Hi Michelle – Happy New Year to you too! It can be incredibly frustrating for parents when you feel you have done all the right things and your child continues to wet. Please be reassured, your daughter’s wetting has nothing to do with what you bave or haven’t done. As I am sure you are aware from your all your reading, nighttime wetting has a number of different underlying causes. Some children wet at night because their body produces more urine than their bladder can store, children who have low-levels of ADH (antidiuretic hormone) produce four times the amount of urine as those who have the hormone and are therefore at a greater likelihood of exceeding their bladder capacity overnight (which would explains why your daughter’s bladder seems to keep filling). If this is the cause children generally stop wetting their bed when their ADH levels return to normal. Other children wet because they experience difficulty arousing from sleep in response to a full-bladder – these children are unable to detect the signals sent from their baldder to their brain telling it it is full and needs emptying. These children will stop wetting when their body matures to a point where they can wake-up in response to their full bladder. Given the amount and frequency of her wetting it would probably be worthwhile just having her bladder capacity assessed by your GP to see if this is a contributing factor. With respect to the nighttime waking, this is typically seen as a practical approach to managing children’s bedwetting in the short-term only but does little to help them to become dry on their own. Lifting at night means children do not get the chance to get used to the signals that the bladder sends to the brain telling them to wake-up and empty their bladder nor does the bladder have the opportunity to stretch and develop. The disrupted sleep patterns can also result in overtiredness making it even more difficult for her to wake on her own in response to a full bladder. It can also result in her bladder becoming conditioned into needing to empty each night, so if you do want to continue this way you should vary the times that you wake her. While many children do outgrow bedwetting on their own, others benefit from more formal interventions. Given her embarrassment and the fact that she is reluctanct to wear aborbent pants I would think about looking into introducing a bedwetting alarm – while this is not typically recommended until children are around 7 or 8 years of age – I think in this instance it would be worthwhile introducing it sooner.

Regards,
Dr Cathrine

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