Bed gets wet nearly each night although diaper is worn

Question

Our 5 (nearly 6) year old son has had problems with potty training for a long time now.

When he sleeps at night, he wears diapers, as he is not aware of peeing during the night yet and does not wake up in time. So far that's ok, we've contacted a specialised doctor and it seems to be normal that some children take longer until they learn how to control that.

The practical problem:

Even though he wears diapers (slip type, which he can put on by himself) in the night, it happens very often (sometimes daily) that the bed is really wet when he awakes in the morning.

My question:

• might it be the wrong diapers?
• can anything be wrong with how he puts on the diapers?
  (We've tought him to make sure that the penis does not point upwards and that seems not to be the case.)
• did anyone else have a similar problem and has a solution that worked for them?

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Remarks:

• we already try to reduce the amount of drinking during the evening meal
• we already send him to the toilet directly after the evening meal
  and a second time later before he really goes to bed. He sleeps about 11 hours.
• sure we use water-proof layers to protect the mattress, but exchanging and washing this layer and the fitted sheet nearly each day is quite a lot of work.
• waking him up in the night for going to the toilet is quite difficult. He normally sleeps very soundly and when I try to wake him up for going to toilet he is kind of confused and mostly angry/grumpy.
• he is sleeping in a loft bed which makes both waking him up or replacing sheets quite difficult

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Important addendum: Toilet training for the night and medical aspects

In case you're having the same problem, one more remark might be important:

For our problems with encopresis and enuresis, which do last for years already, we consulted a doctor, specialized in this topic and still are in regular contact with her.

Concerning bed wetting in the night (and not at all waking up before to go to the toilet) she said:

Children do have to develop the hormonal processes which make them wake up if they need to urinate during their sleep. Some do earlier, some do later, but you definitely can not "teach" them to wake up in the night! That's why a solution with a sensor in his pants which gives an alarm to wake him up will most probably not make sense yet.

Hormone therapy

The only working solution here at this stage would be a hormone therapy, which suppresses the production of urine during the night (if I am not mistaken) and therefore reduces the urge to urinate.

• That would be working instantly
• and could apparently also be used punctually, e. g. if the child is sleeping at a friend's house or at a school camp)
• but she would not recommend to use it permanently at this age (6) without urgent reasons (!)
• and we also do prefer washing bed sheets over feeding our child hormones to avoid that.

(So for the given reasons we did not try that medicament yet.)

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(EDIT) 2 years later

the situation has not changed. He is about 8.5 years now and still needs a diaper each night.
To avoid an "overload" of the diaper, we wake him up and send him to the toilet once per night between midnight and 2 AM. That way, we can avoid the bed getting wet regularly and reduces the laundry dramatically.
It is still difficult to wake him up, but he has become used to it and is cooperative most times (and only rarely reacts angrily).

And for sure he still goes to the bathroom again, directly before going to bed around 8 PM.

We could not find a fixed scheme, at which time in the night he urinates. Mostly, the diaper is still dry when we wake him up, but sometimes it is not. And mostly the diaper will then still be dry in the morning, but sometimes it isn't.
I think the composition of diner and what/how much he has drunk in the evening has a major effect.

Answer 1

Three ideas (one you might not like, but if it works...):

1. Make sure he goes to the bathroom just before bed. Did wonders for our daughter.
2. Try some higher-absorbency pullups. Since he's almost 6, maybe move to GoodNights or something similar for older kids with bladder control issues. You might just be overloading the capacity of the diaper.
3. If you can determine WHERE the leakage is coming from, attach a maxi pad (for menstruation) or a urinary incontinence pad to that part of the diaper, sticky side towards the diaper and absorbent side towards the skin. That will add some extra protection and hopefully help with leaks.

Also, for the fun part of cleaning the sheets and bed, we layered everything. Covered the mattress with a waterproof zipped liner, then placed a waterproof mattress pad on, then a waterproof liner, then fitted sheet, then top sheet & comforter. That way, when we have a leak, we only replace and wash the liner + sheets (and possibly comforter) rather than the mattress pad as well. And you can add additional layers of sheet + liner if you wanna just strip off the top soiled layer and have another beneath it to use.

