How old should a child be before he can sleep through the night without wetting the bed and how do I know if he’s ready to go without pull-ups? I know the age range varies but eventually my son will be too big – and too embarrassed – to wear overnight diapers.

Answer:

The first thing I am going to do is tell you to take a deep breath and relax! You have not told me how old your child is but I will remind you that children develop complete control over their bladder at different ages. I do not usually raise any alarm bells or intervene until a child is five, six and in some cases, seven years old.

There are a host of different studies on when to expect complete bladder control, but somewhere between 12 to 14 percent of children still wet the bed at age six. By age 18 only one to two percent still wet the bed.

When your child says that he or she is ready to deal with bedwetting, then you have the cue that it is a good time to talk to your doctor about what might be done. On occasion, we do see families with a history of bedwetting. In reviewing why some children are delayed compared to others, it may be that the maturing of the nervous system is at the root of the issue. There has to be a communication between the full bladder and the brain that is sleeping to send a message back to the bladder to wait and not urinate.

Children who have never been dry past a certain age are called primary bedwetters – or in medical lingo, primary enuresis. If your child has been dry and then starts to bed wet, that is called secondary enuresis. In these cases, while nothing may be a concern, we want to rule out infections and any other medical causes including stress.

Here are some helpful tips that might improve the likelihood of a dry night:

  • Be supportive of your child.
  • Try and limit night time drinking.
  • Make sure kids try to urinate twice before bed time. For example, have them get ready for bed and go to the bathroom. Conclude your night time routine with a story and then ask them to go again. It is true that some children are deep sleepers and are unaware that their bladder is full.
  • In some cases depending on your child’s age, a bed wetting alarm can be useful. There are different kinds of alarms, but usually they attach to underwear and sense when there is moisture.
  • When indicated, there are also medications that might be offered.

I think the most important point to keep in mind is that usually bedwetting is outgrown with time.

Originally published in ParentsCanada magazine, July 2012