Tired of waiting for your child to outgrow bedwetting or daytime accidents?


Get your child on the path to dryness with the

4th Edition of the M.O.P. Anthology! New guidelines, charts, tools, and stories!

Featured Posts
Recent Posts
  • By Steve Hodges, M.D.

Nighttime Potty Training Is Not a Thing


The world is full of products and strategies available to help your child potty train at night. This would be good news for families, except for this: nighttime “potty training” is not a thing!

You cannot “train” your child to achieve dryness overnight any more than you can — or should — train your baby to crawl or train your toddler to walk.

Overnight dryness happens naturally, typically by age 4. If it doesn’t happen, this likely means your child is constipated — that the child’s stool-stuffed rectum is pressing against and aggravating the bladder, making it impossible for the child to stay dry overnight.

You can stop the bedwetting by resolving the underlying constipation, but you can’t otherwise fast-forward to the day your child wakes up dry for good.

Yet plenty of product manufacturers and potty-training “experts” push the false concept of nighttime potty training. The underlying message is: If you don’t act, you will fail your child (or fail everyone on earth by clogging landfills with your child’s used diapers).

A company called Peejamas recently met its Kickstarter goal, raising over $17,000 for a line of highly absorbable pajamas billed as “the first PJs ever created to help your child potty train faster.”

According to the company’s Kickstarter page, “Diapers are a crutch that only delay a child's ability to potty train at night,” and “by removing the false confidence that a diaper provides, the speed at which your child should become potty-trained increases exponentially.”

The page continues:

Based on our super scientific research :), we strongly believe that when a child uses a diaper, they are more prone to use it. We've found that beta testing children using Peejamas learned to hold their urine at night much more quickly.

As the company seems to concede with its smile emoji, “super scientific research :)” is not the same as actual scientific research. But campaigns like this, well-meaning as they may be, nonetheless reinforce the myth that parents can speed up overnight dryness.

The Peejamas folks are hardly the only ones perpetuating this myth. When I binge-read 14 potty-training books, I founds loads of “advice” regarding nighttime dryness.

One author tells parents: “It needs to be decided whether you’re going to just focus on daytime training or try to take your child out of diapers at night as well.”

Another writes that “becoming dry at night requires a devoted effort on your part. Don’t shirk your parental responsibilities at this final hurdle!”

In reality, you have no responsibilities here! There’s no “effort” or “decision” to make.

Three “Nighttime Potty Training” Strategies Doomed to Fail

Proponents of “nighttime potty training” tend to espouse any of three strategies:

1.) avoid diapers so your child feels wetness

2.) limit your child's fluids before bed

3.) wake your child overnight to pee

The makers of Peejamas seem to subscribe to the first strategy. Their website states: “By not wearing a diaper, children who use Peejamas don't have that known safety net to rely on. . . By removing the false confidence that a diaper provides, the speed at which your child should become potty-trained increases exponentially.”

One book author makes a similar argument, maintaining that today’s pull-ups are too good at “wicking”; kids don’t feel the wetness, the theory goes, so they pee overnight when they otherwise wouldn’t. She attributes bedwetting after age 4 to “aggressive marketing on the part of the big diaper companies.”

In reality, when kids over age 4 wet the bed, it has nothing to do with what they’re wearing on their bottoms.

It’s because their stool-stuffed rectum is encroaching upon the bladder. The mass of hardened stool often stretches the rectum to twice its diameter. You can see this on X-rays. As the mom of one of my patients put it: “Until you actually look at the film, it’s hard to understand. I was blown away. My son was so stuffed with poop that his bladder was basically flattened. I could totally see why pee could not stay in there all night.”

READ: When to X-ray Your Child for Constipation

READ: Want to Fix Your Child’s Bedwetting? Avoid These 5 Mistakes

Not only does the stool-stuffed rectum invade the bladder’s space, shrinking its capacity, but it also aggravates the bladder nerves so that the bladder senses it’s full even when it’s not. Overnight, the hyperactive bladder may suddenly hiccup and empty without warning. The child has no chance of waking up and dashing to the bathroom on time.

OK, let’s move on to strategy #2 for “nighttime” training: limiting fluids. One author even suggests buying “tiny cups, sake cups, mini teacups” to trick your child into thinking they are drinking a lot!

Fact is, a child who is not constipated and has a healthy, stable bladder will easily make it through the night without getting up to pee, even if he does drink a glass of water right before bed. Yes, a child who guzzles a gallon of water minutes before hitting the pillow may well need to pee overnight, but withholding fluids after dinnertime is not a winning strategy.

Neither is the overnight wake-up approach. One author advises starting with two overnight wake-ups and then “once you figure out approximately when your child is typically peeing at night, you can cut down to just one waking.”

Another author writes: “Set your cell phone alarm, have the potty chair right next to the child’s bed . . . hold her up and whisper for her to pee, make a shshhing noise in the kid’s ear.”

My advice: don’t bother!

Most parents of bedwetting children try this approach at some point — after all, it seems logical. Some haul their child the toilet around 11 p.m. or midnight, before they themselves go to bed. But no matter how often you do this, you’ll rarely time it correctly. And even if you’re able to keep your child dry overnight using this technique, you haven’t really solved anything except possibly a laundry problem. You’ve simply adapted your child’s sleeping patterns to her poor bladder capacity. It’s a mug’s game (one of my favorite British expressions, meaning “a futile endeavor”).

Proponents of “nighttime potty training” suggest that if you fail to heed their advice, you’re doomed. As one author writes: “Once a child is past the age of four, night training becomes near impossible.”

Of course, night training is impossible at any age, because as a concept it doesn’t exist. But the larger message — that you had better fulfill your parental duty asap or else — is the last thing parents need to hear!

Parents are often blamed for their child’s bedwetting, as I write in “Constipation, Not Slacker Parenting, Causes Potty Accidents.” But when it comes to potty training, slacker parenting is actually the way to go.

Follow Us
  • Facebook Basic Square
  • Twitter Basic Square
  • Google+ Basic Square
Search By Tags
Archive

Must-read books for kids by Steve Hodges, M.D.

• Bedwetting and Accidents Aren't Your Fault

• Jane and the Giant Poop

CONTACT​ US

Feel free to contact Dr. Hodges or Suzanne directly:
shodges@wakehealth.edu
suzanne@bedwettingandaccidents.com

  • Facebook Social Icon

“We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn fees by linking to Amazon.com and affiliated sites.”