Potty Training 6 and Up
Parent Q&A
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7yo still in nighttime pullups
–Sep 24, 2024My 7yo son is still in nighttime pullups. He has been fully daytime potty-trained since 3.5yo. We knew nighttime training was a separate issue with him, and by 5yo, his pediatrician mentioned that it wasn't uncommon for boys his age to still be in pull-ups, so we didn't worry too much. By 6yo, the pediatrician recommended we just dive right in and try to train again. We doubled up on sheets, put him in underwear, limited his evening fluid intake, woke him up to go pee when we were going to bed, and he was never really able to stay consistently. I had used the Clean Kids Manual with great success for my other (younger) son for encopresis, and now I followed the strategies for bedwetting for my older son by using the bedwetting alarm and keeping a journal. We gave it a good honest 6 months of this, and we could still never get past 3 days of being dry, plus he also started just sleeping through the alarm. We even got him checked by the lab to see if he was concentrating his urine. We decided to give it a rest for another 6 months, but now I'm getting anxious again. He doesn't want to wear the bedwetting alarm, and between sports and schoolwork, he is so tired all the time. We are also tired of the nighttime wakings to take him to pee, plus he's bigger now so harder to drag him out. Any suggestions?
Sep 24, 20246yr old with persistent potty issues
–Jan 31, 2021Hi BPN,
So we have been struggling with our 6+yr old’s potty issues for years. We have the pee issue mostly ok, but have never gotten a handle on the poop front. We have seen a long list of providers over the years including various psychologists, a gastroenterologist, a potty consultant and a biofeedback specialist. Though we have gotten a diagnosis of encopresis, no “treatment” regimen has had any helpful effect and we remain very lost on both the physiological and the psychological aspects. Now that our child is in elementary school, this issue is really having a major effect on quality of life (both our child’s and ours). Has anyone gone through this, what eventually helped, and what type of providers helped with the diagnosis or the solution?
Feeling Stressed and Desperate
Jan 31, 2021
Archived Q&A and Reviews
The pages below each contain multiple discussions about kids 6 and older.
When my kid was going through a similar thing, her pediatrician explained that some kids’ kidneys are just sower to develop in the way that allows them to hold their urine all night. Because our doctor wasn’t worried about it from a medics standpoint, it helped us put it into perspective. So, in the interest of all of our sanities, we just kept her in pull ups until her body was ready. And she got there! It took until she was 11, to be honest, but I do not regret ditching the alarm, etc. Why not give it a rest for a while and put him back in pull ups and let his body have some more time to figure it out.
Hi! Our son was almost 7.5 before he could consistently stay dry overnight. He is a really active kid and a really deep sleeper. We kept him in pull-ups and tried not to stress. One morning we realized his pull-ups had been dry every day for a week, and that was that. Of course keep in touch with your pediatrician, but if you’re looking for encouragement that it’ll possibly just work itself out, I hope this post helps a little.
So hard! I've heard that it can just take time. Will he wear the pull ups? If it were me, I'd just sorta leave it with that and once he was consistently dry using pull ups, then start again. Sounds exhausting for something he will 100% eventually grow out of at some point. My son wore pull ups until sometime in his 5th year and my daughter was waking up dry as an infant. It's just how they're built but I know that doesn't make it easier. Good luck! Remember: He will not need pull ups for forever.
I honestly think some kids (boys, mostly!) just take longer. My son wasn't fully dry every night until right around his 7th birthday. Just make sure that he's not constipated (it sounds like you're already aware of the connection between constipation and nocturnal enuresis). Even children who poop every day can have a big stool burden (they're just doing "choo-choo-train" poops) so maybe try a weekend clean-out with Miralax? Other than that I don't have too many suggestions, just support! It's hard. Maybe take another 3-6 month break before trying again, since you're all tired and a bit stressed by it.
I wish I hadn’t worried. For our son it just took a long long time. In 5th grade spring he used the rx to prevent overnight pee at camp. He was very excited that that worked (very small dose also). It gave him more options to feel comfortable doing overnights.
in hindsight, offering him rewards for staying dry overnight, created an unnecessary pressure to achieve something that his body could not yet achieve. He’s a very very deep sleeper. He’s in college now and there are no problems. I know it is so hard to know when to worry. With respect to this issue, I wish I hadn’t so much. You’re a good momma.
We used guided imagery with Dr. Cantwell in San Francisco and had success with two different kids -- my son (a deep sleeper) was 8 when we did it, and my daughter was younger (maybe 6?). If you're son is motivated, it could work for him.
