Dr Catherine
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Girl
4-7 years

My son is 4 and 1/2 he has started wetting the bed again im do want to put him in nappies or pull ups again im scared that he will not go bk to having dry nights again wha can I do. He has an alarm clock in his room set to go off after 11 but hes lazy and wont get outa bed he knows that its time to go when the alarm clock sounds but he wets the bed instead of going to the toilet.... HELP IN DESPERATE NEED OF HELP as I have a 20 month old who is still I nappies and I cant start with the potty till ive got my older boy trained at night

Dear Toni, managing children’s bedwetting can be incredibly tricky, partily because we often do not understand the underlying cause and partly because there are so many mixed messages out there about how best to proceed. It is often helpful to keep in mind nighttime wetting is mostly unconscious and therefore the kinds of techniques we used in training children during the day (like sticker charts and rewards) do not apply to the nighttime situation. Nighttime wetting at this age is considered to be perfectly normal, with about 15-20% of children continuing to wet at night up to the age of 7 years. As children move toward achieving nighttime continence it is quite common for them to waiver between periods where they are dry then they return to wetting. One of the best indicators that your son is moving toward achieving nighttime continence is an increase in the number of consecutive mornings where he wakes-up dry. While I understand your reluctance to put him back into DryNites, it is important that you do not see this as a backward step. DryNites are designed purely to help manage bedwetting and avoid the stress associated with dealing with constant wet sheets. With respect to treatment, by far the most effective means of treating children’s bedwetting is the conditioning alarm. Unfortunately strategies like setting a pre-emptive alarm like your describe in your question do very little to help children to stop wetting. Conditioning alarms are designed to wake-up your son when he begins to wet. The conditioning approach is based on the theory that by repetitively waking a child at the time of urination the child becomes conditioned into recognising that urination is about to occur. This method requires a great deal of commitment on behalf of the family, as parents need to take initial responsibility in ensuring their child wakes in response to the alarm. Treatment can take up to 6 months, with about a third of children experiencing relapse. I would also recommend having him assessed by your GP just to rule out any underlying physical cause. You can also use this opportunity to discuss more formal measures to help him to stop. Regards, Dr Cathrine