DS1 (5) not even remotely dry at night

[FourArms]

DS1 is now 5yrs 4mnths. He was dry during the day at 2 with no issues, and is now absolutely fine during the day. He wears a nappy to bed, and has only ever had one dry nappy in the morning. I'm not at all bothered by this, and am quite happy for him to wear a nappy for as long as he needs to. From what my MIL says, DH was late-ish to be dry at night too.

However, recently DS1 has begun to be bothered by the fact that he still wears a nappy. Don't know if there has been some teasing from someone.. I suspect there has, but he doesn't want to admit it and gets very tearful when I ask about it.

What can I do to help him? I've bought the pyjama shorts nappy things, to show him he could stay at a friends and they wouldn't know. However, he wees so much, that they leaked into his top, so not great! He does drink a lot at tea (5:30pm ish), and then has milk and biscuits before bed (7:30pm ish). He mainly drinks ribena, which I've heard before acts as a diuretic. I've suggested lifting him during the night, but he doesn't want to do that, and is often wet before I go to bed. I think he just wants a magic wand. Don't we all?

[GrapefruitMoon]

Definitely cut out the Ribena. I would try to ban any drinks after 6pm.

During the summer (when it's easier to dry washing) you could try leaving off the nappy/pull up for a few nights to see how he gets on - sometimes they need to feel the sensation of being wet to get the hang of it. Might take a few nights though so be prepared for changing sheets in the middle of the night! Pampers bed mats are good to soak up the worst of it.

But it's still very normal not to be dry at this age as you say. When mine make a fuss about wearing pull ups I just wait till they are asleep before putting them on them. I'm currently debating whether to put my ds back in them as he has been wet 3 nights in a row...

[quidnunc]

You have just described my DS - now 7. He suddenly became dry at night at 5.11, and suffered only a few accidents in the months afterwards. He too became self conscious about wearing nappies, but in his case I think it was because his younger sister (3 at the time) was completely dry night and day. That's a typical boy/girl thing though. I really wouldn't worry at all, as you seem be be quite relaxed about it.

The only essential is that he goes to the loo immediately before bed, even if he says he doesn't need to, and limit the fluid intake from an hour before bed time. Also, I always left a bathroom light on and gave DS a nightlight, encouraging him to take himself to the loo during the night if he woke up before weeing. He liked the idea of the responsibility and it took a relatively short time.

I'm sure you have already, but do reassure him that it is completely normal and explain that some children still wear nappies at night until they are much older than him. It may help? You know, the whole "everyone is different, and that's normal" type of speech!

[FourArms]

OK, we'll try no ribena, and stop drinks after tea maybe. It won't do him any harm to drink more water anyway!

I think the problem with leaving him with no nappy is he often bed hops, so I could end up with two wet beds. We do have a hippychick bed protector somewhere though, and since he wants to make a go of it, I could suggest that he has to stay in his bed if he wants no nappy.

Has anyone had success with a heavy wetter just taking the nappies off and them being dry shortly afterwards?

Pullups aren't enough for DS1 at the moment, but maybe if we stop the ribena and milk then they might contain him!

[FourArms]

Sorry, x-posted there quidnunc. We did a long spiel last night about it being completely normal, the fact that DH was the same (and every adult he knows ). We do make him go to the loo before he has his nappy on, but he can sometimes have another half hour before he actually goes to bed. Perhaps if we change the routine, and limit drinks, we can try pull ups again, and then he can go to the loo by himself (currently wears size 6 pampers, so he's less inclined to go for a wee as he's got to take his nappy off to do it)

[GrapefruitMoon]

Yes if he really wants to be nappy-free make him stay in his own bed and hold off on going to the toilet till the last minute before he goes go bed.

My ds1 was nearly 7 before he was dry - But he stayed in pullups till then. I ran out of pullups for ds2 a couple of months ago and to my surprise he was dry the next morning. We had a week or two of him being dry every night but now he has the odd wet night - think I need to be more vigilant about drinks

[TigerDrivesAgain]

Mine was nearly 6 before he was properly dry, he gave it a go a few months before but it didn't work,then he had a phase of leaking out of pull ups (I think there was some fiddling going on, can't see how every single one was leaking). What tipped it was his older cousins coming to stay, he just stopped and got me to hide all nappy evidence. We still have the odd accident if he falls into a v deep sleep and doesn't wake for the loo but generally fine.

[FourArms]

Sounds positive then.. think we'll give it a go.. or should I wait until it stops raining!!

[FAQtothefuture]

tip from DS's nurse he's been seeing at the eneuretic clinic.

When he does a wee at night.

Do a wee
Brush his teeth
Do another wee

She has no idea how or why this works, but told us to try and it and indeed without fail both DS1 (and 2 - although it's not for his benefit) both do a little more - so helps empty the out more.

[clumsymum]

My DS continued to be wet at night until he was about 7 1/2, despite the fact that we tried all the usual advice, and a few of his classmates were the same. So I wouldn't worry at the age of 5.