Before we did that with my son, we pulled out the lining from one pull-up and put it in another pull-up -- otherwise we'd be dealing with leaks. We still did a lot of laundry before we had success with guided imagery.
I could have written this... My son was also fully potty trained around 3.5 y.o., and we thought night time was not far behind. But months came and went, we tried most of what you mentioned, and nothing was working and it was making our kid sad/embarrassed/tired/grumpy, and me frustrated with all the laundry. We would stop trying and let him wear night time diapers and regroup and try again a few months later, but it was always the same. He is now approaching 9, and almost able to stay dry overnight, but not consistently. It also doesn't help that most of his water intake happens in the early evenings due to sports practice.
With all that said... Here is what we're doing now which we think is helping nudge him in the right direction.
He does something that we call a "double pee" - so during dinner or shortly after, we remind him to go pee, even if he doesn't feel like it. And then after dinner it's brush teeth and bed, and he pees again, even if he doesn't feel like it. So a double pee gets as much out as we can. If it's a long tuck-in by me or my partner, if we chat and hang out for more than 5 or 10 minutes, then he has to get up and pee one more time, even if he's all tucked and comfy. He used to resist the double and triple peeing because he'll say 'but I already peed!" but now he doesn't argue and it seems to help out.
We also never say 'you wet the bed' or anything that makes it seem like it's his fault. We always say 'the diaper leaked' which puts the blame on the diaper and thus doesn't make our son feel bad.
Lastly, we used to have waterproof pads that were only good for one accident and then need to be washed. But now we use the Guinea Dad cage liners. Not sure if I can link it, but you can google it yourself. It's a super soft waterproofing pad meant for guinea pig cages, and it can soak up A LOT of pee and not stink and stay relatively dry on top, so we use that on his bed and so when there are accidents he doesn't end up sleeping in a wet puddle.
My daughter had the same issue. Our pediatrician told us that it usually resolves on its own by around age 7, so we just kept her in the pull-ups overnight, and that's what happened - like magic, sometime when she was 7 she just stayed dry and never went back. Of course we were always limiting her nighttime drinks just to help the situation, but I guess it really didn't make much difference. She was and is a deep sleeper.
Just let it go. Two of my 3 kids weren't dry overnight until they were around 10 or 11, and the third was dry immediately upon potty training at 2 1/2. Yours will get there eventually - some kids just take a lot longer than others. Why make it stressful? At some point he'll be really self-motivated due to sleepovers, etc., and hopefully his body will be ready by then. It's great that big pull-ups exist. When his pull-ups are always dry you'll be done, and you'll wonder why you ever worried about it.
My son is almost 8 and struggles with this as well so you are not alone!
You could try Peejamas. The logic makes sense to me - the product is designed to contain the pee, but not wick it away, so the child does feel wet and can (hopefully) wake up mid-pee, stop peeing, and go to the bathroom to finish the pee, and then eventually wake up before the peeing starts. You could also try putting a "potty" (? bucket) in his room to make it easier to pee if he does wake up in the night (versus leaving his room to go to the bathroom).
It sounds like he has a lot going on (schoolwork and sports), maybe also worth thinking about what time he gets to bed and if he has the opportunity for enough restorative sleep most nights.
It just takes time! My child was fully toilet trained at 3.5, but wore Ninjama nighttime underwear (basically pull-ups) until age 11-12. Pediatrician said not to worry, and now there is no problem and she can do sleepovers, etc.
This is probably unlikely, but is there any chance your son could have sleep apnea? One of the signs of sleep apnea (OSA Obstructive Sleep Apnea) is bed-wetting or noticing excessive urine accumulating in diapers. The reason for this - and I'll just copy & paste - is "OSA repeatedly reduces airflow and oxygen levels during sleep and influences hormones in a way that increases urine production."
The signs of sleep apnea for us was an excessively full diaper in the morning, loud snoring, sleeping in odd positions such as our son slept with his head bent back at the neck almost at a 90 degree - this was his bodies way of trying to open the air passage to get enough oxygen (because when you sleep your muscles relax so while a child may be able to breath fine during the day, when asleep the problem becomes more acute). Our son was also a subtle mouth breather - and this too can cause problems with teeth & face shape that you want to avoid.
Once our son had his adenoids removed, which had caused his breathing difficulties, then all of those problems were immediately resolved. He also grew like 1.5 inches within a month and this too is a common result because sleep apnea interferes with growth, once the body gets enough oxygen at night, they sprout up. Anyway just a thought.