What to do about night-time accidents?

Posted by Barbara F. Meltz  March 14, 2012 06:00 AM

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I have a four year old daughter who is still having accidents. She can sometimes go up to 12 days without accidents yet she can have 3 days in a row with an accident [each day]. She still wets the bed three or four times a week, sometimes even twice [a night]. I have tried everything I can think of to stop them from potty charts, ignoring it, punishing it etc. At the moment if she has accident, she doesn't get a story at bed time. It upsets her a little but she still has the accidents. I wondered if you had any ideas.

From: Sarah, Hartlepool, UK


Dear Sarah,

Sometimes these problems are the result of an immature urinary system and they go over time as a child grows. On the other hand, there could be an underlying problem of some kind, either a stress that waxes and wanes in her life, or a medical problem such as a urinary tract infection or an over-active bladder. To be on the safe side, I'd ask her pediatrician if he thinks it's worth consulting with a pediatric urinary specialist. Meanwhile, I would stop imposing consequences for the accidents until you know what's going on. If it causes distress in the family (especially if she is upset to have the night-time accidents), suggest that she wear a pull-up for now at night. You'll have to re-adjust your attitude so you can do this in a totally non-judgmental way; otherwise she'll never go for it, because she knows how unhappy you are about this.

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7 comments so far...
  1. My four (almost 5) year old son is the exact same way. I totally understand the frustration of wake-ups and changings and all that, but honestly - he's doing it in his sleep, so I don't impose any consequences. If he gives me a hard time about using the bathroom, that's a different story, but I don't think a consequence will prevent an action that a kid isn't doing consciously.

    I defer to Barbara's expertise, but as an additional point - I recently read an article that night wetting is *always* a result of some physiological condition. Not sure I believe that. My son is an incredibly heavy sleeper in the first half of the night, and that is always when he has accidents. Supposedly my husband did the same as a child, and he outgrew it.

    What I do find helps (actually, always works) is having my son use the bathroom several times in the late afternoon/evening... before dinner, right after dinner/before PJs, and again right before getting in bed. Sometimes he protests and that will result in missing his bedtime story, but I do it more as a "you spent too much time fussing for us to read" consequence, if that makes sense.

    Good luck - I feel your pain!

    Posted by marriedmom March 14, 12 08:17 AM
  1. When my daughter was fully trained during the day but wetting the bed at night, her pediatrician told us that her body just wasn't ready to go that long without emptying her bladder, and since she is a deep sleeper, her body wasn't sending her brain the signal to wake up if she had to go to the bathroom. I started making sure she went right before her bedtime (8:00), and then I would wake her up when I was going to bed (around 11:00) and bring her to the bathroom again. As I said, she is a deep sleeper, and it wasn't always easy to get her up, but she always had to go again, and this prettymuch solved the bed-wetting problem. We started that when she turned 4 and continued for about a year, and then she began to wake herself up when she had to go. Essentially, she got used to being woken up and taken to the bathroom, and her body began to associate that full-bladder feeling with getting up and going pee. Just a suggestion, but it worked well for us.

    Posted by Beth March 14, 12 09:30 AM
  1. My son wet the bed about once a week until he was 13. At ages 4, 6, 8, 10, and 12, I took him to a specialist who did ultrasounds, etc. and determined there was nothing medically wrong. I also took him to two different hypnotists since that worked for some of his friends. Mind you, he is a smart, athletic, healthy child, who has NO other issues other than he is a very very deep sleeper and just didn't wake up at night. Bottom line, nothing worked until he just outgrew it last year. He had to wear pullups and "hide them" when he went to sleepovers and sleep over camps. Now, he is still in the habit of not drinking much at night and peeing right before bed. Age 4 is NOTHING . . ..

    Posted by Summer Fun March 14, 12 11:31 AM
  1. For nighttime accidents, waking them up to pee just before you go to bed seems to work well for many kids. (Mine didn't even wake fully, just enough to shuffle into the bathroom with assistance.)

    The daytime wetting is a separate issue.

    Posted by TF March 15, 12 12:27 PM
  1. My heart just breaks a little at the thought of this small child being punished for toilet accidents. How sad.

    Posted by Sarah March 15, 12 03:35 PM
  1. I'm disturbed that this mom punishes her daughter for wetting the bed. I wonder if the day time wetting is related to how the mom is reacting.

    My eight year old will still wet the bed if we don't get him up in the middle of the night. I second the suggestion on pull ups until she feels more in control of the situation. I'm glad this mom is seeking more information about bed wetting and I hope she stops punishing her child for something that is out of her control.

