"Your Growing Child's Nighttime Needs"
Dr. Wolffe Nadoolman, MD, Pediatrician
From a parent's perspective, when your child is a young toddler, it doesn't matter if it is during the day or during the night—the child needs a diaper or training pant. As children gradually develop the motor skills for those parts of the body, they also develop emotionally. They want to gain a sense of control, or at least figure out what it is they can really control independently. So potty training, ideally, isn't about behavior or obedience. It's about helping that child feel that this is something they can manage, triumphantly affirming that they are big kids! Of course, not every child is ready or able to be potty trained by 3 years old. Some are a little earlier, some later. To potty train a child, we often use some behavioral incentives, as well as our approval and applause when the child is successful. Nothing is more motivating than the attention of a loving parent.
With potty training, we help the child understand the sensations that tell them when it’s time to go. But at night, it’s hard for them to be aware when they are asleep. Because bedwetting happens when they are sleeping, a child doesn't respond to charts with stars, little rewards or teaching. If we try an incentive such as letting them wear regular underpants when they aren't consistently dry, we may set them up for feeling bad about failing, and worse, about disappointing their parents.
In my practice, parents sometimes tell me that a child is not 'potty-trained at night.' I think it's better to call it bedwetting. It's normal. It's normal for many kids at four, but also normal—for some children—at 11 or 12. Bedwetting is something that your child might do, and there is no 'training' to make it go away. It happens as a result of complex body signals that occur involuntarily while the child is asleep. There is no way that your child can control these. The signals change and develop as the child ages —in some kids a little earlier, some later. There's often a family history, which suggests a genetic influence. Ask your child's grandmother, you might be surprised what you learn! The most important thing you can do is help the child not feel bad about it, so don't treat it or even talk about it as failure. Be supportive and prepared. I recommend GoodNites® Underwear to help ease the stress of nighttime accidents and keep sheets dry.
Even though bedwetting is almost always normal, start mentioning it at every check-up visit with your child's doctor around age 4 or 5. The doctor will want to know if your child has ever been dry at night. If your child has been dry for long periods, but has recently started being wet at night, make an appointment with your physician. When a child has been successfully potty trained but suddenly has daytime accidents, it could signal a medical issue.