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Friday, October 20, 2017

Bed-wetting: Not a problem — yet

Q: My 5-year-old is still wearing a Pull-Up at night. I tried for a week to put him to bed without training pants, but he’s such a sound sleeper that he woke up on soggy sheets, which was frustrating for both of us. How can we make this transition, and how “normal” is it to not be night trained at this age?

A: Don’t be surprised if your child is dry all day but still wets the bed at night. Learning to be dry during the day and at night are two completely different things.

For a child to be dry at night, the nerve pathways between the bladder and the brain have to become better developed. This also means that your child must be motivated enough to climb out of a cozy, warm bed and venture out to a dark bathroom. And his/her body may not have developed the slowdown in urine production that naturally develops between ages 2 and 7. This may be genetic, and often takes longer for kids who are deep sleepers.

Many parents feel and believe that having their child off Pull-Ups is a major developmental milestone. While it’s certainly something to look forward to, and a skill that many children develop by the time they turn 5, not all kids do. Twenty percent of 5-year-olds are still wetting their beds at night.

Ask your pediatrician

The good news is that they usually don’t need any treatment. But it is always a good idea to check with your pediatrician if:

  • Your child has been dry at night for a while, but then begins to wet at night again and must go back to wearing training pants.
  • Your child is 5 and is consistently wetting the bed.
  • Your child is completely toilet trained for at least six months and suddenly begins to have many accidents during the day or at night.

After a trip to the doctor, you may want to consider backing off for awhile. Some patience and understanding (two things in short supply in the middle of the night) are keys to helping you figure out how best to support your child.

The most important thing to consider is figuring out if your child is motivated to become dry and if he/she is ready to work on it.

Signs that your child is ready for night training:

  • Your child starts to notice that he is wet in the morning and doesn’t like it.
  • Your child doesn’t want to wear Pull-Ups anymore.
  • Your child says he wants to be dry at night.
  • Your child asks if any family members wet the bed when they were children.
  • Your child doesn’t want to go on sleepovers because he is wet at night.

Keep in mind that bed-wetting is a process that is not under voluntary control. Children do not wet the bed on purpose, and most pediatricians do not consider bed-wetting to be a problem until a child is at least 6 years old.

How to help

Here’s how to create a supportive environment for learning, and reduce the stress associated with bed-wetting:

  • Remind your child that it’s not his/her fault.
  • Let your child know that many children at his/her age are also wetting the bed at night.
  • Don’t punish or shame your child.
  • Make sure the child’s siblings don’t tease him/her about wetting the bed.
  • Let your child know if anyone in the family wet the bed growing up.
  • Praise your child if he/she wakes up at night to use the bathroom, has smaller wet spots or has a dry night.
  • Let your child decide whether to wear a Pull-Up or not each night.
  • Handle accidents without anger or shaming.
  • Avoid punishment for wet nights or too much praise for nights without accidents (this can make children feel bad when they aren’t successful).
  • Limit fluids before bedtime.
  • Make sure the path between your child’s bed and the bathroom is lighted.
  • Let your child be in charge of the process as much as possible.

Learn more

Dry nights come with time and patience.

When parents are matter-of-fact about “potty learning” and don’t make a big deal about it, children are more likely to follow their own internal desire to reach this important milestone.

If you have more questions about potty learning or other developmental concerns about your child, you can contact Southwest Human Development’s free Birth to Five Helpline at 877-705-KIDS (5437) or visit birthtofivehelpline.org.

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Ana Arbel

Ana Arbel, MSEd, is a senior program manager for the Birth to Five Helpline and Fussy Baby programs at Southwest Human Development.

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