drier sheets.

December 18, 2006 8:26 PM

how do we get a five year old boy to stop wetting the bed?

all i can find is "train him to hold his pee longer" and "wake him up in the middle of the night to relieve himself."

he's already training himself to hold his pee longer since he refuses to go to the bathroom until the very last minute, sometimes causing him to pee his pants during waking hours. waking him up in the middle of the night sounds easy enough, but he usually can't get back to sleep once he's up moving around. we don't really want to go the route of shock/alarm therapy either... this is only day three but just taking him out of the diaper and letting him sleep in his own pee doesn't seem like it will get anywhere.

posted by anonymous to Health & Fitness (28 answers total)

Is this a sudden change? If so, he may have a UTI.

The American Academy of Family Physicians via this familydoctor site considers bedwetting at 5 to be within a normal range, and doesn't recommend behavior therapy or medicine at that age.

"Children achieve bladder control at different ages. By the age of 5 years, most children no longer urinate in their sleep. Bed-wetting up to the age of 5 is not unusual, even though it may be frustrating to parents. Treating a child for bed-wetting before the age of 5 is not necessary and may even be harmful to the child."
posted by desuetude at 8:47 PM on December 18, 2006

Wait awhile? I understand it's pretty common for kids--especially boys--not to be dry at night until even older than 5. With my own kids, I'm hesitant to make things more stressful for them than they already are, or to introduce, even implicitly, the idea that there's something wrong with them if they're not able to do X, Y, or Z. In the absence of any evidence of a medical problem, I'd be inclined to assume his bladder and the connection between his bladder and his sleeping brain might just need some more time to mature, and keep putting the nighttime diapers on him awhile longer.

I don't mean to be unhelpful, but it just doesn't seem like that big a deal to me for a boy that age to still be in nighttime diapers, and as a parent of small children myself, I don't see much reason to create stress for myself by worrying about whether they "should" be doing something by virtue of being a certain age. Unless you have a really burning need to get him out of nighttime diapers for some reason you didn't mention in your post, or he wants it himself because he doesn't want to go to the big sleepover in a pull-up, I'd back off and give yourselves a break for awhile.
posted by not that girl at 8:50 PM on December 18, 2006

Does he go pee (or at least try to) right before he gets in bed? That's the procedure I followed with my daughter and it resulted in very few nighttime accidents. I also limited how much water she drank before and during bedtime.

I've always heard, from both doctors and girlfriends, that holding it when you have to pee is bad and can lead to a UTI. I'll offer that teaching him to be in tune with his body's needs rather than ignoring them might better help him along the road to bladder control.
posted by bizwank at 8:56 PM on December 18, 2006 [1 favorite]

Get him into a routine before bed.

1. PJs - check
2. Brush teeth - check
3. Potty - check
4. Story - check
5. Lights out - check
posted by Pollomacho at 9:09 PM on December 18, 2006

I used to occasionally wet the bed as a child. The only thing that got me over it was time as I finally grew out of it.

My brain would present dreams in which I got out of bed and went to the toilet, and thereby wet the bed.

My parents never made a fuss about it, I was embarrassed enough as it was. It just finally went away, probably later than 6 years.
posted by tomble at 9:18 PM on December 18, 2006

Buy a good-quality waterproof mattress cover and forget about it. This is normal and he will outgrow it. Apparently there is a prescription drug that will also help.

The important thing is not to criticize your son or make him feel bad about this. Explain that when he is asleep, the brain forgets that he isn't supposed to pee in the bed.

Here is a good column about the issue.
posted by LarryC at 9:20 PM on December 18, 2006 [1 favorite]

I second the waterproof mattress cover recommendation. And not worrying about it. When my 5-year-old wets the bed, I have him help me change the sheets in the morning (mostly I have him move his stuffed animals while I change the sheets). Since I bought that mattress cover, though, I don't have the headache of worrying about the mattress anymore.

Also, if he happens to wake up in the middle of the night (which mine does) and want to crawl in bed with me, I have him go to the bathroom before he gets in my bed.
posted by eleyna at 9:23 PM on December 18, 2006

I used to be a bladder-retention-disadvantaged kid. I was mostly fine except at nights; if I dreamed of urinating - well, I'd physically urinate.

Does your young one have similar trigger?

