Dear Dr. Rain:
Our oldest daughter is in kindergarten and will be 6 years old next month. She is doing so well, but she still wets at night. We wake her up to use the toilet which helps, but it seems like she still has this problem. It’s not like she has gone backwards, she has never been dry at night. But, in the daytime, she is fine. It’s embarrassing to her and she refuses to sleep over at her friends because of it. We have tried rewards, but she cannot stay dry and it upsets her that she cannot get the reward.
Are there tricks to try and help her?
Signed,
Lots of Laundry
Dear Lots of Laundry:
This is a common problem in young children. Your first step is to talk with the pediatrician to be sure that there is no medical problem that is contributing to night time wetting with your daughter. In the absence of a medical problem, your best strategy is to approach this as a developmental issue.
There is a very wide variation in the time it takes children to master night time bladder control. It typically varies from 3 years old up to 9 years old. A handful of children do not master this task until their teenage years. It is a complex developmental task that is mainly biological in nature. Family stressors and faulty learning are sometimes the cause of night time wetting. However, more frequently it is caused by the child’s own biological timetable.
There are things you can do to assist your child. For example, by restricting evening drinking, the bladder will be less full, giving the child a better chance of being able to retain the fluid all night long. Be sure you do not let your child load up on fluids right before bedtime. Encourage your child to use the toilet just before bedtime.
Talk to your daughter and let her know that when her body is ready, she will be able to stay dry at night. This is not a failing of your daughter since the biological ability to stay dry at night is typically not controlled by will power. Talk to her about all of her areas of achievement. For example, perhaps she rides a bicycle, is a good student in kindergarten, and is a good friend. Remind her that all of those things came with age and practice and that night time dryness will also come with time. Focus more upon her strengths rather than upon what she cannot currently do.
One disadvantage of night time wetting is that it can wake up the child and parent. She may be lying on a wet sheet, uncomfortable and drowsy. Some children leave their wet bed and wake up the parents as they seek comfort. Not only does this interfere with the parents’ rest, but it creates an unintentional reward for bed wetting if the parents then allow the child into their bed for the night. Be sure that you walk your child back to her room; do not allow her to sleep in your room when she wets. A good solution in these types of problems is to instruct your child how to put a dry towel on top of her sheet so that she has a dry place to finish her sleep. In the morning enlist her help in stripping the bed and placing wet sheets and the towel in the laundry.
Pull-ups are a great invention. For many children, it allows them to sleep through the night despite night time wetting, and it keeps the bed dry as well. Do not call them diapers. Call them pull ups, or perhaps big girl night time underwear. If she balks at wearing these, be firm and remind her that even many adults wear these (Depends) to help stay dry at night. Reassure her that when she is dry for many nights in the pull ups that she can return to wearing undies at night. Be sure you have her mattress encased in a zippered plastic encasement so that the sheets do not soak through to the mattress.
There is a device called The Bell and Pad that some department stores sell to encourage night time dryness. When liquid hits the pad that the child sleeps upon, a loud bell goes off, waking up the child so that she can finish emptying her bladder in the toilet. After using this for a while, many children learn to awaken before wetting.
There are a couple of medications on the market that can be prescribed by Pediatricians that help many children with night time wetting. Again, however, for a 5 year old, the use of medication seems unwise since it is developmentally normal to still be wetting at night and it is a tolerable problem.
With respect to the embarrassment of wetting at sleepovers, let me recommend to you that 5 years old is very young to be sending on a sleepover. The fact that she has been invited does not mean that you, as her parent, need to allow it or encourage it. At age 5, children still need to be in the fold of the family every evening. While occasional overnights at a beloved grandparent might be developmentally appropriate, overnights at a friend’s house is premature. Save play dates for the day time during the weekend. Save overnights until she is about 10 years old. And, even then, restrict the overnights to homes where you know the parents and the children very well, and can trust them to provide good supervision.