Once he was mainly dry, I certainly saw more 'accidents' when he'd had ribena to drink during the day, altho perversly, I also found he tended to wet the bed if he'd had a day without much to drink, whereas if he's had plenty to drink during the daytime he would be more likely to be dry overnight.

Get a couple of waterproof mattress covers, the ones with the terry towelling on them are best. Oh, and it does help to give them an incentive. My DS wanted to do sleep-overs, so I made him a promise that we would organise a sleep-over when he had had a whole week dry.

[FourArms]

Good idea. Brushing teeth a second time won't hurt either (they like to do it in the bath as well!).

So, no ribena, lots of water, and the promise of a sleepover (do I have to do that one - actually, he'd love to do this, but is too scared his friends will see he still wears a nappy )

[amberflower]

I would definitely encourage incentives. My DS has only very recently become consistently dry at night (he's just turned 5) and I think one of the things that helped him (as well as completely cutting out bedtime fluids, he has nothing to drink after 5:30pm) was the incentive factor. He got a sticker every morning the pullup was dry, and seven stickers bought him a new little Disney 'Cars' diecast toy or kiddie comic or similar. It took a good few months but we got there.

But as others have said it is very normal for boys of this age to not be completely dry at night - lots of DS's classmates still either wear pullups or are lifted at 10pm or both. When I asked the HV about it when DS was 4.5 or so, she said they don't even worry about it until they are 7.

[danthe4th]

My ds is 7 and still wet, but if you do give it a go I recomend making up his bed with 2 fitted sheets and 2 waterproof sheets so if he wets the bed can be stripped and the dry sheets are already on, bung them straight in the wash they'll be done by morning and your son has barely been disturbed. I can't stand changing beds in the middle of the night, this way you only have to strip it, and remake in the morning.hope that makes sense.

[Sidge]

Being bothered by being in pull-ups is a good thing as it means he will be more motivated to try and be dry! I run an enuresis clinic and find that where the child isn't bothered, and that they are there because it's the parent that is more bothered, actually means we don't often get very far because the child has no motivation to be dry. I don't personally believe in reward charts (you are rewarding a child for something they have little or no control over) but offering incentives can't hurt. Don't put too much emphasis on 'achieving the prize' or making it conditional on being dry as this can add pressure which in itself causes anxiety which can cause wetting. Reward a behaviour ie drinking more fluids, going to the loo more regularly, getting up to change PJs if wet or coming to tell you rather than lying in the wet bed, rather than rewarding the outcome ie a dry bed. This way you are rewarding something the child can actually influence rather than wetting, which in most cases is beyond their control.

There tends to be a few possible reasons for the nightime wetting - a low level of a hormone we all start to make from the age of about 3 can mean that the kidneys make as much wee at night as they do in the day, so the bladder can't hold it all and the child wets. You can get a tablet form of this hormone from the GP/paediatrician (don't use the spray, it's awful having something squirted up your nose!) - the GP can prescribe DesmoMelt which is a melt tablet so just dissolves under the tongue. This is usually indicated where the child is still producing gallons of wee, often early on in the evening - the parent will check the child before they go to bed and find that s/he has wet.

Another reason for night time wetting is a lack of arousal - this is when the child just doesn't wake when they wee, even when they are soaking wet. Pull-ups don't help this as they keep the child so dry and comfy, so they don't get a message to the brain saying oy, wake up, you're wet. A way to try and increase arousability is to remove the pull-ups, protect the bed with waterproof stuff and see if they start waking when they wet the bed. If they don't this is when you can try an alarm. These can be body worn, or a mat, which go off (loudly!) when the child wets. The idea is that the child gets up, goes to the loo to finish weeing and then changes the bed and PJs. After a while the brain gets a stronger signal that they need to wee and starts waking them when they need to go, not that they have already been. A bit like you waking up every day a few minutes before your alarm goes off.

Lifting doesn't help as it reinforces the 'wee whilst asleep' message to the brain, as children rarely wake up properly when they are lifted.

The most important thing in helping night time dryness is bladder training; the bladder is a muscly bag and like any muscle gets stronger if given a workout. A strong toned bladder can hold more wee than a weak flabby one, and so can usually hold enough wee to last overnight or send a stronger message to the brain to wake up when full. To train the bladder and give it a workout it needs filling and emptying regularly, so encourage 6-8 good sized drinks a day (ie about 250ml) and aim to have most fluids during the core of the day so from breakfast time to dinner time, tailing off and stopping an hour before bedtime. The child should aim to wee every 2-3 hours and not hold on until bursting. This regular filling and emptying strengthens and tones the muscles.

Avoid red and brown drinks, so coke, hot chocolate, berry drinks (Ribena, apple and blackcurrant etc) and tea and coffee; they are all diuretics (make you wee) and in many children blackcurrant irritates the bladder.

A good website is Eric.

Good luck

[DidEinsteinsMum]

Sidge could you come talk to me about daytime dryness regression. Will create a new thread if you prefer.

[DidEinsteinsMum]

Am watching this for tips as we have been advised to try to get ds (4 1/2) out of nappies due to soriosis issues on his bits. He has had dry weeks every so often so is capable but have other issues. Hope you get some success.

