Night-time dryness almost always follows daytime dryness and often there is a considerable period in between before your child will manage to achieve dry beds.
You should only ever look towards helping your child to become dry at night when they are reliably dry during the day. As a rule, most children are daytime toilet trained by the time they are 3 years old, but many are older.
It is not at all unusual for a four- or five-year-old to still be in night-time nappies and even then, many continue to have the odd accident throughout childhood. In fact, one in ten seven-year-olds still regularly wet their bed. Girls tend to be dry at night sooner than boys, but this isn’t always the case.
If your child has a very wet nappy in the morning and is no longer taking a night bottle or drinking a lot during the night, this is a sign that they are not yet producing enough of a special hormone called vasopressin. This hormone reduces urine production at night and until its action kicks in and if your child is under five, it means that they are probably not yet ready to come out of their nappy or pull up.
It is perfectly ok to give them as long as they need, but if they are over five years old and you are worried, you might find it helpful to have a chat with your GP practice, school nurse or health visitor.
You can help your child to develop healthy bladder control by:
• Offering plenty of fluids during the day.
• Stop them from having a drink an hour before bedtime
• Drop feeds or big drinks during the night.
Once they are confident with using the potty or toilet during the day and have dry or nearly dry nappies fairly consistently in the morning, you can take this as a signal that it is time to start night-time potty/toilet training.
Helping your child to become dry at night is more effective if you keep the whole process as relaxed as possible. Suggest that they might like to have a go at sleeping without a nappy. Make sure that you have a waterproof mattress cover on their bed and encourage them to use the toilet before they go to sleep. Don’t make a big deal about it or over-pressurise them, however.
Many parents choose to lift their children and put them on the toilet later in the evening, just before they go to bed themselves when the child is asleep. Nowadays this isn’t considered to be a good idea, as the child doesn’t learn about bladder control, and it just teaches them to wee in their sleep.
From a sleep point of view, it is not good to disrupt that very special and precious deep sleep that happens at the start of the night, either, and there is also the risk that rousing a child out of deep sleep can cause distress and confusion.
If your child wets their bed, it is best to remain calm and if they wake up, quickly change the sheets, encourage them to go to the toilet to see if they have any more wee left and then re-settle them to sleep.
Let them know it’s okay, it’s not their fault and you’re not cross.
If your child manages a dry night, praise them gently but don’t overdo it, or they might feel they’ve let you down if they wet their bed next time. Do not use a reward chart, as night-time dryness or wetness for that matter is not something that is entirely within their control. You can, however, praise them for the things that they have done to help themselves achieve dry beds, such as waiting until morning to have a drink or for going to the toilet when you ask them to, and so on.
As with so many milestones, helping your child to become dry at night is more effective if you follow their lead.
Here are some tips for night-time toilet training [once your child is dry during the day]
1. Encourage your child to drink enough during the day [6-8 glasses] – but not fizzy or caffeine-rich drinks. Restricting daytime fluids can cause the bladder to be less efficient.
2. If you are still giving a bedtime bottle, now is the time to drop it. If your child is well hydrated during the day, a big drink at bedtime or during the night [unless they are unwell or it is very hot] is not necessary.
3. Do not allow your child to get constipated, as this can affect bladder function.
4. Use waterproof easily changeable protection on the bed to minimize night-time disruption.
5. Use the toilet just before bedtime.
6. Leave a soft light on and if the toilet is not easily accessible, have a potty in their room.
7. If your child wets the bed and wakes up, praise them for telling you and still take them to the toilet to see if they can do a bit more.
8. Praise your child gently but warmly when they manage a dry bed and don’t expect this to be every night at first.
9. Expect just the occasional dry night at the first few attempts.
10. If your child doesn’t manage a dry bed after 3 – 4 weeks of trying, you should give up and try again a few weeks later or when they start to have dry-ish nappies in the morning.