Toilet training can sometimes be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves, and the bed, overnight. It may leave you wondering what’s normal and what you can do to help your child.

Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime wetting happens in children who are very deep sleepers, as their brain and bladder aren’t communicating as they should while they sleep. It is so important to keep in mind that this is not your child’s fault!

Reassurance

One of the most valuable things you could do is provide reassurance to your child. It is important that your child knows that they are not alone. Nighttime wetting is very common, and likely occurring in at least one or two other kids in their class. They may feel alone, embarrassed or ashamed that they are wetting at night, so providing reassurance for your child is key.

The majority of children with nighttime wetting will outgrow this on their own. Unfortunately, there is no way to predict when each child will outgrow the condition, but there is a very good chance it will resolve over time.

Keeping your child’s bladder happy during the day

It is important to keep your child’s bladder happy. A happy bladder during the day will lead to a happy bladder at night, which increases the likelihood of nighttime wetting resolving on its own (and maybe even quickly).

Our bladders are designed to fill and empty regularly throughout the day. Children are often restricted access to the bathroom at school, and therefore, drink much less and urinate infrequently during the day. These behaviors can make bladders irritable, and may contribute to nighttime accidents. Try these tips:

1. Have your child carry a water bottle to school. This allows them to slowly hydrate throughout the whole day. This avoids dehydration during the day, and the need to drink large volumes of fluid closer to bedtime to make up for what they missed earlier in the day.

2. Encourage your child to use the bathroom every two to three hours throughout the day. This will help avoid holding for too long and subsequent mad dashes to the bathroom.

3. Monitor bowel movements. Constipation can contribute to wetting, as the hard stool puts a lot of pressure on the bladder. Increasing water intake and dietary fiber are both essential in maintaining good bowel health.

Does my child need to see a urology specialist?

There is not a set age at which your child should achieve nighttime dryness. It is very important to let your child guide this process when they’re ready. A successful treatment will be largely associated with their readiness and motivation in the process. Here are a few tips for knowing when to seek help:

• Your child should be seen by a urology specialist if they are also experiencing other urinary symptoms, including daytime wetting, urinary tract infections or urinary urgency/frequency.
• You should seek additional treatments for nighttime wetting if the condition is becoming bothersome to your child, and affecting their social development and/or self-esteem.

Get more facts and tips to help your child with enuresis, or nighttime wetting.

Katie Gawerecki is a nurse practitioner in pediatric urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL.