A GP’s guide to nighttime toilet training

Kinderling News & Features

Wouldn’t it be awesome if we could get daytime and nighttime toilet training down pat in one go? Alas, this is not often the case. 

Dr Elysia Thorton Benko is a GP at Bondi Road Doctors, and she shares some of the common issues that come along with nighttime toilet training, and hiccups that prevent nighttime toilet training from working. 

“The key is not embarrassing the child and helping to support them … and not getting cross,” Elysia says. “It never would be on purpose. They try their little hearts out with these things and we just have to keep it low-key and support them with it.” 

How can you tell if they’re ready?

A couple of signs that your child might be ready to give up nighttime nappies, is that they’re consistently waking up dry, and/or asking you frequently to stop wearing nappies. But Elysia cautions that this may not fully translate into immediate dryness, and it’s very important to support the child. 

“It’s about reading the child, observing them and supporting them and being aware that most children are dry at night by six to eight years, if not prior. Parents and caregivers whom have any concerns or questions should seek professional input and guidance,” she says. 

Don’t worry if they wait a while 

While it would be nice to get toilet training over and done with in one go, it can be better to wait a little longer to toilet train at night.

“Every child is different and you do have to be guided by them and listen to them,” Elysia says.

Elysia assures that you don’t need to worry until your child is six or seven. “Boys sometimes take a little bit longer than girls. Not always, but just putting that out there,” she says. 

Even then, there’s no cause for huge concern.

Listen to Elysia on Kinderling Conversation:

“If they are otherwise well, they're thriving, eating, drinking normally, there's no issues during the day - then six or seven that's probably time to look into it, in a very low-grade kind of way, because you don't want to obviously make the child feel uncomfortable and embarrassed about it,” Elysia explains. 

Do seek help if they’re old enough to toilet train at night but aren’t. It will just be a matter of raising it with your GP to rule out any potential issues. 

Do seek help if they revert

If you have toilet trained your child at night and suddenly they’re bedwetting, not as just a one-off, but as a consistent pattern, then you should have it checked out.

“It doesn't mean something terrible, it could just be a simple urinary tract infection but that's something that you go, no that's not okay,” Elysia advises. “There is a reason for this and you do need to go and see your GP for that.”

They would have to be dry for a consistent, prolonged period, so at least three months, if not six months.

So with these guidelines in mind, here are a few tips if dry nights are not yet the norm at your place.

Tips for nighttime toilet training

Make sure they are drinking plenty of water

‘What?’ You may be thinking. ‘I DON’T want them to wet the bed.’ But Elysia says you don’t want to have fluid restrictions on kids.

“Children who don't drink enough water during the day can actually have more issues. So, you want them to be drinking regular amounts of water throughout the day but certainly at night, not overdoing it and certainly not having caffeine or chocolate type of drinks at night time.” 

Notice their bowel movements

Elysia says that if a child is constipated it could hinder their ability to control their bladder. 

Know that deep sleepers can have trouble

If your child sleeps very deeply overnight, that can be a factor that results in fewer dry nights. Elysia’s own daughter is a deep sleeper that had this trouble. She was wetting the bed soon after falling asleep, while Elysia was still up. 

As a way to try to combat bedwetting, Elysia decided that before she went to bed, she would get her daughter up for a toilet trip.

While still quite asleep, she’d go to the bathroom, and there wouldn’t be any bedwetting issues. 

“I consistently did that for a number of weeks and then interestingly enough, her brain and bladder must have started talking to each other because then she would actually either stay dry and not get up, or around that time get herself up. That doesn't work for all children but it does work for some and it's worth considering for sure.” 

Medication

While Elysia isn’t a huge advocate for taking medication, when you’ve excluded any serious cause and are still having problems, there is the option of Desmopressin, which can be very effective. This is an anti-diuretic (diuretic meaning wee) hormone, which your body is supposed to produce naturally. 

Bedwetting alarms

Bedwetting alarms can help the situation, but Elysia recommends involving a GP initially, to help support and advise the most appropriate options in your circumstances. 

Another helpful resource is the Continence Foundation of Australia, check out their information on bedwetting alarms and medication on their website

Most important is that you support your child through it all, and seek help from your GP whenever you think there may be a problem.