Under the age of five, many children may wet the bed. However, after this age, it classed as a medical condition called nocturnal enuresis

If your child is over five and still bedwetting, please don't worry! My eldest daughter was over 5 when she became dry at night and my youngest is also 5 currently and not yet dry. So this post is here to help you. We explore the reasons for continued bed wetting and some of the strategies you can use to reduce it over time. Here’s everything you need to know. 

Why Do Children Wet The Bed At Night? 

Bedwedding isn't a child's fault or a serious medical condition. However, it's something that a lot of parents become more concious about as a child gets older as they don't want it to impact their child's self esteem. 

Bedwetting can occur for several reasons mostly to do with biology. Some children have small bladders that don’t hold the pee released from their kidneys at night. Eventually, the bladder fills to the point where it automatically releases its content. 

Other children’s bladders fail to properly signal the need to go to the toilet to the brain at night. Consequently, the child doesn’t have the sensation of being full and therefore, released into the bed. 

Finally, some children produce too much pee at night, perhaps because of drinking a lot before sleeping or hormone issues. 

While there are many reasons for bedwetting, they are treatable using evidence-based approaches. These deal with the root of their bedwetting issues, helping them move toward drier nights. 

Bedwetting doesn’t mean a child is naughty. It is a natural part of growing up. Some children are able to control the issue later than others, which can cause some parents to feel concerned. All children are different and it's important not to compare your child to others.

If your child has a bedwetting incident at night, be supportive. Don’t blame or punish them for what happened. 

Understanding Night Time Potty Training

Sometimes health complications can drive bedwetting at night. Therefore, you should rule these out with a healthcare provider first. 

For example, your doctor might identify constipation as the driving force behind the bedwetting. A full bowel engorged with hard stools can press on the bladder from behind, causing increased urgency. Urinary tract infections can also increase the risk of bed wetting along with type II diabetes (rare in young children). 

Sometimes bedwetting can occur transiently. These situations are trickier to deal with because they often involve outside factors. For instance, your child may feel stressed due to external events such as starting a new school, disrupting bladder-brain signalling at night. Anxiety can increase the release of vasopressin, a hormone that slows the kidney's urine production. When the brain makes too much of this hormone, more urine is produced at night.

Night-time potty training involves using various strategies to control bedwetting when none of the above reasons apply

If you notice sudden-onset bedwetting (something that occurs after successfully being dry at night for more than 6 months), speak to your doctor or paediatrician. Medical professionals can provide effective treatment. Stopping bedwetting requires knowing the cause. You need to understand what is driving it before intervening. 

Overnight Potty Training: Mastering the Process

Here are some strategies you can use to prevent bedwetting in your child: 

  1. Go To A Bladder And Bowel Assessment

The first step is to take your child to a bladder and bowel assessment – something NICE guidelines recommend for all children bedwetting over 5 years. This allows medical professionals to identify issues preventing a child being dry at night. In the UK, although the NICE guidelines recommend age 5, it did used to be age 7 so some GPs still now do turn patients away and say come back when the child is 7. I wrote about this on our Instagram the other day where one of our followers share that this had happened to her - feel free to check out our advice.

As well as getting help from the GP, there are many other routes to getting the help your child need. I am compiling a list of trusted people and organisations that I personally have spoken to on our website - this includes private incontinence consultants as well as eric charity. Your school nurse might also be helpful in providing some support and guidance on next steps. The main thing is not to worry because support is out there.

2. Use Bedwetting Alarms

Some parents also use bedwetting alarms. These help children with poor nighttime arousal – children who don’t wake up when their bladders tell them they need to wee. 

These devices contain a sensor that activates an alarm when they sense moisture. As wee starts to trickle out at night, they activate, waking the child and encouraging them to go to the bathroom. 

Alarms can be highly effective at training the brain to react to bladder fullness signals. Eventually, the child associates the wee sensation with the need to wake up. 

However, implementing this strategy is challenging for many parents. Children don’t always want to wear alarms or wake up at night to go to the toilet. Parents must often wake up, too, to encourage the proper use of devices. 

Furthermore, some conventional devices can cause autistic children distress because of the noises and light effects they produce. Therefore, choose your alarm carefully. 

