Dr Catherine
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4-7 years

Trying to ascertain the best 'nappy' for my sons age. Unsure whether to keep him in a nappy or change to a nappy pant, pull up or dry nite. He sometimes floods a nappy so liquid capacity is a big factor. Thank you.

Dear Melissa,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. Leakage can result from improper fit, which can occur if your sons absorbent pants are too small or large. Check that they are fitting him properly around the leg. DryNites are best suited for managing nighttime wetting and are more appealing to older preschoolers and school-age children. Pull-Ups are designed for toilet training and therefore offer much lower levels of absorbency.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. 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