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Family life: Our son is five but still wets the bed, should we be worried?


David Coleman

David Coleman

David Coleman

Our son is five but still wets the bed, should we be worried?

You need to take the risk, again, of removing the nappy at night time

Can you help me with my son? He turned five last month and is still, unfortunately, in nappies at night. He was toilet trained within two days at the age of two years and 10 months and has been dry during the daytime ever since then.

All my friends told me that when he had a dry nappy at night, three nights in a row, then you can take it off. He had two nights dry in a row when he was about three and a half but wakes up with a fully soaked nappy ever since.

We did decide a few months ago to tell him to start going to the toilet at night instead of wetting the nappy. We ended up having three months of him up half the night. He had always been a fantastic sleeper (7pm-7am) but was suddenly so concerned about staying dry that he would wake to go to the toilet at about one in the morning and then couldn't go back to sleep.

My husband and I eventually gave in and just told him it was more important to get a full night's sleep for everyone's sake. He seems to be a child who's afraid to miss something; during the day he'll dance around bursting to go to the toilet but waits until the last second to go.

He drinks a lot of water in the day, but I don't give him a drink after six in the evening, just a tiny sip before going to bed. We always make sure he goes to the toilet last thing before going to bed. I'm wondering is it a physical problem or just a bad habit?Bedwetting is a very typical childhood problem and is more common in boys than in girls. The delay between being trained by day and trained by night is often frustrating but completely normal. Usually night-time dryness comes between three and six months after day-time toileting is established.

However, almost half of all children will wet the bed up to the age of three. Night-time accidents are very normal up to the age of seven with approximately one in 10 children still wetting at night. There also seems to be a strong genetic or family component to bedwetting since about three quarters of children whose parents both wet the bed as youngsters will do the same.

Bedwetting appears to be most strongly associated with a physiological immaturity. Most children who wet the bed can't help it. Staying dry at night is difficult for children to control as it depends on how deeply children sleep. Sometimes they may not get the messages from their bladder that it needs to be emptied.

Some children develop the capacity to hold wee, and so despite not waking they stay dry. Other children need to be alerted by getting the "I'm bursting to go" feeling strongly enough that it wakes them up so they can get up to the toilet. There are some children that will get that signal but won't respond to it because it doesn't override their continued sleep.

Your son sounds like he quite happily ignores that physical signal until the last minute during the day and so it may be that he is not motivated to respond to it at night either. Being in nappies (or training pants or pyjama pants) also reduces his motivation to stay dry. Part of the reason he has a fully soaked nappy may be because he can wee in his sleep with no consequences.

In fairness, it sounds like when you took the nappies off him he did manage to wake up during the night, although I wasn't clear if it meant he successfully got to the toilet in time? The fact that he woke up at all, does mean that he can respond to those physical signals and that bodes well for helping him to stop wetting the bed.

I think you need to take the risk, again, of removing the night-time nappy and encouraging him to wake when he feels the "bursting to go" feeling. You can reassure him that once he goes to the toilet once in the night it is highly unlikely that he will need to go again. It may also be worth reassuring him that a wet bed is not a big deal. This may give him the confidence to allow himself to fall asleep again after weeing.

If he struggles to wake himself you could consider lifting him at night before you go to bed. If he is in the habit of falling asleep by about 7.30pm then a semi-conscious trip to the loo at 11 or 11.30pm should see him dry through the rest of the night.

Lifting a child like this may delay his night-time control, but that control will come eventually. More often than not staying dry requires a physical maturity of the bladder and so we just have to wait it out. Any additional delay caused by lifting needs to be balanced against the hassle of changing bedlinen.

It may also be worth bringing your son to your GP just to make sure that there are no physical problems and your GP may have other ideas to resolve the bedwetting. Your Public Health Nurse is another good source of information and advice, as are websites like www.bedwetting.ie

Sometimes only patience and positive thinking are required and we find that our children will mature in their own good time and that dry nights will come with that maturity.

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