DD deliberately wetting the bed - time to go cold turkey?

[MadMonkeys]

DD1 is 5. I have suspected for a while that she is ready to be dry at night. I know that night dryness is controlled by the production of specific hormones and that there is nothing a child can do to be dry until these hormones start to be produced. However, I am 99% certain DD1 is dry for the majority of the night, then wakes and has a wee at about 6am each morning. I think she just doesn't want to go to the bathroom, so she wee's in her pyjama pants, which sometimes overflow. I suspect this because the accidents often happen on the floor rather than in her bed, so I think she gets up, starts to play then does a wee. She has a nightlight on the landing, and a torch, and knows she can turn on the lights to go to the bathroom, and she knows we are more than happy to go to the bathroom with her if she doesn't want to go on her own.

We have been encouraging her to go to the bathroom when she wakes up but she hardly ever does. She did a couple of mornings ago, at 6am, and bingo, her pyjama pants were bone dry. cue lots of praise from us etc. So I'm wondering if now is the time to take the bull by the horns and put her to bed without pyjama pants and see what happens... Any thoughts?

How about a reward system? A sticker every morning that she is dry with a small toy / sweet / other treat after 4 dry mornings?

It is not just hormones controlling night time dryness, there are other reasons such as weak bladders, irritable bladders, inability to wake to brain signalling full bladder. If she has had dry pull ups most mornings then she is releasing vasopressin, as otherwise she would be wet, a large amount, early in the evening - every night.

I wouldn't recommend a reward for being dry, but rather a reward for using the toilet so the reward is based on a positive activity that she can control.

And yes, lose the pull ups - she won't get dry whilst she is wearing them as they are just encouraging her to take the easy option of weeing in them rather than the hassle of stopping playing and using the loo.

My sisters daughter is over 6 and is still in pull-ups every night which are wet every morning. I've told my sister she had to go cold turkey else things will never change!!

I would try bribery/rewards for dry nights.

My dd is just 5 and has a wet nappy every night. She recently fell asleep on me when and wee'd on me so I think mostly she is not ready but there is definitely an element of 'I like my nappies' too. Difficult one!
Reward charts for your dd I think..

I have just done this with my 6yo dd. My son wasn't dry until he was 7-8 but he genuinely couldn't control it. I suspected dd was just to lazy to go to the loo so took the pull ups away. We are on day 3 of being dry... Previously every pull up was wet.

Give it a go, lots of praise for dry, don't make a fuss if she is wet and if it doesn't work out just try again later.

Personally I'd just try ditching the night nappy and see what happens. I wouldn't bother with a reward chart - she might be fine without one.

Pull ups prevent your child becoming dry at night, they just encourage the child to wee whilst asleep. And when they do,went there is no discomfort, cold wet bed, having to get up and change, help change bed etc. although this is not a good time of the year to bite the bullet with everything going on, and getting laundry dry.

I really would discourage setting up reward charts for being dry as this is something the child cannot control and is setting them up to fail and putting pressure on them. Rewards should be for things like getting up to use the loo, helping to change he bed, drinking more during the day (which can increase bladder tone).

Your school nurse should be able to support you with getting your child dry at night, ask for a referral from school / GP.

I recommend this booklet, it is really good www.eric.org.uk/assets/18512%20ERIC%20Bedwet%20Guide%20red.pdf

I have a 10yo who is still in nappies. Ime going cold turkey doesn't work if she isn't ready (physically or emotionally).

Reward charts for going up the loo might be working, if this is the issue and only if you don't make the link between going to the loo and bring dry (if this is the reason, then she will find herself that she is dry)

Also is she always dry during the day or does she forgets when she is playing that she needs to go to the toilet?

rhino how can you say that pull ups encourage a child to wee whilst asleep and not to set up a reward system for dry nights as it's something the child can't control, in the same post?!

My ds is now reliably dry at night at 8, and all the pants did was hugely reduce the stress of night time upset and bed changes.

I have a long running thread in behaviour and development about it if you want some tips/advice op, lots of us on the journey

Because if a child is wearing pull ups the brain is conditioned to know there are no unpleasant consequences of releasing urine whilst asleep, ie cold wet bed, having to get up. Also, children can be half asleep and prefer to go in their pull ups if awoken by a full bladder rather than leave their nice warm bed to use the loo.

And whilst training to be dry at night, accidents will still happen, it's like if you were learning to do something new and you got penalised for not doing it right, even though you were trying your hardest, you would soon feel demoralised.

