Dr Catherine
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2-4 years

I have 2 sons, 4 yrs and 2 yrs, have started night training with both and my 2 yr old is dry 99% of the time but my 4 yr old will wet the bed multiple times a night and will not wake up even though he is drenched and cold. I usually try to wake him up before I go to bed and again during the night but sometimes he still wets before/after these times. I try to stop him having anything to drink after 5:30 and he is in bed by 7:30 every night. Any advice or is it best if I put him back in nappies until he has dry nappies every night? (he does not want to be in nappies or pull ups at all)

Hi Bianca, the three most common causes of bedwetting include (1) an overproduction of urine overnight – children who have low-levels of ADH (antidiuretic hormone) produce four times the amount of urine as those who have the hormone and are therefore at a greater likelihood of exceeding their bladder capacity overnight (and explains why his bladder seems to keep filling). If this is the cause children generally stop wetting their bed when their ADH levels return to normal; (2) Difficulty arousing from sleep in response to a full-bladder – these children are unable to detect the signals sent from their bladder to their brain telling it it is full and needs emptying. These children will stop wetting when their body matures to a point where they can wake-up in response to their full bladder; and (3) a genetic disposition – children who wet the bed are more likely to have a family member who also wet the bed as a child. While I understand his reluctance to wear Pull-Ups, it is important that this is 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. It’s fine to reduce the amount he drinks in the evening although you need to let him drink if he is thirsty as failure to do so may lead to constipation, which will only contribute to his bedwetting. In the short-term make sure he drinks water regularly throughout the day, eats lots of fresh fruits and vegetables and limits fizzy drinks – particularly before bedtime. Take him to the toilet just before bedtime; making sure he fully empties his bladder. Try to avoid waking him throughout the night as this does not give his body the opportunity to either learn to store the urine he produces or become accustomed to the signs of a full-bladder and wake-up and go to the toilet. I would not be overly concerned given his age, however if you do find that his bedwetting begins to cause him (or you!) stress then it would certainly be time to consult with your GP. I do apologise for the delay in responding to you, unfortunately I have been ill for the past three weeks. Regards, Dr Cathrine