Dr Catherine
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4-7 years

My almost 6 year old girl still wears a nappy at night and it is wet 99% of the time. Toilet training was a nightmare with her, she would have frequent accidents and jsut didn't seem to care if they were clean or dirty pants. I wonder if she is waking and doing wees on waking or if she is weeing in the night too. We have started a sticker chart for 'get up, go wees' but that hasn't encouraged her either. I think she might just be lazy but don't want to make a huge deal of it in case there is more to it. Would an alarm system work in this case?

Dear Nicola, it is perfectly normal for your daughter to still be wetting the bed at night with at least 1 in 7 6-year-olds continuing to wet the bed on a regular basis. The most common cause of nighttime wetting is a neurological-developmental delay. Young children whose nervous systems are still forming may not be able to know when their bladder is full. Consequently, they do not wake up in time to go to the toilet. Other children wet the bed because they produce double the amount of urine overnight, while others may do so due to a small bladder capacity. The most important thing to recognize about bedwetting is that it is uncontrolled – that is, children wet when they are asleep, which is why things like punishment or incentives have little effect. The majority of children your daughter's age will outgrow bedwetting on their own without the need for treatment. You can encourage a healthy bladder by making sure she drinks plenty of water throughout the day, eats lots of fresh fruits and vegetables and limits fizzy drinks – particularly before bedtime. While treatment is not typically recommended until children reach the age of 7 years, if bedwetting impacts on children’s emotional wellbeing or has reached a point where you're struggling to cope then it is time to consider treatment options. The first step is to consult with your local GP – they will most likely run some tests first to ensure there is no underlying physical cause following this she can start on a treatment program. All the best!Kind Regards,Dr Cathrine