    Posted by rml March 20, 12 12:38 PM
  1. I feel that the people who comment on not punishing your child for accidents have NO IDEA what you are going through. I have a 3 1/2 year old that started potty training at 2. She did it herself and did great until 3 months later. Then we have had a never ending potty training adventure since. She poops on the toilet and never poops her pants...but continues to pee on average 8-10 times a day in her pants. The doctors have tried the medicine to release the bladder from spasms and she has continued to pee. She tells me she can't feel it and will walk around with SOAKED pants. At one time I did believe she was doing it on purpose...and at that moment in time you do what you think is best. So we have tried all forms of help/punishment...and I do understand where people don't agree with spanking your child for having an accident here or there. When your child pees so much they start lying about it and covering it up I think each parent has the right to choose how to handle it. I am still on the search to figure out what is going on as my daughter is just about to turn 4. I have prayed over it, saught medical attention, gotten x-rays, taken advice, done about everything I can think of. At the end of the day she is still peeing and you either choose to wait it out...if its truly developmental or keep on being an advocate for your child until you get answers. Praying for your sweet girl...and YOU!

    Posted by Teryn June 19, 12 12:26 PM
 
7 comments so far...
  1. My four (almost 5) year old son is the exact same way. I totally understand the frustration of wake-ups and changings and all that, but honestly - he's doing it in his sleep, so I don't impose any consequences. If he gives me a hard time about using the bathroom, that's a different story, but I don't think a consequence will prevent an action that a kid isn't doing consciously.

    I defer to Barbara's expertise, but as an additional point - I recently read an article that night wetting is *always* a result of some physiological condition. Not sure I believe that. My son is an incredibly heavy sleeper in the first half of the night, and that is always when he has accidents. Supposedly my husband did the same as a child, and he outgrew it.

    What I do find helps (actually, always works) is having my son use the bathroom several times in the late afternoon/evening... before dinner, right after dinner/before PJs, and again right before getting in bed. Sometimes he protests and that will result in missing his bedtime story, but I do it more as a "you spent too much time fussing for us to read" consequence, if that makes sense.

    Good luck - I feel your pain!

    Posted by marriedmom March 14, 12 08:17 AM
  1. When my daughter was fully trained during the day but wetting the bed at night, her pediatrician told us that her body just wasn't ready to go that long without emptying her bladder, and since she is a deep sleeper, her body wasn't sending her brain the signal to wake up if she had to go to the bathroom. I started making sure she went right before her bedtime (8:00), and then I would wake her up when I was going to bed (around 11:00) and bring her to the bathroom again. As I said, she is a deep sleeper, and it wasn't always easy to get her up, but she always had to go again, and this prettymuch solved the bed-wetting problem. We started that when she turned 4 and continued for about a year, and then she began to wake herself up when she had to go. Essentially, she got used to being woken up and taken to the bathroom, and her body began to associate that full-bladder feeling with getting up and going pee. Just a suggestion, but it worked well for us.

    Posted by Beth March 14, 12 09:30 AM
  1. My son wet the bed about once a week until he was 13. At ages 4, 6, 8, 10, and 12, I took him to a specialist who did ultrasounds, etc. and determined there was nothing medically wrong. I also took him to two different hypnotists since that worked for some of his friends. Mind you, he is a smart, athletic, healthy child, who has NO other issues other than he is a very very deep sleeper and just didn't wake up at night. Bottom line, nothing worked until he just outgrew it last year. He had to wear pullups and "hide them" when he went to sleepovers and sleep over camps. Now, he is still in the habit of not drinking much at night and peeing right before bed. Age 4 is NOTHING . . ..

    Posted by Summer Fun March 14, 12 11:31 AM
  1. For nighttime accidents, waking them up to pee just before you go to bed seems to work well for many kids. (Mine didn't even wake fully, just enough to shuffle into the bathroom with assistance.)

    The daytime wetting is a separate issue.

    Posted by TF March 15, 12 12:27 PM
  1. My heart just breaks a little at the thought of this small child being punished for toilet accidents. How sad.

    Posted by Sarah March 15, 12 03:35 PM
  1. I'm disturbed that this mom punishes her daughter for wetting the bed. I wonder if the day time wetting is related to how the mom is reacting.

    My eight year old will still wet the bed if we don't get him up in the middle of the night. I second the suggestion on pull ups until she feels more in control of the situation. I'm glad this mom is seeking more information about bed wetting and I hope she stops punishing her child for something that is out of her control.

    Posted by rml March 20, 12 12:38 PM
  1. I feel that the people who comment on not punishing your child for accidents have NO IDEA what you are going through. I have a 3 1/2 year old that started potty training at 2. She did it herself and did great until 3 months later. Then we have had a never ending potty training adventure since. She poops on the toilet and never poops her pants...but continues to pee on average 8-10 times a day in her pants. The doctors have tried the medicine to release the bladder from spasms and she has continued to pee. She tells me she can't feel it and will walk around with SOAKED pants. At one time I did believe she was doing it on purpose...and at that moment in time you do what you think is best. So we have tried all forms of help/punishment...and I do understand where people don't agree with spanking your child for having an accident here or there. When your child pees so much they start lying about it and covering it up I think each parent has the right to choose how to handle it. I am still on the search to figure out what is going on as my daughter is just about to turn 4. I have prayed over it, saught medical attention, gotten x-rays, taken advice, done about everything I can think of. At the end of the day she is still peeing and you either choose to wait it out...if its truly developmental or keep on being an advocate for your child until you get answers. Praying for your sweet girl...and YOU!

    Posted by Teryn June 19, 12 12:26 PM
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Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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