Dr. Cathryn Tobin explains why nighttime potty training before age 5 or 6 backfires. Bedwetting is biological, not behavioral, caused by insufficient antidiuretic hormone, small bladder, or constipation. Waking kids for bathroom trips creates tension and sleep disruption, as shown when one toddler became aggressive at preschool. Use pull-ups at night and wait until your child stays dry naturally for 1-2 weeks.
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Liberty, liberty, liberty, liberty. Welcome to Toddlers Made Easy. I'm Dr. Cathryn Tobin, your host, and today we're going to be talking about nighttime potty training. Imagine 2.5-year-old Mia. Who's mastered daytime potty training with great enthusiasm, and she had very few setbacks. She's proudly using the toilet during her busy, playful days, rarely needing reminders. However, nighttime tells a different story. Despite her daytime success, Mia often wakes up to a wet bed. Now her mom has tried limiting fluids before bedtime, and her dad lifts her out of bed and takes her to the bathroom around midnight for a dream pee. But Mia's preschool teacher has started to complain to the parents that Mia just doesn't seem herself. She started hitting her friends when she's upset, which is completely out of character. Now, her mom and dad weren't making any association at this point with what was happening at nighttime. Mia's mom called me as she wasn't sure what she should try next. And after chatting with Mia's mom, I decided to create today's podcast which is focused on this concept of nighttime potty training. Actually, this is really more of a tale of how nighttime potty training hurts everyone's sleep for several good reasons. So let's step back for a moment and consider Mia's experience. In the daytime while she's busy playing, she gets an urge to go pee and she's easily able to recognize this feeling and she even knows how long she can delay before making a trip to the bathroom. But at nighttime, the situation is completely different. Mia isn't able to recognize that "I need to go pee" feeling because she's sound asleep. In fact, she's such a deep sleeper that Mia's parents often say that a thunderstorm could roar through her bedroom and she wouldn't stir an inch. By age 5 or 6, 85% of kids will be dry overnight, In fact, 20% of 5-year-olds and 10% of 7-year-olds still wet the bed, according to the Academy of Pediatrics. At nighttime, our body has a hormone that helps keep us dry called DDAVP. A younger child may not have enough of this hormone to keep him or her dry till morning. Plus, a young child often has a small bladder, which can make overnight dryness less likely. And you know, there's one last factor that actually is a huge contributor to nighttime wetting, and that's constipation. Imagine an already small bladder now further impeded by poop in the bowel taking up some of that precious real estate space needed to store urine overnight. So let's get to the point here. Young children wet the bed and it's not their fault. It's biology. The bladder isn't big enough yet to hold a night's worth of pee. So wait for your child to be dry for 1 to 2 weeks before trying undies at bedtime. This typically happens first at nap time, then at bedtime. So think of this as one of those things you don't need to worry about and just let nature do its thing. And otherwise, Forget about nighttime potty training. Nighttime training typically does nothing. You can see how that would be because it's about an anatomic problem of a small bladder or a low hormone. And typically nighttime training, it really does nothing but create tension and disturb everyone's precious sleep. Now let's circle back to Mia for a moment. When her dad stopped waking her in the night, For that dream pee, she got a better night's rest and the behavioral concerns at daycare fizzled away. A child also needs enough of the nighttime dryness hormone and a large enough bladder to remain dry overnight, as I mentioned earlier. So as I told Mia's mom, I'd just use a diaper or a pull-up, give it a cute name like nighttime undies, and let your child know that at nap time or bedtime, they don't need to use the potty. Most children are dry by 5 years of age, but daytime dryness tends to precede nighttime. Bedtime wetting, again, it's caused by those several issues we've discussed. So now that you know the reason for bedtime wetting, let's talk about when is bedtime wetting a problem. In other words, when should you talk with your healthcare provider? If a child is still wetting after age 5, which is the age where we expect a bigger bladder, more of that DDAVP hormone, then it's time to chat with your healthcare provider. If your child starts to wet after being dry for months, and that's at any age, please chat with your healthcare provider. If there's pain with peeing, unusual thirst, pink or red urine, hard stools, hard poops, or snoring. These are all reasons to have a chat with your healthcare provider. When a child comes to me who is still bedwetting by age 5, I want to know a few things. Has the child had an extended period of dryness and now all of a sudden is wetting, which means this is a new problem, or is this an ongoing situation? In other words, an old problem. Now I'm going to spare you all the steps and considerations about what might be going on, And let's get back to the focus here, which is really about sleep. Forget about nighttime potty training. Just let nature do its thing and the whole family will get a better night's rest. So thank you for listening. Before we go, I want to share a little news with you. I've launched a new venture to empower moms with businesses or those even thinking of starting one. It's called Insta Made Easy. and I offer targeted strategies to boost your Instagram presence so you can focus more on what truly matters, and that's spending quality time with your kids. I also want to help you increase your income and enjoy more freedom, and the place to begin with all of that is Instagram. Join us at Insta_Made_Easy and start transforming your passion into a thriving business. Now don't worry, I'm as committed as ever to Toddlers Made Easy. In fact, my book is coming out in the next few months and you'll be the first to know when it's available. So have a great week everyone and happy parenting. We'll see you next week.