If you are seen by the GP and after carrying out a bladder and bowel assessment don't find any issues, they may provide you with a bedwetting alarm. 

How To Use Bedwetting Alarms Effectively

Bedwetting alarms won’t work immediately. Instead, your child must use them for at least a month, usually longer, because training their brain to react to alarm/wee signals at night takes time.

Some parents sleep in the same room as their child for the first few nights of alarm use. This approach reinforces the child’s response and means you can help them to the toilet. 

Before strapping the alarm onto their clothing, explain to your child how it works and what it’s for. Show them how it operates by wetting it with water so they can see the lights and sounds it makes and know what to expect. Children can feel distressed if unfamiliar noises wake them at night. The brand you purchase the alarm from will provide a wealth of information and advice on how to use the alarm so make sure you read all of this.

When Will You Know The Bedwetting Device Is Working?

Your child won’t stop bedwetting immediately after fitting the device. As explained, it takes time for their brain to adapt to the device’s signal. 

Most children continue to wet the bed for the first few nights. Then, bedwetting becomes more sporadic. Over time, the number of dry nights in a row should increase. 

You can declare victory when you have 14 days of dry nights in a row. A prolonged dry spell like this suggests the device has done its job. 

If you don’t notice any progress after three months of treatment, stop using the alarm for a couple of weeks before trying it again. It can take some children a long time to potty train at night. Failure doesn’t necessarily mean the approach isn’t working. 

  1. Get Bedwetting Medications

Sometimes alarms won’t work no matter how long you use them. In these cases, your doctor may recommend medication to reduce the urge to pee at night. 

The main drug for this purpose is Desmopressin. It increases the body’s vasopressin levels, the wee-controlling hormone discussed above. Letting more of it enter your child’s system reduces wee production at night. 

2. Use Special Tactics When Travelling

Bedwetting can be problematic when your child travels (particularly when they go alone). However, there are additional strategies you can use to keep them dry at night. 

First, you can talk to your doctor about taking Desmopressin to reduce night time urgency. You can also provide your child with a Hygge Sheet Mattress Protector or nappy, extra bedding and clothing, just in case of an accident. We always take our Hygge Sheet when we go on holiday as do many of our customers. I really don't know what I would have done without it (My youngest daughter is 5 and a half)

Top Tips for Potty Training at Night

Here are some quick tips for potty training at night:

  • Check your child doesn’t have daytime bladder issues, such as an overactive bladder or constipation
  • Ensure your child empties their bladder before bed - sometime a double void where a child wees twice before bed is helpful. 
  • For boys - it's recommended they sit down for a wee before bed. More on this here.
  • If your child is sleeping in a bunk bed, move them to the bottom bunk to make changing the bed easier in the night.
  • Remind your child that they will eventually achieve a dry night
  • Get your child to drink plenty of fluids early in the day - filling up and emptying the bladder exercises the bladder muscles.
  • Get your child to stop drinking at least 1 hour before they sleep -  ideally they have stayed hydrated through the day.

Potty Training Your Toddler at Night: A Guide

You can also implement various strategies to prevent bedwetting in children under 5. These increase the chance of dry nights during the potty training process. 

Research shows your child stands a higher chance of remaining dry if they can nap for two hours or more during the day without weeing. This ability suggests their brain-bladder signalling is working well and can carry them through the night. 

When potty training your toddler, the same general advice applies as above. Ensure the child wees before napping and understand that there will be some accidents on the way. Also, protect the bed with a waterproof sheet if it is their first time sleeping without a nappy. 

Bedwetting In Older Children And Teenagers

Bedwetting can occur in older children and teenagers, too. 

You may need to talk with your child sensitively and reassure them it isn't their fault and that it's a medical condition. Doctors can analyse their case and identify an underlying condition driving the problem.

Now You Know How To Potty Train Your Child At Night

Reading this, you should have a clearer idea of how to potty train your child at night. While nighttime bedwetting can be distressing for everyone involved, the problem usually subsides using the above strategies.

I hope you have enjoyed reading this. You may also want to check out our other blog posts and follow us on Instagram for more tips! 

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