life at summer camp, for the camper and the counselors, can be a disaster because of bedwetting. It is a major problem summer camps are forced to address. It is neither the fault of the child nor the parent. Despite the frustrations that families have to endure, many parents do not raise the issue with their healthcare providers. The most important thing to remember is that with care and perseverance, nocturnal enuresis is a problem that can be successfully treated.

     

    Nancy Muller, PhD

     

Published On: September 23, 2011