Night Time Dryness After Toilet Training a Disabled Child
World Bedwetting Day with the theme Time to Take Action takes place today on 29th May and is designed to raise awareness of bedwetting.
Toilet training is a challenge for many families and even more so if a child has disabilities. Once daytime toileting has been mastered not all children naturally become dry at night. It is not possible to teach a child to be dry at night in the same way that we teach them during the day.
Bedwetting or ‘enuresis’ (the medical term for wetting during sleep) is one of the most common medical conditions in children. Because a child has a disability does not mean they cannot have enuresis. Most children who have delayed toilet training will be dry at night about six months after they have learnt to be dry in the day. If your child is over five years old and is dry or mostly dry in the day, but still wet at night then, treatment is available.
Most children sleep all night without needing to wake up to wee. Bedwetting is caused by a child not waking up when the bladder signals that it is full. However, children who wet the bed also have a problem with one of the following:
- The bladder is not big enough to hold all the wee their kidneys make while they are asleep
- The bladder gets ‘twitchy’ and empties before it is full
- The child is not making enough of a special chemical messenger called vasopressin. Vasopressin tells the kidneys to make less wee at night. If there is not enough vasopressin, the kidneys make more wee at night than the bladder can hold and if the child does not wake up when the bladder is full, they will get a wet bed.
Things you can try to help stop the bedwetting
Encourage your child to drink plenty of water-based drinks during the day, about 1.5 litres is right for most school aged children. Try to avoid giving your child tea, coffee, hot chocolate, cola and energy drinks as these contain caffeine, which can make wetting worse. Fizzy drinks can irritate the bladder so should also be avoided.
Try to make sure your child is not constipated. If the bowel is full of poo, this can upset the bladder and cause bedwetting or make it worse. If you are worried that your child might be constipated, speak to their doctor or nurse.
Try not to give your child a drink or any food in the last hour before bed. The kidneys make more wee after a drink or food, particularly food that has a lot of salt or protein in it, so having these before bed can increase the likelihood of wetting.
Make sure your child has a wee just before they settle for sleep. Try to have the same bedtime routines every night, avoid light in the bedroom and try not to let them use electronic devices just before bed.
What if these things don’t work?
If you have tried to do the things suggested above, or if your child cannot manage them and the bedwetting is still happening, then you should speak to their GP, practice nurse or school nurse about assessment and treatment for bedwetting. Some areas have special clinics for children that wet the bed or have other continence problems. There are several treatments available and these should be discussed with you.
Things to remember
- Bedwetting is not your child’s fault
- Bedwetting does not happen because of anything you or your child has done or are doing
- Children with disabilities can be offered assessment and treatment for bedwetting
- There is help and support available
Where to find more information:
- Your child’s doctor or nurse
- The following websites:
Bladder and Bowel UK also have a confidential helpline at firstname.lastname@example.org or at Tel: 0161 607 8219