When should my child be dry at night?

Written by Claire Burgess, Family Consultant

The important thing to remember is that under the age of 5 it is completely normal for some children not to be dry through the night. Try not to worry about night-time dryness — for most children this will develop by the time they are 5. However, if you are at all concerned then you should visit your GP to discuss.

Looking at the stats, around 20% of 4–5-year-olds and 10% of 7-year-olds still wet through the night. Bedwetting also runs in families — if one parent wet the bed as a child, there’s about a 40% chance that your child will too, and if both parents did, it’s around 70% (Source: ERIC — The Children’s Bowel & Bladder Charity). But it’s no one’s fault.

Why night-time wetting happens

Over the age of 5 there can be a number of reasons for night-time wetting (nocturnal enuresis), which is defined as wetting twice a week or more for three consecutive months or more.

These can be one or more of the following:

Sleep arousal — some children are very deep sleepers and are not able to wake when their bladder is full. This is completely normal and tends to improve as their sleep patterns mature and their brain becomes more responsive to signals from the bladder.

Vasopressin levels — to achieve night-time dryness, your little one’s brain needs to release enough of the hormone vasopressin. Vasopressin acts on the kidneys to control urine production overnight. If your child has low levels of vasopressin this can lead to them passing a lot of urine through the night. This is often 3–4 hours after going to sleep and can see them soaking their pyjamas, bedding etc.

Under the age of 5 this is not something to be concerned about (and it’s absolutely fine to keep them in pull-ups or night-time nappies), but over the age of 5 this might need to be looked at with a GP as it can be supported with medication. Some GPs will recommend waiting until your child is closer to 7 before doing anything, as it can take longer for some children for the hormone release to trigger strongly enough to stop the night-time wetting.

An overactive bladder — if your child has an urgency to get to the toilet during the day and then only passes small amounts of wee, this can be a sign of an overactive bladder. If they frequently go for a wee during the day (4–7 times during the day is considered normal and 8 times or more would be considered frequent), it can mean that the bladder is also overactive at night — this is when you may find that they are continuing to pass small amounts of wee throughout the night.

Constipation — this can also be a factor in night-time wetting, as a full bowel can press against the bladder, causing both day-time accidents and night-time wetting. We have a blog all about constipation and what you can do to help — you can read it here.

Sleep quality and breathing — sometimes, disturbed sleep can make it harder for children to stay dry. Children who snore, mouth-breathe, or have enlarged tonsils or adenoids may not be getting the deep, restorative sleep their body needs. These issues can cause small breathing pauses (or even mild sleep apnoea), which interrupt the brain’s ability to respond to bladder signals during the night.

If you notice your child snores loudly, breathes through their mouth, or seems unusually tired in the morning, it’s worth mentioning this to your GP. Supporting better sleep and clearer airways can sometimes make a real difference to night-time dryness too.

What not to do

Lifting your little one to do a ‘dream wee’ might seem like the way to get a dry night, but unfortunately what this does is confuse the signals from the bladder to the brain.

The bladder is a muscle which needs to fill and release, and it does this by sending a signal to the brain when it needs to empty. If the brain is not getting this signal (because the bladder has emptied without telling the brain while the child was lifted to wee in their sleep), the brain thinks that the bladder isn’t filling and so there’s no need to wake up. The bladder then doesn’t send the signals in the same way, as it hasn’t reached the ‘full’ stage before being emptied.

In short, this is not something that’s advised and it won’t help your child develop their night-time dryness in the long term.

What you can do to help

Allowing your little one to wear a nappy or pull-ups at night until they are dry won’t have any impact on potty training in the day (but it will make your life a lot easier!). As soon as your child has been dry through the night on a number of consecutive occasions (waking up with a dry nappy and then using or asking to use the toilet on waking), you can gently suggest that they sleep without a nappy or pull-ups and support them if they have any accidents (it’s always good to have spare sheets close to hand just in case!).

Things you can do to help with night-time dryness (whatever age):

• Make sure that drinks are given throughout the day so the bladder learns to fill and empty properly.

• Avoid drinks for 1 hour before bedtime (but don’t restrict fluids during the rest of the day).

• Make sure that your child isn’t drinking all of their fluids in the morning or at the end of the day — they need to be spaced out and regular throughout the day. Children should drink between 6–8 cups (preferably of water) per day.

• Avoid the following drinks where possible as they can irritate the bladder:

• Fizzy drinks

• Fizzy water

• Citrus fruit juices such as grapefruit, lemon, pineapple, and orange

• Blackcurrant or red berry juices or squash

• Drinks containing aspartame and saccharin

• Incorporate into your bedtime routine that the last thing your child does before switching off the lights is to go for their last wee of the night.

• As mentioned above, make sure your child isn’t constipated as this can impact night-time dryness.

• If your child snores, mouth-breathes, or seems to have disturbed sleep, mention this to your GP — sometimes small airway or sleep adjustments can really help.

 ERIC - The Children’s Bowel & Bladder Charity, have a great ‘Guide to Night Time Wetting’ with loads more information, which you can read here. 

If you want more information about potty / toilet training have a look at our other Toilet Training blogs or download our step by step video guide.  

Don’t forget that we also offer parent consultations should you need support with anything from potty training, sleep to behaviour and so much more! Details of the packages we offer can be found here.

We also have a podcast with lots of episodes about toilet training - ‘Newborn to Teen and Everything in Between’ - listen here.