I stopped having involuntary urination once I realized that, for some reason. I'd still dream it, but my body wouldn't do it anymore.
posted by porpoise at 9:26 PM on December 18, 2006

It's not that strange at this age, but not common. Probably one or two other kids in his class do it too. You might try a bedwetting alarm. It takes some time for these things to help, but they do seem to help kids train their brains to wake them when they have a full bladder.
posted by caddis at 11:08 PM on December 18, 2006

(Strangely,) I remember a story told by, I believe, Adam Corolla on Loveline, involving bed wetting. His grandfather would wake him up in the middle of the night with a bucket ready so he could pee without much movement (I mean, standing up was probably part of the, um, peequation, but not running to the bathroom, turning on the lights, etc.). Perhaps something like that could assist with the getting-back-to-sleep issue.
posted by wemayfreeze at 11:31 PM on December 18, 2006

Chart the next month and stick the chart on the fridge. Buy some gold star stickers or whatever. Tell him he can have the object of his desire when he gets 7 stars in a row, and that he gets a star for a dry night. Explain that the easiest way to get a star is to have a really good pee just before bed. Explain that even if you don't think there's any pee in there, you should still make a trip to the toilet, just in case.

I reckon you'll have cracked it within the month.
posted by i_am_joe's_spleen at 11:37 PM on December 18, 2006

Chart the next month and stick the chart on the fridge. Buy some gold star stickers or whatever. Tell him he can have the object of his desire when he gets 7 stars in a row, and that he gets a star for a dry night.

No no no. It is an involuntary action. Acting like it is something he can control is justing setting him up to feel ashamed.
posted by LarryC at 11:56 PM on December 18, 2006

Actually, many of the experts actually recommend trying the star chart prior to using the alarm. Maybe it is just cost. The alarm works, but hey, stars are cheap. It is all about training the brain to recognize the full bladder. The sleep of death that kids of this age sleep only makes matters worse. How many people older than say 12 could be carried from one room to the next and deposited into bed without waking (absent intoxication)? That is normal for a five year old. I know kids for whom the star chart worked and I know kids who used the alarm, and all the kids with the alarm improved, but it takes a few months usually. I am not naming names here, but damn, parents discuss such stuff in way too much detail. Diaper rash discussions were worse though.
posted by caddis at 12:21 AM on December 19, 2006

But to LarryC's point, if you do the chart, you have to be very careful to focus solely on the positive, never on the negative. If it does not show results in the first few weeks then move on. Or, just use the alarm, it works.
posted by caddis at 12:23 AM on December 19, 2006

Why is this an anon question? It isn't necessary to be uptight about a kid wetting the bed!
Kids vary. My daughter was pretty early at toilet training and had no problems at night, but after probably a year of dry nights she started regularly wetting again. *Shrug*
She is 5 and in the age group where it is not identified as a medical problem and has no environmental stresses etc. that might indicate a cause.
My son is 3 and never wets. It annoys my girl that he is more advanced in this area, and she would do anything to catch up, so I am 100% sure it is out of her control.
Two observations:
- it takes a few hours to work drinks through, so a big pee at bedtime with less drinks in the hours before might help.
- she sometimes wakes and ostensibly looks for her favourite dolly. I think she is actually waking from bladder pressure, and if she urinates at that time she doesn't wet. Unfortunately, she is usually to sleepy to do this on her own.
Lastly, try not to make a big deal over this, it isn't something shameful and the use of the anon makes me suspect you need to reinforce that.
posted by bystander at 1:21 AM on December 19, 2006

Would you want other kids at your school searching the internet in a few years & discovering that your parents had asked about you wetting the bed? Children can be very cruel...
posted by pharm at 1:49 AM on December 19, 2006

A, um, friend of mine had this until they were around 6-ish. Years later, this friend discovered they had sleep pattern disorder of some sort as a child. Said friend got over it and did not later go to college in diapers, so it worked out OK.
Said friend had a friend of the family who used to stay overnight and would get up in the morning and wash her own sheets when she was in her early teens. (It was before they invented really big diapers.) This kid was raising several siblings for an alcoholic single mother, and we figured the stress wasn't helping.
They seem to get over it on their own schedule, and they don't seem to be able to help it, and getting all "OMG" over it just seems to delay the process. Stress always makes it worse, so being low-key is the right thing to do.
posted by unrepentanthippie at 5:41 AM on December 19, 2006

A friend of mine's parents tried all kinds of things - alarms, Sudafed, charts, etc... always focusing on the positive but it was still hard for him. When he was around 10, one visit to a hypnotherapist, and that was that.
posted by mimi at 6:37 AM on December 19, 2006

My son is now 8. He still occasionally wets the bed. Much less often than before, but it still happens sometimes. I would consider our progress to be a success as it has improved a lot over the last 3-4 years. At one point I was getting up nearly every night to change wet sheets but I haven't had to get up overnight in several months.

