Keeping the bed dry at night requires a large enough bladder to hold the urine that is made
during the night and the ability to awaken from sleep to go to the bathroom, if needed. The
age at which the child has these abilities varies. Later ages to keeping the bed dry run in
families. If the child was dry at night for at least 6 months but is now wetting at night it is
usually from some stress. This stress should be addressed. If there has not been any big
stress or change it is important to check for a urine infection or diabetes with a urine test.
Most children can keep the bed dry all night by age 7 years old. If the child is wetting every
night it is probably too soon to try to train them to be dry. Instead, protecting the mattress
with a pad and possibly using pull on style paper pants at night is the best plan. When the
child starts having some dry nights each week it is possible to speed up the process. The
method with the best evidence is the use of an alarm that goes off when the child starts to
wet. The way this works is that the child is awakened at the first drop of urine and learns to
recognize when their bladder is full. The child should then get up, use the toilet, put a towel
over the wet spot on the bed, reset the alarm and return to sleep. This may require an adult
at first to be sure the child wakes up and follows those steps. No punishments should be
given, instead a reward for a dry night is a good idea. What gradually happens over a couple
of months is that the child learns to stop the urine when their bladder is full, or wake up and
use the toilet. When the child has a dry bed every night for one week she or he should then
be given extra to drink at night. This pushes the child to work harder to stay dry and makes
the dry bed training more effective. When the child has had a dry bed for two weeks the
alarm can be removed. The majority of children then continue to be dry using this plan.
