Dry Nights
How do I stop night-time nappies when my child is dry during the day?
Night-time dryness often develops much later than daytime toilet use. In this article, we look at what’s biologically normal, when to expect night dryness, and how parents can support their child without pressure or shame to stop nighttime nappies. And night-time accidents are not a setback!
Night-time dryness comes after a child is toilet trained during the day. Often there is a considerable period between daytime dryness and coming out of nappies at night. Think about helping your child to become dry at night when they are confidently 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.
Signal from the brain
To be dry at night, children need to receive a signal from the brain to let them know their bladder is full. It can take a while for them to get the hang of reading and responding to that signal. This is especially the case when they are asleep!
Be reassured that it’s not at all unusual for a four- or five-year-old to still be in night-time nappies.
20% of 5 year olds regularly wet the bed.
Vasopressin
Vasopressin [or anti diuretic hormone] reduces the amount of wee produced at night. It is made in the pituitary gland. Levels of this hormone increase with age. 
If your child has a very wet nappy in the morning and is no longer taking a night bottle, it is a sign that they might not yet be producing enough vasopressin. When they’e over five years old, your GP practice, school nurse or health visitor will be able to advise you.
Ways to help them with nighttime bladder control
♥ Offer them plenty of fluids during the day, to exercise their bladder!
♥ Try to avoid them getting constipated.
♥ Stop them from having a drink an hour before bedtime.
♥ Drop feeds or big drinks during the night.
♥ Use the toilet just before bedtime.
Are they confident with using the potty or toilet during the day and have dry or nearly dry nappies fairly consistently in the morning? If so, you can take this as a signal that it is time to start night-time potty/toilet training!
Making a start
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. A spare set of bedding close to hand will make it easier to get your child comfortable and back to sleep more quickly if they wet the bed. Then encourage them to use the toilet before they go to sleep.
Should I 'lift' them when they're asleep?
Many parents choose to lift their sleeping child and put them on the toilet later in the evening, just before they go to bed themselves. I know lots of families that do this and it works very well.
However, nowadays this isn’t considered to be a good idea. That’s because 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 the important deep sleep that happens at the start of the night.
There is also the risk that rousing a child out of deep sleep can cause distress and confusion.
If they wet the bed
If your child wets their bed, stay calm. Quickly change the bedding and their nightclothes if they have woken up. Keep things as calm and as quick as you can. Encourage them to go to the toilet to see if they have any more wee left. After this, re-settle them to sleep. Their wee is sterile, which means it has no germs in it, so a bath or shower can wait until morning! Let them know it’s okay, it’s not their fault and you’re not cross.
If they manage 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 this 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. Examples would be waiting until morning to have a drink or going to the toilet when you ask them to, and so on.
Top 10 dry night tips
1. Encourage them to drink enough during the day [6-8 glasses.] Restricting daytime fluids can cause the bladder to be less efficient. No fizzy or caffeine-rich drinks.
2. Drop the bedtime bottle! As long as they are 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. Give plenty of fruit & vegetables to encourage a healthy bowel. If they are constipated, this can affect bladder function.
4. Have 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 in the corridor and if the toilet is not easily accessible, have a potty in their room.
7. If they wet the bed and wake up, praise them for telling you. Take them to the toilet to see if they can do a bit more.
8. Praise them 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, give up and try again a few weeks later. Or wait until they start to have dry-ish nappies in the morning.
Further help
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