Bedwetting and the preschooler

Your mother swears you were out of diapers—day and night—by the time you were two and a half. The three-year-old down the street recently pitched his nighttime pull-ups and never looked back. So how come your almost-five-year-old wets the bed at least three times a week? The reason: that’s what is normal for him.

Like learning to walk or talk, staying dry through the night is a developmental milestone that children reach at different ages. “It’s usually around age four that children are ready to give up diapers at night,” says London, Ont., paediatrician Fabian Gorodzinsky. “But age six is also not unusual. There is always a wide variation.” And when you consider what it takes to not pee in your sleep, it’s no surprise that some 15 percent of five-year-olds wet their beds at least twice a week.

To stay dry all night, a couple of things have to happen:

• your child must not sleep too deeply, so that the bladder can signal the brain that it’s full, and then the brain can signal back to hold it
• your newly toilet-trained child must somehow control those recently mastered muscles to hold back the urine while sleeping

That’s a tall order for some small people! So if your preschooler would be more comfortable in diapers or pull-ups at night, don’t sweat it. He will eventually be physiologically mature enough to stay dry. But what if your child feels that diapers are too babyish and really wants to wear underpants to bed? First, be sure he’s ready. Essentially, he needs to have woken up dry for a while—a week or so—and gone to the toilet right away. In that case, it’s fine to try.

Second, set the stage for every possible outcome by preparing your child’s room; some suggestions:

• protect your child’s mattress with a waterproof cover
• have extra sheets ready for quick nighttime bed changes
• consider having a box of baby wipes for quick bottom cleaning
• keep fresh jammies and underpants nearby in case of accidents

Besides getting his room ready, you can also help your child by:

• leaving a light on in the bathroom and setting up the stool, potty seat or whatever your child normally uses so that he can get to and use the toilet without any trouble in the night
• talking through the nighttime toilet routine, letting your child know that he can get you for help if he needs to
• having him empty his bladder completely before going to bed

If you do all of that, and your child wets his bed, Gorodzinsky advises to keep trying for a few days. But if the wetting continues for two weeks, “then your child is almost ready,” he says. In that case, take the stress off everyone and consider going back to diapers for a month before trying again.

Remember, too, to reassure your child—and yourself—that this is normal, and that dry nights are not a matter of if, but when.