Dr Catherine
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4-7 years

My seven and a half year old daughter will wet the bed unless I get her up every hour from 7:30 till 10:30. Originally I had to wake her every hour till 12:30 but I have managed to bring it forward two hours and she still remain dry. We stop her drinking from 6:00pm with dinner. Some nights even after taking her to the toilet every hour she will still wet the bed. I would love some advice as it is frustrating to her and she gets upset. I want to help her and am concerned that my only option is the hospital.

Dear P.D., Managing children’s bedwetting can be incredibly tricky; partially 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 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. By far the most effective means of treating children’s bedwetting is the conditioning alarm. Unfortunately strategies like lifting at night and reducing fluids do very little to help children to stop wetting. Lifting at night means children do not get the chance to get used to the signals that the bladder sends to the brain telling them to wake-up and empty their bladder nor does the bladder have the opportunity to stretch and develop. Conditioning alarms are designed to wake-up your daughter when she 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. If this occurs you need to reintroduce the alarm, with most children being treated in a much shorter period of time. It is important to discuss this with your GP first as the more guidance you receive the better the outcomes. All the best! Please accept my apologies for the delay in responding; I have been unwell and unable to answer questions during this time. Regards, Dr Cathrine