Parents who have potty-trained their little ones are often surprised and disappointed to find them still wet the bed at night. However, nighttime bedwetting does not mean that your potty training plan has failed. It means that your daytime potty training was successful, and now you may start training the child for dry diapers during the night.
The reasons why a child wets the bed at night may differ from those behind daytime wetting. It is why the manner you tackle each differs, too. There is much to learn about nighttime bedwetting and how to avoid it. Let’s start with the basics.
Why Does A Potty-trained Child Still Wet The Bed?
There are usually three main reasons behind nighttime accidents among children who have completed daytime potty training (1).
- The child may usually not be able to wake up from deep sleep, despite the sensation of a full bladder.
- The kidneys produce more urine during the night.
- The child’s bladder may not have enough space to hold the excess urine produced during the night.
These reasons usually diminish as the child grows older. For instance, 15% of children aged five wet their bed at night while only 5% of ten-year-olds are nighttime bedwetters (2). and usually almost all children stop bedwetting before they attain puberty. Nevertheless, it is essential to tackle nighttime bedwetting with appropriate training.
Is Nighttime Potty Training Possible?
Nighttime potty training is possible through steps that aim at minimizing the chances of accidents at night, eventually conditioning the child to prevent nighttime bedwetting naturally. Since the child is asleep at night, most of the training happens during the waking hours, especially those that lead to bedtime.
Difference Between Daytime And Nighttime Potty Training
The following points indicate the differences between daytime and nighttime potty training (3).
- Nighttime potty training usually begins at a later age since children need to first complete daytime potty training.
- The reasons and factors that lead to nighttime bedwetting are often within the child’s control only when they grow older. For instance, a child would be able to awaken themselves from deep sleep due to a full bladder only when they are a bit older. Therefore, nighttime potty training is possible at a later age when compared to daytime potty training.
- Nighttime potty training may require periodic review and update based on the child’s progress to prevent regression. The reason is that children cannot communicate their urge to visit the bathroom when asleep and may regress due to stress or other reasons, even when achieving some success with nighttime potty training. On the contrary, a child is awake during the daytime and can communicate their need to visit the bathroom or other problems instead of regressing.
When To Start Nighttime Potty Training?
There is no specific age to begin nighttime potty training. You may observe the child and determine their readiness based on their success in daytime potty training.
Once your child is daytime potty-trained, you may consider them ready for nighttime potty training if they display any of the following signs (4).
- The child can understand and recreate most of your actions.
- They can express when they need to ‘go’ or when they are ‘going.’
- They can pull clothing up or down without help at all times.
- They can walk to the bathroom on their own.
Most children achieve these abilities by the age of four, although most may achieve them earlier (5). You may start nighttime potty training from the age of four or whenever your sense your child is ready for nighttime potty training.
Nighttime Potty Training Tips
You know the right time to start nighttime potty training, but how do you go about it? Here are some helpful tips.
- Set a consistent daytime potty training plan: A structured, systematic daytime potty training plan that takes into consideration your child’s individual needs and personality helps you extend it to nighttime, too. The daytime plan habituates your child to go to the potty whenever required, and this habit could prompt them to do the same at night.
- Try to stick to a regular bedtime: When the bedtime is more or less constant, it helps the children regularize their bladder and bowel habits. When they are taught to empty their bladder just before going to bed and that time is fixed, it becomes easier to set up a routine. The child’s sleep doesn’t get disturbed by being asked to visit the bathroom just when they are ready to doze off, which is what happens when there is no sleep routine in place.
- Consider the family history: Did you know that bedwetting often runs in the family (6)? Research shows that genetics may be to blame if your child is unable to get potty-trained at night after the age of five. Check your family history and also check when you or your siblings stopped night bedwetting. Taking into account the family history could help you improve potty training and take the help of a pediatrician if needed.
- Check when it is a problem: Sometimes, a child may have nighttime bedwetting due to underlying problems. If your child seems to be unwell and has a fever or other symptoms, then the bedwetting could be a result of it. Speak to a pediatrician before you begin potty training since, in some cases, the treatment of the underlying cause could reduce nighttime bedwetting episodes.
