Is this small change enough to continue overnight training in 6yo?

[TracyK]

ds has just turned 6 and is a really deep sleeper.

We have decided to try and stop wearing pj pants overnight. We tried a couple of months ago and gave up after 8 days of waking up soaking at his normal time. So he was sleeping through peeing and being wet for goodness knows how long.

This time round - he pees - but then wakes up.

Night 1 - pee at 12, woke up, fresh pjs on and dry until 7.30am.

Night 2 - pee at 12.30, woke up, fresh pjs on and dry until 7.30am

Night 3 pee at 5.30am, woke up, fresh pjs on and dry until 7.30am.

Is it worth continuing since he is actually waking up after he's peed?

or is he just not ready to go a full night yet?

I´d feel inclined to wait a bit longer when he starts to wake up with dry nappies/pull-ups. Its not considered a problem til around 8 years of age, some children take longer to make the correct hormone in sufficient quantity that actually stops them pee-ing in their sleep. The other thing you could try if its bothering your DS is to take him for a pee when you go up to bed and see if he lasts til morning.

Well, we're in the same position with our 6-year old ds - he used to sleep in a soaking wet bed, but now wakes up (albeit I don't think always straight away, but after it's got a bit cold) and comes in and tells me. He specifically asked to go without nappies this time around, so we are sticking with it as I don't think it's fair to go against his wishes, and I do think the waking up is progress. If your ds is definitely waking up straight after he's peed, then that is even better progress, as waking up straight after is a step closer to waking up just before, or waking up during the event... However, in my ds's case I think the real problem is his bladder is rather small and irritable, as to help with the nighttime wetting we've been getting him to drink more during the day, as advised, and it's resulting in him wanting to go to the loo rather a lot, only to wee out relatively small amounts (only around 100ml at a time, whereas at his age, a full bladder should be able to hold over twice that amount without leaking). Therefore, I suspect we will be quite a lot longer before he is reliably dry at night, as a small, irritable bladder has a tendency to empty itself in a child's sleep without sending much in the way of a warning to the sleeping child's brain! If our ds can learn to hold onto more urine during the day, hopefully the messages between brain and bladder will start to work better at night and the chances of him going all night without needing a wee will improve, too. And wouldn't it be lovely if that could all happen over the summer, when daily washing of bedsheets and clothes is less tiresome!!!!!

ps if my ds hadn't asked to go without nappies, I'd happily put him back in nappies, but still work on the daytime drinking and increasing his bladder capacity...

I read on a thread lately that its something to do with a hormone that is released as a child sleeps?? therefore no amount of training or age expectations will matter - the release of the hormone is the only succesful way.

The hormone that nickschick is referring to is anti-diuretic hormone (ADH). This can actually be given to children to stop them wetting the bed, then it is stopped after a while to see if the hormone has kicked in naturally. I doubt you need to do this at age 6 as not getting through the night without peeing is relatively common but if there was a special occasion like a sleepover with friends then it could be used then. Anthony Cohn is a Consultant Paediatrician and mentions this in his book "Constipation, Withholding and Your Child: A Family Guide to Soiling and Wetting".

The hormone isn't the only thing implicated in nighttime wetting, as some children wake up before they wee and can go to the toilet in the night and others don't - so the amount of urine produced during sleep is only part of it. There are also drugs for relaxing the bladder muscle for those with problems like my ds's (ie an overactive bladder rather than an over-production of urine at night), and there are nighttime bedwetting alarms for those who don't wake up. And there's staying in nappies or constant bedsheet washing for those whose children are happy to do this. Age sorts this problem out for the vast majority of children - ie waiting a bit longer - but staying in nappies until it all happens naturally doesn't work for every child or every parent (and it may not happen this way until a child's age is in double digits in some cases).

Oh, and I've also been told that bedwetting alarms are effective in around 80% of cases - ie result in a long-term resolution of the problem once use of the alarm has ceased. They can be used from the age of 5, although that seems quite young to me to be trying this. Most children tend to find the problem has resolved on its own by about age 7, which is why, if there isn't a daytime wetting issue aswell, referrals to eneuresis clinics don't tend to take place until a child is at least 7 years old. Wearing nappies until age 7 may possibly increase the amount of time it takes for a child to learn nighttime control, because they are so effective at taking any sensation of dampness away from the skin.

