Q: Six months ago, my wife and I decided it was time for our 7-year-old to stop wearing GoodNites overnight and for us to really encourage him to get up and use the bathroom at night. We would wake him up twice at first, and then reduced it to waking him up once before we went to bed. He has had some successful nights, but even after a round of probiotics from the doctor, he continues to have accidents more often than not. He does not want to go back to wearing GoodNites, so we’re not sure what to do next.
A: Ah, nighttime potty training: the nightmare of so many parents. Your child trains like a champ during the day, only to struggle keeping dry at night, for years and years. This is shocking for parents. How can the child be consistently toilet-trained every day, and then not be able to control their bladder at night?
Well, it turns out there’s a lot we don’t know about nighttime bed-wetting (or nighttime incontinence/nocturnal enuresis). It is extraordinarily common, especially in children younger than 7. Even after that age, many doctors see incidences of bed-wetting, and a majority of these incidences do not have a medical cause. It seems that most children are simply deep sleepers and/or have an “immature bladder,” meaning it can’t store urine for an entire night. Many cases of bed-wetting are hereditary. It is also worth noting that boys suffer from bed-wetting far more than girls, and cases like this solve themselves in time.
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After children reach 6 or 7, doctors usually become involved with the bed-wetting (as is the case with your family). It is rare, but there can be urinary tract infections, diabetes, sleep apnea, spinal cord issues, or deformities of the bladder or urinary tract, and doctors will order tests to start to rule out these issues. Again, these issues are extremely uncommon (only 3 percent of bed-wetting children). Bed-wetting can also be a sign of extreme stress or trauma; these children are usually trained in the day and night, and then will inexplicably begin bed-wetting. If there has been any trauma or important transitions in the family, please let your doctor know, as this will greatly impact your son’s care.
Your son is stuck between a rock and a hard place. He has given up training pants and doesn’t want to move backward; the thought of wearing them again is probably humiliating and they can feel like diapers for babies. But without the training pants, he wakes up wet and has to change his bedding daily. Doctors warn it is the emotional stress of bed-wetting that causes the most harm to children, not the bed-wetting itself. So, what are you to do?
Cultivate the confidence that this will get better. Do you actually know this? No, but your son needs to see hope and confidence . If he feels that you are relaxed and unruffled by this, he will also be able to stay calm and move forward. It is important to regulate your emotions around this process, rather than “working” on your son like he is a project.
Handle the laundry issue. Buy waterproof sheets, use as little and as easily laundered bedding as possible, and have your son help you. A little bit of agency on his part will help him to feel less like a “failure.”
If the issue isn’t medical, investigate using an alarm or “pee pad.” It is not guaranteed to work, but many parents swear by it. Talk to your doctor before going down the alarm path.
I know this is a challenging time, but do your best to stay laid back. One way or another, your son will eventually stay dry through the night. Keep in touch with your doctor, treat this as a laundry issue, stay compassionate and good luck.
Years ago in 1975 I had a 4 yo daughter and a 6 yo son who continued to wet the bed at night. Limiting night time fluid intake and taking them to the bathroom at 11pm did not work. We lived in a NYC apartment and we could walk to a deli and a candy store where on occasion the children would bring their piggy bank change to buy treats at the stores. They knew the value of money. My husband came up with the brilliant idea of putting a small dish for each child on the dining room table . We started them off with 25cent in each dish . If the child was dry in the morning , we put a nickel reward in the dish. If the child was wet, we took a nickel out of the dish.
Bed wetting ended within two week though we kept the game going for a few months.
This is a super familiar situation for me! My oldest son was wearing the nighttime pull-ups for.ev.er and did not care one bit about it. Until his little brother learned to stay dry overnight all on his own at age 5-and-a-half. At that point my oldest was 11, and the jealousy helped spur him into action. We talked to his doctor, who prescribed desmopressin. He took that for 3 months. It kept him dry and taught his body to wait until morning. That was a year and a half ago, and we’ve had no further issues or regrets.