Toilet training is a universally dreaded task among parents of young children, for many reasons. It’s hard to know when they’re really ready; there are too many methods to choose from; once you start, you really don’t want to stop; it takes some kids much longer, or they require way more consistency, than others; they’ll pee in the potty but they won’t poop. And every parent has that one annoying friend who swears they potty-trained their barely-two-year-old in, like, a day. (Shut up! Shut the hell up.)
What you may not be thinking about as you embark on this journey, however, is that even once you achieve a consistent willingness to relieve themselves on a toilet, what happens next is a whole bunch of “accidents.” There are the daytime accidents that largely occur because they forget to go potty, the ones that happen because their little bladder wouldn’t hold it in long enough to get there, or the one that can be chalked up to the fact that the public toilet flushes way too loudly.
But what’s even harder to overcome are the nighttime accidents they sleep through, only waking once it’s too late and they’re thoroughly soaked through and shivering. Some kids will sail through this phase fairly quickly, but for other kids, it can take literal years to overcome.
The causes of longterm bedwetting
Before you became the parent of a longterm bedwetter, you may not have realised that some children struggle with it for as long as they do. But while it can be frustrating for parents and embarrassing for kids, it’s actually quite common. The American Academy of Pediatrics says approximately 20 per cent of children have some problems with bedwetting at age five, and up to 10 per cent still do at age seven. By the late teens, the estimated rate is between one and three per cent.
While longterm bedwetting can seem to last forever, it’s important for parents to remember that it’s likely not a serious health problem — and they will outgrow it. But why is it a struggle for some kids and not others? Here’s what Children’s Hospital of Philadelphia cites as the most common causes for bedwetting in older kids:
- In many cases, bedwetting is a genetic pattern, inherited from a parent, aunt or uncle.
- Most older children who wet the bed are very sound sleepers, so the signals of a full bladder aren’t strong enough to wake them.
- Some children have small bladders or don’t produce enough of a hormone (vasopressin) that reduces urine production during sleep.
- Bedwetting can be triggered by stress and by changes in the family, even positive ones, like a new baby or a different bedtime schedule over vacation.
Tips to reduce the bedwetting
Although bedwetting in older kids will mostly be eliminated with time and growth, in the meantime, there are a few things parents and kids can try to help reduce the incidents.
Limit fluid intake in the evening
What kids are eating and drinking throughout the day will affect their bodies in the evening. Focus on having them hydrate early in the day, rather than having them quench their thirst later in the day. If they participate in sports or other physical activities later in the day, have them hydrate before they play in order to limit fluid intake later on.
You should also try to get them in the habit of using the bathroom regularly during the day (about every two to three hours), even if they don’t feel the urge to go. And, of course, they should go right before bedtime.
You can try waking your child once during the night to urinate (but not more than that, as waking too much will disrupt their sleep pattern). You might also try a bedwetting alarm, which many kids and parents have success with — but only if you really stick with it. Here’s what the AAP says about bedwetting alarms:
Research shows that about half of children who properly use enuretic (bedwetting) alarms will stay dry at night after a few weeks. These alarms buzz or vibrate when a child’s underwear gets wet. Over time, the brain is trained to associate the feeling of needing to pee with the alarm going off, and getting up and going to the bathroom. This therapy requires active participation by an adult to make sure the child fully wakes up and goes to the bathroom when the alarm goes off.
Talk to their doctor
If the bedwetting has extended beyond age five, or if it started back up after a prolonged dry period, you may want to talk to their paediatrician about other options. Their doctor will likely ask questions about their sleep patterns, family history, and any potential stressors they’re currently experiencing.
The doctor may opt to do a urinalysis or other health screenings to rule out any possible signs of disease or infection. Medication is also an option. The paediatrician can help you find a solution that works best for you and your child.
Never shame them
Prolonged bedwetting can be frustrating for kids and parents, but it’s critical to never shame a child for it. Children may already be feeling embarrassed or anxious about it, and it can lower their self-esteem, particularly if they feel like it is keeping them from attending overnight camps or sleepovers with friends or other family members.
Remind them (and yourself) that it is normal, it is not their fault, and it is out of their control. Use a waterproof mattress cover, keep clean sheets on hand for quick changes, and focus on taking whatever steps you and their doctor decide is best.