When should my child should be dry at night?
The important thing to remember is that under the age of 5 it is completely normal for some children not to be dry through the night. Try not to worry about night time dryness as for most children this will develop by the time they are 5, but if you are at all concerned then you should visit your GP to discuss.
Looking at the stats on this, there are 20% of 4-5 year olds and 10% of 7 year olds that wet through the night. Bed wetting also runs in families - if one parent wet the bed as a child, there is a 40% chance that your child will too and if 2 parents did, it’s a 70% chance (Source ERIC - The Children’s Bowel & Bladder Charity). But it’s noone’s fault
Over the age of 5 there can be a number of reasons for night-time wetting (Nocturnal Enuresis) - which is defined as wetting twice a week or more for 3 consecutive months or more.
These can be one or more of the following:
Sleep arousal - your little one is in a very deep sleep and is not able to wake in order to go to the toilet through the night.
To achieve night time dryness your little one’s brain needs to be releasing enough of the hormone Vasopressin. Vasopressin is released in the brain and acts on the kidneys to control urine production overnight. If your child has low levels of vasopressin this can lead to them passing a lot of urine through the night. This is often 3-4 hours after going to sleep and can see them soaking their pyjamas, bedding etc. Under the age of 5 this is not something to be concerned about (and it is an idea to keep them in pull ups or night-time nappies), but over the age of 5 this might need to be looked at with a GP as it can be supported with medication. Some GPs will recommend waiting until your child is closer to 7 before doing anything though as it can take longer for some children to have this hormone release triggering enough to stop the night time wetting.
An overactive bladder - if your child has an urgency to get to the toilet during the day and then only passes small amounts of wee when they use the toilet, this can be a sign of an overactive bladder. If they frequently go for a wee during the day (4-7 times during the day is considered normal and so 8 times or more in a day would be considered more frequent), it can mean that the bladder is also overactive at night; this is when you may find that they are continuing to pass small amounts of wee throughout the night.
Lifting your little one to do a ‘dream wee’ might seem like the way to get a dry night, but unfortunately what this does is confuse the signals from the bladder to the brain. The bladder is a muscle which needs to fill and release and it does this by sending a signal to the brain when it needs to empty. If the brain is not getting this signal (because the bladder has emptied without telling the brain when the child was lifted to go for a wee while still asleep) the brain thinks that the bladder is not filling and so there is no need for it to wake the child to go for a wee. The bladder also then doesn’t send the signals in the same way, as it hasn’t got to the ‘full’ stage before being emptied. In short, this is not something that is advised and will not help your child in the long term develop their night-time dryness.
Allowing your little one to wear a nappy or pull ups at night until they are dry won’t have any impact on potty training in the day (but will make your life a lot easier!). As soon as your child has been dry through the night on a number of consecutive occasions (waking up in the morning with a dry nappy and then using or asking to use the toilet on waking) you can gently suggest that they sleep without a nappy / pull ups and support them if they have any accidents (it’s always good to have spare sheets close to hand just in case!).
Things you can do to help with night time dryness (whatever age):
Make sure that drinks are given to your child throughout out the day so that the bladder learns to fill and empty.
Avoid drinks for 1 hour before bedtime (but as above don’t restrict fluid intake during the rest of the day).
Make sure that your child isn’t drinking all of their fluids in the morning or at the end of the day, they need to be spaced out and regular throughout the day. Children should drink between 6-8 cups (preferably of water) per day.
Avoid the following drinks where possible as they can irritate the bladder:
citrus fruit juices such as grapefruit, lemon, pineapple and orange
blackcurrant or red berry juices or squash
drinks containing aspartame and saccharin
Incorporate into your bedtime routine that the last thing your child does before switching off the lights is to go for their last wee of the night.
As mentioned above, make sure that your child isn’t constipated as this can have an impact on night time dryness.