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Toddler asleep

Potty training is a rite of passage for every toddler, and saying goodbye to nappies during the day is a big milestone. But becoming dry during the day doesn’t mean your little one can go without a nappy at night straight away. Bedwetting (or nocturnal enuresis) is a common phenomenon, but it can still be distressing for parents and children if it’s not properly understood, especially as your little one gets older.

At what age should my toddler be dry at night?

It’s very normal for children to be out of nappies during the day at two and a half or three, but they will still need a nappy at night. “One in 12 children wets themselves regularly – that’s twice a week – at four years old,” says Dr Rahul Chodhari, a consultant paediatrician at Royal Free London Foundation NHS Trust. “And one in 20 children will wet the bed until around 10.”

Why is my child wetting the bed at night?

All kids are different, and certain factors may mean that one child is more likely to need night-time nappies for longer than another. “Boys are affected a bit more than girls,” explains Dr Chodhari, “and sometimes it runs in the family, particularly if the father of a child had a bedwetting issue when they were younger. It’s not a marker of disease, it’s just a family trait.” Constipation is another medical factor to consider. If your little one is suffering from a build-up of stool in the rectum, this can press on the bladder, reducing its capacity and causing bedwetting as a side effect.

Restricting drinks towards bedtime can help, but it’s not a cure. “A sensible plan is to only give drinks to your child if he is thirsty in the two or three hours before bedtime,” explains Dr Chodhari. It’s important not to restrict drinks the rest of the time, as most children should drink about six to eight cups of fluid a day. He adds, “If you limit drinks all day, the bladder cannot be trained to hold on to larger amounts of urine.”

What can I do to help?

Introduce having a wee last thing before bed as part of your child’s bedtime routine.

Some parents also use ‘lifting’ as a way around the issue – they will carry the child to the toilet for a wee, just before they go to bed themselves. “It’s common practice to wake children up to take them to the toilet several hours after they go to sleep,” says Dr Chodhari. “However, this lifting may prolong the problem, because children need to get used to waking up themselves when their bladder is full.”

Do remain supportive, and only take action when necessary. “You shouldn’t punish your child for needing to wear a nappy at night as it’s not their fault and is completely normal,” Dr Chodhari advises. “But if you notice an improvement, do praise them.” However long your child takes, reassurance is key. Dr Chodhari adds that parents should never compare their child’s progress towards getting dry at night with siblings, or other children of the same age, as all children are unique and different.

When should you worry?

Doctors don’t recommend any treatment or management for bedwetting until your little one is over five years old. “Until this age, night-time bedwetting isn’t considered a disease, and you won’t need to put in place any measures,” explains Dr Chodhari. “We recommend that by their sixth birthday, you should get advice from your GP.” This is so your doctor can assess if your child has an overactive bladder, or to look into the rare possibility that the bedwetting could be caused by a more serious medical condition.

For further information, contact ERIC, the children’s continence charity.

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