Here's what we did and it's a combination of everything suggested above:

1 - first, understand that he's not happy about it either. It disrupts his sleep and even if you're really nice about it it will put a small dent in his self-esteem. So I wouldn't recommend making him feel bad about it, not that you are. I would recommend being matter-of-fact about it. Also, understand that it will not stop right away. Accepting this will help get you past any resentment you may be feeling. I certainly didn't like getting up at night to change sheets, but you have to make sure that you don't let resentment drive your parenting. Again, I'm not saying you're doing this, but it can happen.

2 - get a waterproof mattress cover. Some can make the bed uncomfortable but we got one at Sleep Country that has a flocked top and apparently lets vapour through while stopping the liquid, like gortex, but not actually gortex. It was moderately expensive - like maybe $100. In the end, it was definitely worth it versus letting the mattress get wet all the time. Less smell, easier to wash & dry.

3 - get overnight pull-up diapers. GoodNights is one brand. Again, it's another $10 a week. But it beats wet sheets.

4 - reduce fluid intake at dinner and no fluid after dinner. My son never got thirsty until then though because he was too busy all day to drink. So, insist on more drinking until 6 PM or so and then cut him off. Just cutting off at 6 may not work if he's thirsty.

5 - get a check for a urinary tract infection, just in case. My son has a sensitivity to soap in his urethra so no soapy bath water or bubble baths. Once we cut those out the overnight peeing cut back a bit. Not completely, but it did help.

6 - regular pee schedule at night. I'm a big believer in bedtime routine in general, but semi-obviously, always have a pee before bed. Even if he doesn't feel like it.

7 - make sure nothing is preventing him from getting up at night to go to the toilet. At some point my son admitted that he didn't like getting up at 6 AM to go to the bathroom because it was too dark. So he just went in bed. Not so cool. We got a night light for the bathroom and he started going to the bathroom himself more often.

At one point we'd take him pee in his sleep around 10 PM when we went to bed (his bedtime is 8). That helped but wasn't along term solution because it didn't solve the problem and ended up disrupting his sleep too much. If I had to do it again, I'd skip the assisted night-time bathroom visit and go straight to the rest of this stuff.

I would avoid the hold-it-longer strategy as it just ends up resulting in an emergency when he can't hold it any longer. I would encourage more frequent urination actually. Does he dislike the bathroom? My son is very sensitive to smells and, when younger, would dry-heave if someone had used the bathroom before him. So we had to help him get past that.

At any rate, my son was out of diapers during the day by that age but still, 3 years later, still wets overnight occasionally. Getting out of diapers is a process and doesn't happen in a day. I would suggest that it's OK to continue with diapers at night until he figures this out. Like everything with kids, it'll take time. I don't know if I have a lot to add versus the other commenters, but I thought you might appreciate a first-hand story of dealing with the problem. Good luck!
posted by GuyZero at 7:07 AM on December 19, 2006

I've talked to my doctor about this just last month. My son will turn 6 soon. Here's what the doc said.

No liquids for 4 hours before bedtime. Potty just before bed, then 2 hours after. That should result in 50% dry mornings.

We have modified that a bit. We let him have about 4 oz of milk with dinner. Further, if he's wet when I go in to take him potty, I just let him sleep. That probably sounds awful to some, but I don't see the benefit of waking him up only to put an unwashed body into clean clothes and sheets.

Oh, and if odor is a problem with laundry, a quarter cup of vinegar in with the detergent does the job.
posted by kc0dxh at 7:23 AM on December 19, 2006

reasons why this is anonymous:
1) i'm not even his parent, just his dad's girlfriend
2) the boy's future!

he told us that he stays at his friend's house and the friend doesn't wear diapers to bed, so why does he? we asked him if he wanted to try not wearing diapers and he said yes, so now he's gung-ho to do this. (which is to say: we're not forcing the issue.)

the first night he woke up at 3 and thought he'd be in trouble, we said "no, this is just what happens" changed the sheets and put him back to sleep. the next night he slept all the way thru until morning but the sheets were still soaked. same story the next night. he didn't really seem fazed by it, he just wanted to get in the bath in the morning. the sheets smell fine, we already had the waterproof lining in place, that's not the problem.

last night we got him up at 12 and at 4 (after going to bed at 8) and he was accident free. he came out of his room shouting "i did it!!" and he did. but we have to physically wake him up. i'm not sure if he'll eventually learn the pattern and wake himself up or if this is just saving him from diapers and wet sheets. time will tell.

thanks for the ideas.
posted by thisisfake at 7:44 AM on December 19, 2006

One thing to also remember is that when a boy is going through a growth spurt, the bladder may not grow as quickly, resulting in more accidents. This is the case with my son, also 5.