[Sidge]

DidEinsteinsMum - I'm certainly no expert on daytime wetting where there has been regression but will offer some ideas.

How long was he dry for before regressing and starting wetting again? How long has he been wetting for? Is there any pattern?

Daytime wetting can be due to psychological reasons (eg starting school, new sibling), constipation, infection, detrusor instability or lack of fluids and toileting routine.

If you want to start a new thread with some more info then I'll pop over there

[DidEinsteinsMum]

thank you thread here.

[FourArms]

Sidge - thankyou very very much for taking the time to type all of that out. It is very helpful.

DS1 is producing a lot of wee - a pull up isn't enough for him, he needs a Pampers nappy. He does wee before I go to bed at 10pm (he might have only been in bed a couple of hours at this point). However, he does currently drink a lot in the evenings, and this includes coke (not too often I promise ), hot choc and ribena as well as milk.

Currently, if DS1 does get wet in the night (sometimes DH puts DS2's nappy on him by accident , or it gets put on wrong) he doesn't wake up, and I only find out when I notice his damp PJs in the morning.

If DS1 starts to get very upset about this, and we stop the evening fluids, and do the concentrating on weeing properly, and lots of fluids early in the day etc etc, do you think the GP would try the hormone, or refer him to an enuresis clinic bearing in mind that he is only 5?

[FabBakerGirlIsBack]

DS1 was over 7 (but not 8 iyswim) before being dry properly at night and we get the odd accident if he is poorly.

DD is almost 6 and has had a few dry nights but no set pattern so she has a nappy on.

DS2 is 4 and not even thinking about it tbh.

They will do it when they can. Imo you can't night train.

Only pain for me is remembering to buy the nappies as I always used washables but there are none that suit my kids body shapes.

[Sidge]

I doubt an enuresis clinic would see him as nigh time wetting in a 5 year old is still 'normal'. Our criteria is that we only see 7 and over.

I would certainly ask the GP if you can try DesmoMelts - but first I would try a couple of weeks of serious bladder training. Try getting him to drink more between breakfast time and say 1500, and avoid all the stuff I've mentioned. Tail it off after dinner time and stop all fluids for an hour before bed apart from a very small drink of water if the weather is very warm. Also milk seems to set some children off, so try and give that a miss.

You may find that if he's drinking more in the day and tails it off before bed he makes slightly less wee. If not ask the GP for desmo - it can have great results very quickly and is generally very well tolerated.

Let me know how you get on!

[superfrenchie1]

Ooh this is really useful thank you all, especially Sidge!

ds just turned 6 and until recently a very heavy wetter and was soaking his pull-ups every night.

recently when he turned 6 we tried to leave the pull-ups off, he never has any red or brown drinks anyway, we did a wee then teeth then another wee before bed, and we are doing lifting at midnight when we go to bed.

it is working - he is normally waking up with a dry bed these days. we do tend to praise the dry bed rather than the behaviour though (never thought about that) and we are doing the lifting thing and you're right he doesn't really wake up so maybe we need to try another way.

i know they'll all get there in the end.

dd is 2 and is suddenly dry in the daytime and probably will be dry at night quite soon which might make ds feel a bit weird but i am always so careful to reassure him that it's normal - i even told him the statistic that there was probably another kid in his class iwth the same porblem

thanks again, i'll stop talking now!

[Surfermum]

Have you actually tried him without the pull ups? I was waiting for dd to have dry ones in the morning and she never did, then I read on here that it wasn't necessarily a sign that she wasn't ready.

So I gave it a go and bingo! She was around 5 at the time. I didn't lift her, restrict drinks or anything. It just happened.

[bumpybecky]

sorry, hugely rude but can I hijack and ask sidge the expert about the desmomelts?

dd1 has been on them for about 18 months now I think. She had to increase the dose to the 240mg level as they stopped being effective. She's started having accidents now even taking the stronger dose Is it possible / safe to take more?

I'm not sure if the GP will know (they were farily clueless when we asked for the melts in the first place) and we seem to have been discharged from the enuresis clinic again and will have to be referred again and there's a big wait

She's 11, but skinny (2nd centile for BMI accoridng to the letter home from school the other week), not sure if the dose is dependant on body weight....

[Sidge]

You're right superfrenchie, they usually all get there in the end! Some just need a bit of help and advice to do it though

I do agree with FabBakerGirl - as a parent you can't night train them, they have to do it. I think most do it with little or no intervention from a parent but some take that much longer and need some extra support. I always say to the families I see that if everyone is happy with pull-ups/lifting/changing beds etc then they don't need to come to my clinic. However when the child starts to think that they want to stop wetting or wearing pull-ups then that's where we can often advise.

[bumpybecky]

superfrenchie, I can understand about the younger sibling thing. dd1 has seen dd2 (2 year younger) and dd3 (7 years younger) manage to get dry at night before her. It does upset her a bit

6 is still very young though they won't refer to the clinic until the child is 7 as it's so common in that age group.