Well giving it another go tonight!

Since dh has encouraged the issue - he is getting up in the night to change sheets and pj's. So I'm not going to suggest going back to pj pants. I'll let him get that idea himself. He poo poo's the hormone theory when I mention it - so I'm letting them get on with it!

I'm just worried that dh's negative attitude to pj pants will give ds a phobia about them!

Good luck tonight. See how it goes, if its not working after a few days I´d take the pressure off and get the pj pants back on - or try bed mats - they´re meant to go under the sheet but could try putting one on top as well to save on sheet changing - might have to tape it down at the sides tho to stop it shifting in the night.

Well, used a bed mat last night. Strange - his pjs were wet - but the mat and sheets weren't - so I'm thinking not too big a wee. But still not dry - bah!

I've told him that we are going to be experimenting with drinking as much as poss during the day and wee - ing into a jug to measure how much pee he can hold - a la rabbitstew. In the hope that he can stretch his bladder a bit and hold more.

At least the sheets were dry! A Cohn (paediatrician mentioned above) says to allow no drinks an hour before bed and then try and get them to pee twice, maybe once downstairs and once after brushing their teeth upstairs to make sure the bladder is completely empty - might be worth a try (along with everything else). Hope he has a dry night soon. Is he ok with it all? Or feeling disappointed? Try not to make him feel under too much pressure - it will happen soon.

Good luck! My ds1 did a lot better holding onto his wee, today - once we stopped his habit of holding onto his willy when he needs the loo! I'm not sure how long it will take for this to translate into a real nighttime improvement, though, as he has been known to wet the bed twice in one night! However, he still seems to be very positive about everything - not getting discouraged at all (but that might be because he gets a reward for coming in to tell me the bed is wet!). I think ds1 will be getting a lot of stickers and rewards over the next few months, as the only thing he's not rewarded for is lying in a wet bed without telling anyone about it... I needed something to keep everyone's morale up, though, if he's going to be adamant about not going back into nappies!!!!! And he is rather enjoying seeing how much wee he can hold onto!

I was very surprised when I saw that ds was only pee-ing out 100ml - that's not much is it Rabbitstew??

That was the 1st first time I measured it. I've been trying to get him to drink loads and hold on till he's desperate. Though the last time he said he was absolutley bursting - he managed to get out the car, have a swing in the garden, take his shoes off, eat a biscuit and THEN go to the loo!

So he's been having 1 pee in the night and then pee-ing in a jug when he wakes up in the morning. He's peeing 150-180 ml when he wakes - so I'm guessing that's quite a while since his 'in the night pee'. But he's sleeping through the pee - bah - a step backwards I think!

Ah, we're living the same life! I'm speaking to the school nurse, tomorrow, in the hope I can hire or be lent a bedwetting alarm, rather than having to fork out for one! I think it's likely to be the only way we'll stand a chance of some kind of resolution to ds's nighttime problem in the next few months, rather than the next year...

I just wonder if its all worth it. cos surely all this controlling input and output will all go to pot at friends houses/holidays/special events etc. or do you think that it will suddenly become second nature to them??

Let me know what your school nurse says - I might approach mine next week and see what their approach is in our district - ie will they make us wait till 7yo?

I definitely don't think it will suddenly become second nature to them! I think it's a very labour intensive way of trying to speed up what would probably happen on its own, eventually, because ds1 is not happy with the status quo (even if his mummy is). It is also something positive ds can do, rather than just go to bed every night in the vain hope it will be different this time. I have higher hopes for the alarm, because from what I've read and been told, it's about the only treatment that has a proven long-term success rate for the majority of people, if used properly (and after all, the issue of having an overactive bladder and that of not waking up when wetting the bed, whilst very commonly connected, are two separate issues, as there is no reason why someone with an overactive bladder shouldn't wake up several times a night to pee if necessary, rather than sleeping through it).

I will let you know what the school nurse says! And if we try an alarm (whether through her or buying it ourselves), will let you know how that goes and whether ds1 sticks with it or decides to go back into nappies.

