The ability to hold your bladder comes with age, and children reach this ability at different times. By ages 2-3, children start to gain control over their pelvic floor muscles and bladder sphincter to hold back the flow of urine. As the brain matures over the coming years, the ability to hold urine until you reach a toilet becomes easier. According to the American Urological Association, 90% of children are able to stay dry all night by age 7.

Let that marinate for a moment.

Physiologically, many children are not able to withhold urine during the night at the same age they may do potty training.

What we are trying to show here is that nighttime training may take more time - and that is okay. It is not something that will hold them back from starting preschool and should not be of major concern until age 5. Even then, some children are really just deep sleepers and their brains are still learning how to alert them to wake up to go to the bathroom. As you probably are piecing together, the communication between the bladder and brain, coupled with muscle strength and control, is extremely complex and takes time to build.

Signs of Readiness

Just like daytime potty training, you will want to look for similar signs that they are ready to go sans diaper at night, such as:

  • There have been several times where their diaper has been dry all night
  • They consistently use the potty during the day with few to any accidents
  • Your child takes the initiative to use the potty without your prompts (shows signs of recognizing when they need to go)
  • They can hold their bladder for a few minutes (or more) if there is not a bathroom nearby (shows they are learning control).

Actionable Steps For Night Time Training

Now that you have seen the signs, it’s time to give it a go! Here are some tips that we recommend to set your child up for a successful night.

  • If you haven’t already, think about transitioning them from a crib to a toddler bed so they can get up if need be. Of course, keep them safe by using rails where needed, but take steps to make the bathroom accessible in case they want to head that way during the night.
  • Keep a nightlight on in their bedroom and light the way to the bathroom so they can see in the dark.
  • Limit fluids in the evening to prevent their bladders from becoming too full. Of course, don’t dehydrate them and certainly give them access to fluids. But from dinner on less is best. Rather, have them get their fill during the day when they can show their skills with the potty.
  • Have them go potty 30 minutes before bedtime and then again right before lights go out.
  • Greet them first thing in the morning when they wake up and have then use the bathroom right away. Even if they have an accident overnight, this step will help them learn that we use the potty first thing in the morning.

Not seeing signs yet?

No stress!

Remember, it can take several years to gain bladder control overnight. If you want to start encouraging them to recognize overnight wetness, you may want to switch from overnight diapers to regular diapers, as they are less absorbent and may cause them to feel wetter.

Some parents also use a timer to wake their child up at night to go potty. For children under 5, this step is probably not necessary, as completing REM cycles is far more important for their development.

Again, give your child some grace and space and celebrate the wins when they do come. For example, having them use the potty right when they get up is a reason to celebrate, even if their diaper is soaked!

What To Do When You Do Become Concerned

If you do have concerns, certainly reach out to your pediatrician. You know your kid best, and if you think there is something else interfering with their ability to stay dry at night, it is important to address it. You do not need to wait until age 5 if you are concerned that something is amiss. Keep the lines of communication open.

However, if your child is getting closer to age 5, definitely bring up nighttime wetting (formally called enuresis) at your well-child check-ups or schedule a consult. Your pediatrician will have several questions for you, so it can help if you come prepared with the following information:

  • Keep notes of their bowel and bladder habits at home and bring them with you to the appointment. Make note of when they go to the bathroom (like time of day - be specific), and note the quantity and quality of their pee and poop. This can help your doctor rule out functional problems versus other complications (like urinary tract infections, etc.).
  • Record any accidents and note if there was anything they were doing, such as laughing or coughing (this may indicate trouble with muscle control)
  • Note any physical signs that may have changed or be unusual for your child. They may start to become more independent as they get older, but helping them with bathtime can give you a chance to note anything that may look out of the ordinary for your child.
  • Let them know if there have been any major stressors in their environment, such as at home or school.

Keep your pants on.

The full article is coming soon.

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