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Bed-Time

A regular bed-time routine is always beneficial.

Basic rules

• ensure the child is getting enough sleep,
• ensure the bladder is completely empty before they go to sleep,
• ensure your child is awake if taken to the toilet in the night,
• encourage your child to be part of the process of getting dry,
• ensure easy access to the toilet.

Sleep Duration

Disturbed sleep has not been shown to be the cause of night-time wetting. However ensuring an adequate duration of sleep is extremely important in improving daytime concentration and studies have linked a lack of sleep to poor behaviour.

A child who has had sufficient sleep will normally wake spontaneously in the morning and not require significant stimulation to wake. If this is not the case the bed-time should be moved earlier, in 30 minute steps, until the child wakes easily in the morning.

Double micturition

Micturition means to pass urine (urinate, pee, void, wee wee). There is more chance of a dry night if the bladder is completely emptied before bed. Unfortunately in the rush at bed-time, emptying the bladder is often not complete. We suggest when your child starts to get ready for bed they go to the toilet. Then immediately before they get into bed they should go to the toilet again. If there is a significant volume on the second micturition then they should continue this practice. However if they cannot micturate the second time they can discontinue it.

Lifting

Many families ‘lift’ their child at night. Usually when the parent goes to bed, they take the child to the toilet to empty their bladder. Most children can micturate without actually waking. This however is encouraging bed-wetting whilst asleep. We have no objection to this practice as long as the child is woken prior to micturating.

Cleaning-up

Your child needs to be engaged in the process of trying to get dry at night. We therefore recommend that there is a clear plan for the child to help cleaning after an accident. This is not a punishment, but an acceptance that the problem will not be solved without the family working together, as a team, and for the child to accept that they must engage in the process too.

Nappies or ‘pull-ups’

Many centres advise avoiding the use of nappies or ‘pull-ups’; however there is no evidence that the use of nappies or pull-ups is detrimental. We are therefore happy for these to be used if needed.

Access to the toilet

There should be easy access to the toilet during the night. A torch or night light may be helpful. If sleeping in bunk beds, the bottom bunk is preferable. If access to the toilet is difficult then the use of a ‘potty’ may be required.