- Say no to caffeinated and sugary drinks: Caffeine-containing liquids such as soft drinks and energy drinks should not be given to children and definitely not to infants and toddlers. Even sugary drinks and fruit juices with preservatives are better avoided. There are many good reasons for this and minimizing the risk of bedwetting is one of them.
- Limit liquids before bedtime: Avoid serving the child liquids close to bedtime. If you serve milk, serve it a couple of hours before bedtime. Ask your toddler to drink water an hour or two before bedtime to reduce the risk of nighttime bedwetting. During summers, encourage the child to have plenty of water during the day so that they do not feel too thirsty by night. Water, though, is not forbidden at night. We are not saying that let the child go thirsty because bedwetting doesn’t happen due to a full bladder alone rather it is mainly due to inability to wake up when it happens.
- Make peeing a part of bedtime: Create a routine where the child goes to the potty right before going to bed. Also ask them to relax while peeing and not to be in a hurry which leads to partial emptying of the bladder. Some children might need to be told to pee again in a short span of say 30 minutes to fully empty the bladder..
- Be prepared for accidents: There are likely to be accidents especially during the initial phase of the training. Therefore, be prepared . You may keep the child’s spare clothes handy and use plastic sheets or waterproof mattresses on their bed to make cleaning up easier. Never scold or shame the child for accidents. Emotional trauma is much more harmful than bedwetting.
- Try to find out the cause of regression: Some children may respond positively to training only to regress to their old habits. Regression could happen due to several factors, such as illness, stress, change in surroundings, or change in routines (7). Try identifying the cause for regression to deal with it better. If you are unsure of the reason, speak to a pediatrician.
- Avoid diapers: Letting your toddler wear diapers at night may give them a sense of security, reducing the effectiveness of potty training. The lack of diapers may seem scary to some parents due to the mess they need to clean later. However, there are alternatives, such as waterproof mattresses or plastic sheets, that could minimize soiling. You may also consider bedwetting alarms, but only for some time since the child may become dependent on them.
- Wake up the child: If your child happens to wet the bed around the same time at night, you may consider waking them up before that time and take them to the bathroom. Doing it for a few weeks would habituate the child to wake up during the night and go to the bathroom. It may not be an ideal solution for children who turn fussy if they are woken up from deep sleep or for those who find it difficult to go back to sleep.
- Wait until they are consistently dry: Some children may respond positively to nighttime potty training within a few weeks, and it may seem that you can now sleep peacefully without worrying about bedwetting. However, do not yet take off that waterproof mattress for the child may still have accidents. Wait until the child stays dry for a couple of months or more before you can be certain that they have completed their nighttime potty training.
- Praise and appreciate: Shower the child with appreciation when they respond well to the training or have become successfully trained. Praise is a great way of reinforcing good habits, including good bathroom habits. Encourage them to notify you at night the moment they feel the urge to go to the bathroom. Praise the child if they show a desire to go to the bathroom themselves (8).
Each child is different and could take their time to master nighttime bladder control. Do not panic and do not blame yourself or the child. Nighttime continence is a skill that a child needs to master gradually, just like other skills, such as walking and talking.
Remember, slow nighttime potty training and regression is neither the fault of the parents nor the child. Never punish your child for bedwetting since they are most likely as unhappy with it as you are. Give yourself and the child adequate time. If your child is older than seven years and still unable to become nighttime potty-trained despite all your efforts, speak to a doctor.
2. Bedwetting to Potty Training; Urology Care Foundation
3. Angela Oswalt, Early Childhood Physical Development: Toilet Training; GracePoint Wellness
4. Toilet Training Guidelines; American Academy of Pediatrics
5. Important Milestones: Your Child By Four Years; CDC
6. Bladder Control Problems & Bedwetting in Children; National Institutes of Health
7. Regression; American Academy of Pediatrics
8. Bedwetting; Royal Children’s Hospital