The posters above who recommend limiting the amount of liquid in the evening have it right on. I also suggest that the pee is the last thing to be done before he gets tucked in at night. We've found that our son will pee at bath time and again before he dives into bed.

Also, if he's been in pull ups or diapers at night all this time, he may not have really felt what was happening during the night and didn't realize he was wetting himself in the night. Keep him out of the diapers. Let him feel wet. It will take a little time to retrain his body, but he can do it.

Finally, for your own sanity, ease off waking him for potty runs in the middle of the night as quickly as possible. Encourage him to pee more frequently during the day. You stated that he's already holding during waking hours until the last second. Don't ask him if he needs to go. Tell him to go potty. If he says "I don't need to" and you know it has been several hours or you see him starting to clench or squirm or whatever his cues are, send him to the potty. He'll then start to feel the urge earlier in the process. If he's afraid that the activity in which he's engaged will end because of the potty break, remind him that it will still be there when he returns. Ask him to go before you leave the house. I bet reconditioning his waking behavior will positively impact his nights.
posted by onhazier at 8:04 AM on December 19, 2006

I'm going through the same thing, anon, with my nearly four-year-old. She got to the point with pullups where she would say, "I'm in a pullup, right?" and proceed to use it.

I stopped the pullups/goodnights. I wish I'd never used them, honestly. I read somewhere not to punish, but to reward her, and we have a standing rule about 3 nights in a row will net her a "bubble machine" as soon as she can do it. We have acheived 2 nights in a row quite a few times, but that third night seems to elude her. At this point she wets the bed probably 5 of 7 nights a week.

I think dealing with the pee is the way to go. Be prepared to do *lots* of laundry. I don't yell at her, but I also let her know that it really is Not Okay to be peeing in bed.
posted by frecklefaerie at 8:34 AM on December 19, 2006

I forgot to mention: I tried the waking up at night thing and it just didn't work. We also have a "10 second potty" for the times at bedtime that she claims to not have to pee. She sits on the toilet and counts to 10. Usually she does actually have to pee, and those nights especially she seems to wake up dry.
posted by frecklefaerie at 8:37 AM on December 19, 2006

Have a look at this, it might help.

http://www.kk.org/cooltools/archives/001517.php
posted by Rc at 2:44 PM on December 19, 2006

Do nothing.

The kid is six. Yeah, he has a friend who doesn't wear any protection to bed, and he had others who do but (like him) doesn't talk about it.

Get the waterproof mattress cover and a few sets of extra sheets. When the kid wakes up dry say, "good job!" and when he doesn't say, "OK, let's change the sheets." The key is to say both with the same unjudgemental affection so that the kid feels NO STRESS WHATSOEVER about his involuntary functions. Either his body will figure it out, or he'll need help from a professional. But the professional is only an issue for a very small percentage of kids (thus not likely in your case) and not for a few years yet.

And doctors are mostly worthless in this area. Really: is it a medical problem? No, it is not. A medical problem would be if the kid had either a problem with blockage or voluntary control. Since this isn't the case, why bother with an MD? I'm not anti-doctor, but I am against asking doctors for parenting advice. A shrink, maybe, but a pediatrician? No.
posted by terceiro at 4:28 PM on December 19, 2006

My dad was a urologist. He strongly recommended cutting out jello, koolaid and other foods with a lot of dye in them. The dye may irritate the bladder. The child should also have no caffeine or other known irritants in their diet.

The star chart may help a child's subconscious learn to control the urge. If the child is unhappy about the bed-wetting, then the stars alone may help as much as a big reward. But make sure not to use punishment; on wet nights, no big deal, but on dry nights, a star. Reward might be a new sleeping bag, or related item.
posted by theora55 at 5:07 PM on December 19, 2006

he came out of his room shouting "i did it!!"

That is so cute. Kids are great.
posted by LarryC at 7:35 PM on December 20, 2006