I am really sorry. I had no idea that these problems were the norm in 6 yr olds.
Ds1(6) has gone to bed , nappi-less since 3.5
As far as i know, no playground mum has said to met that their 5 yr old, now 6 yr old wakes up at night.
Ds never did. wakes up at 6am and immed needs a pee. this i thought was normal.

? Who said these problems were the norm in 6-year olds? And what sort of conversations do you expect to have in the school playground?!

It isn't normal to have an overactive bladder, and children who wet the bed at age 6 are in the minority. If your ds wakes up dry every morning, then he doesn't need to get up in the night to pee, which is why he doesn't do it... Most people should be able to get through the night without needing to go to the loo. Those who can't need to learn to wake up before they wet the bed and preferably also find ways of increasing the capacity of their bladder or, if the problem is that they produce too much urine to hold on all night even with a normal bladder capacity, maybe get help with artificial hormones to reduce the amount of urine produced overnight. I certainly wake up before I wet the bed on the rare occasions I do need to get up in the night to go to the loo, so it isn't exactly odd to expect a child to learn to respond to the signals a full bladder is sending in the night, just as he does during the day, nor is it unachievable.

So in summary, Oblomov, I really don't understand what you are getting at or why you posted.

well - by default we had a dry night - ds had a nose bleed at 1am and came to us and also had a pee in the loo. Though hardly any came out at all - so maybe he would have made it till 7 - we'll never know!

So - had to wash bedsheets from bleeding nose today - rather than from pee - if it's not one thing it's another!!

I wonder how common it actually is Rabbit - I know I'm loathe to mention to anyone other than very, very close friends - so I guess it's not a topic for the playground.

Plus what's 'normal' Oblimov? I guess my ds will do 'something' that your ds can't and vice versa!

Hi, TracyK,

The school nurse said she would rather not try out an alarm for ds until he's closer to 7, as it is more likely to work once the child is that little bit older (and would be a bit disastrous if it didn't work this time around, as he may be put off trying when he's closer to 7). I've also arranged to go in and see her with ds, because we thought it might help him if someone other than his mum talks to him about bedwetting and how many children still do it. In the meantime, I think I'll just have to deal with the wet sheets each morning and keep reassuring him that it doesn't matter (and that it may carry on happening for quite a long time). I might even invest in a tumble dryer! Not quite what I hoped, but more or less what I expected. I think, from what she says, I've been giving ds false hope that we can cure his bedwetting within a few months, whereas we can't really make that promise.

Did she say it was quite common then??

I might send dh in to see nurse/doctor - I think he has an old fashioned attitude to it all.

I'm just worried that we are 'engineering' the situations leading up to bed time - and that it isn't really natural for ds yet iykwim.

I wonder if there are any homeopathic type remedies out there to reduce the pee or maybe strengthen the bladder muscle. I'll google later.

But I think I might have been blinkered into thinking ds bladder volume was ok - it was only when you said 100ml wasn't very much - makes me think that ds bladder isn't very big after all - and so by expanding it as much as poss during the day - might help (eventually)

maybe we should do a survey on here - asking mums to measure their 6yo's wee for a day and see what the average is?

I am sorry. I wasn't being judgemental. It was just that I opened the thread and I hadn't realised that there were lots of parents, as there clearly are, that face these issues.
Sorry for posting.

Saw on an Australian website - volume should be age +1 x 30ml so ds should be 210ml during the day and 50% at night being 100ml odds.

So he seems to be consistently doing 100 ml day and night. It also mentioned dribbling after weeing as being a problem. Think I'll start another thread about that - I thought it was just boys being messy!

! Might make interesting reading! ERIC inform me that a 6-year old's bladder capacity should generally be around 210ml. Being able to hold onto more during the day should help at nighttime, as it may allow a deep sleeper to go through the night before their bladder is full. It will only help if you can achieve increasing the bladder capacity without getting your ds too tense about the whole thing, though - which is why I'm seeking help from the school nurse, as I think we're beginning to focus on my ds's wee too much, now, which isn't going to be helpful if it goes on for months without improvement! (It was fun at first, but I really don't want ds asking me to get the measuring jug out every couple of hours for the next year!).