Answer 2

My younger son struggled with night-time wetting until he was 14. In his younger years, we weren't too worried about it; I had several friends who assured me he would grow out of it. He was a VERY heavy sleeper, and even if I went in to wake him for a bathroom break in the middle of the night, he didn't really wake up. I actually stopped doing that after I watched him bounce off the walls walking to the bathroom one night.

So, we had "night-time undies" (Good Nights pull-up type) that he changed into at bedtime every night. We put a waterproof cover on his mattress and used an extra-large rubber mat over his bottom sheet. Taught him to change his own pajamas and wet linens, and (as he got older) how to put them in the washer ... all the practical clean-up stuff.

When he turned 11, though, he joined Boy Scouts ... and then the wetting was a problem. It's embarrassing and a real problem if you're on a camping trip with 20 of your peers and you wet your sleeping bag. And by the time you get that bag home, there's no keeping the secret, because it REEKS. Not to mention finding a discreet way to change into his night-time undies without his peers finding out about his problem.

So we went to his pediatrician and explained the problem. Here's what I learned:

• Boys have this problem more frequently and to a later age than girls.
• By age 18, apx. 3% of boys will still be night-wetting on a frequent or regular basis.
• If it lasts past the onset of puberty, it's likely to be a hormone issue. Especially in "late-bloomers."

The pediatrician prescribed desmopressin, and we had immediate improvement. He took the hormonal replacement supplement for three years, periodically taking a night or two off to see if he still needed it. With the onset of puberty at age 14, suddenly, he no longer needed it to stay dry at night.

Answer 3

At the request of the OP I have added this as an answer and deleted the comment. I would like offer an alternative to the maxi pad suggestion: try wool long underwear. I have a heavy wetter (not toilet trained yet, but still...) and I had the same laundry issue as you. And it isn't easy changing crib sheets either, so I feel your pain. Anyway, you can find wool "longies" online and they are the ONLY thing that has worked. You lanolize the wool and it acts as a water resistant barrier. (The wool will initially repel the water, but once the inside layer is saturated, the wool starts to absorb-up to 40% of its weight.) Plus, they just look like pants, and may give his self esteem a boost. I think a wool mattress pad may be a good idea too, and will further protect the sheets/bedding. It should go on top of the fitted sheet. Trust me, I was skeptical about the wool, but it has been a life saver! I used to face wet stinky diapers, covers, pajamas, sheets, blankets and mattress pads daily, and I've swapped all that for a dry baby and washing/lanolizing the wool every two weeks, and changing sheets once a week like normal people do. Try wool! IMHO, for every situation where a synthetic fabric fails, there is a natural fiber solution.

Answer 4

To @Valkyrie's excellent suggestions, I would add that mastering toileting is your child's "job," and at this age you might consider making him part of the clean-up process. If the sheets are wet in the morning, he has to help pull them, he helps wash them, he helps put them back on the bed. By making him responsible for these daytime activities, he may begin to internalize his night-time responsibilities. The more you take responsibility for his toileting, the longer it will take him to master it.

(Shame about the loft bed - that really makes it harder!)

Answer 5

Have 2 bedwetters a boy 9 and a girl 7, after much trial and error finally settled on terry cloth diapers and plastic pants on both of them. We have had no leaks since switching to them almost 2 years ago.

Answer 6

I, and my four kids, have all been wetting the bed until at least seven years of age. My answers are:

1. Quit worrying until he is eight or nine.
2. Get a REAL diaper (not a pull up).
3. Quit coming back to the same thing in almost every response. What I mean is you always say "a specialised doctor." That is not the right spelling, and it is called a urologist.
4. In reference to all of my previous answers, quit being so stubborn. You worry about a natural phase, you will not try to solve the problem in a practical way, and you only have one reason to reject people's answers.