More info on reward systems are in the NICE guidelines:
www.nice.org.uk/guidance/cg111/chapter/1-guidance#reward-systems

Interesting guidelines.
The ones think I've notice though is that it has nothing uk do with experiencing unpleasant consequences but it's all about training the bladder/learning to wake up when feeling you need a wee.
I'm a bit as I though that if a child had never had a dry night it was because the child wasn't producing the right hormones. And in that case, why even trying??

That's right - it's about getting the brain to associate a full bladder with waking up - that is how an alarm works. If a wee goes into a pull up the bladder is emptied without the need to wake up.

It's easy to understand why parents continue to use pull ups, laundry, night waking etc but it does delay getting dry at night. I would recommend waterproofing the bed and bedding, and removing pull ups.

The hormones CAN be a factor, but not always, the vasopressin medication (Desmopressin) is the third line of treatment, not the first. By age 5 you would expect vasopressin to have kicked in. This hormone reduced production of urine overnight, which is why we have dark concentrated wee in the morning. Bright night lights can also interfere with the release of this hormone, as the brain may not trigger the release of vasopressin if it thinks it's daylight.

If a child was not releasing vasopressin you would expect a large amount of urine in the bed early in the night, as the OP's child has a dry pull up at 6am I would say they are releasing vasopressin, but are probably being lazy/reluctant to leave the bed or what they are doing to use the loo.

Prior to age 5 night time wetting would not be considered a problem.

Why not leave a potty in her room? Or tell her to call you when she wakes up as maybe she doesn't want to go alone as is scared?

Thanks for the replies, very useful. She knows she can call for us when she needs the loo, she does occasionally.

I have tried a reward chart for going to the loo in the night but she hasn't massively got excited about it. I think I'll try to enthuse her about that and try going without the pull ups. Thanks everyone.

Appreciate it might not be the case for the OP.

But when you read the guidelines, the alarm us about teaching the child to wake up instead if wetting the bed/nappies.
The medication is in effect hidding the symptoms (it specifically says that if you stop, children are likely but not always, going to start wetting the bed again.
If the assumption is that you shouldn't wake up at might for a wee anyway, aren't all these systems just a way to 'wait until the body is ready' but wo the nappies? Why not carrying on with nappies until the child doesn't need them instead?
I mean I wouldn't want to have to get up several times in the night up to go to the loo. I would be exhausted after a few weeks like this. So why asking a child to do that?
And why is it better for the child to wake up rather than using nappies?

Sorry xpost. That was done questions for Rhino as she seems quite clued up on the subject!

Ds is 5 in a week and we have the same situation. If he gets up for a wee then the nappy is dry and if he doesn't despite a bastard sticker chart then his pull up is wet. We have had the odd occasion where he gets wet in the night which made me wonder what was going on. Dh out him in pants one night which ds was happy with and he was soaked in the middle of the night in his sleep so he still has some nights where he wees in the night but because he is too lazy to get out if bed in the morning I have no idea whether he's had a dry night or not because he's doing his first wee in his bloody pull up.
No idea what to do to encourage him to. Get up and wee. Bloody stickers don't work.

A sticker chart is for getting up to do a wee in the morning not for having a dry night as obviously that's beyond his control. I would just like to. Be able to tell how many dry nights he's having compared to wet ones.

It's annoying isn't it Quiet when you just don't know whether they would be dry if they went to the loo... We're going to try a night without pull ups tonight (if DD cooperates by the time we get to bedtime) and see what happens.

TheFriar, the systems are also helping increase bladder tone so that the child doesn't have to get up several times a night. Also if a child frequently wees small amounts of urine, the bladder sensors can send the signal to the brain when it isn't actually at capacity, but is holding the small amount it is used to urinating. A child's bladder holds approx (their age + 1) x 30, the OPs child should have a bladder capacity of approx 180mls. Adult average is 1300-1500mls.

With an alarm, you would hope to gradually see decreased size of wet patches and longer periods between the alarm going off, eventually lasting all night.

The OPs child is lasting all night without weeing, and is doing it in her pull ups in the morning.

Thanks Rhino. I have arc who is 10yo and nowhere near dry so I'm trying to learn more about it.

I agree with pp that it's hard with nappies because you don't actually know exactly when they wet themselves.

TheFriar what is arc? Not sure if it is auto correct or an acronym!

Eeek, I've done it, put her to bed without pull ups... She wasn't too keen on the idea 'because that means I have to go to the loo in the night...' but agreed happily enough after a little chat.