kids, parenting, parents, Pediatrics, pelvic health, physical therapy, postpartum, potty training

LIFE IS A HIGHWAY…and bedtime’s a bumpy road

The brilliant Whitney (pediatric pelvic health physical therapist) writes again to tell us about how to kick the nighttime potty training nightmares to the curb! 

Go to Sleep Little Baby

For many parents, the word “bedtime” is (let’s face it) an exciting one! After running on high throttle all day at work, coming home and keeping the pedal to the metal with errands, chores, dinner, and caring for our kiddos, “running on fumes” is an understatement. Bedtime can bring some time to unwind and refuel. But, for some parents, bedtime = more laundry or clean up in the morning.

I’ve got chills, they’re multiplying….

Why? Bedwetting. I’ll say it again: B.E.D.W.E.T.T.I.N.G. (Did you get chills? I did.) Cleaning the sheets, changing mattress pads, buying pull-ups, changing pull-ups and giving baths are NOT how parents want to start their day. Worried about running on fumes? Try starting on fumes and then having to rat race through the day, only to do it again tomorrow. Frustration, anxiety, fear, embarrassment….Parents! We feel all of these things! And so do your kiddos.

MANY children have trouble with bedwetting. Recent studies show that 5%-15% of children ages 5-15 wet the bed, and many children grow out of this problem as they age. But what does that mean for Little Sister who’s 12 and won’t spend the night with her friends because she wears a pull-up at night? She would do just about anything to put the bedwetting monster to bed for good, or at least throw him the cage and keep him better hidden.

All jacked up! I’m all jacked up….

So, what do you do when your car is all jacked up? You take it to the mechanic and the problem gets fixed! When your child needs attention, the pediatrician should be the first go-to mechanic. Most pediatricians will tell you that bedwetting is “self-limiting”, meaning the child will grow out of it. In most cases this is true. But, if your car mechanic told your car problem will resolve with more mileage, wouldn’t you want to do everything you could to fix, or at least improve the problem until that time comes? Make the bumpy ride a little more bearable?

I’d sure hate to Break Down Here…

Bedwetting has many possible causes, some of which can be the result of an underlying hitch in the engine (i.e. kidney or bladder issues, hormonal imbalances, sleep disturbances, etc.). Your mechanic (pediatrician) needs to check for these to ensure proper treatment. Other times, however, bedwetting can be the result of other factors than can be address with 3 simple changes at home.

  1. Manage constipation. Constipation is the leading cause of bedwetting. When a child is constipated, the size of the rectum (poop storage area) is so large that is compresses and irritates the bladder. An irritated bladder with smaller storage capacity can lead to leakage at night.
  2. Fluid balance. This one is a double-edged sword. It makes sense that too much water can lead to bedwetting, but too little water can do the same. When too little water is consumed, the urine becomes very concentrated. This causes irritation in the bladder as well and, yep, leakage can occur. Make sure your little one is getting the right balance of water during the day, at moderate intervals (no chugging). And, (aha!) the right amount of water will improve constipation! 2 bolts with 1 nut, here, people!
  3. Bedtime Routine: The bladder is teachable, but like with any skill, routine is key.
    1. Set a stable bedtime.
    2. Allow only clear water 2 hours before bed.
    3. Allow no fluids an hour before bed.
    4. Have your child use the restroom twice in the hour before bed.
    5. Have your child use good sleep hygiene.   (Google “CHOC Children’s” or “Seattle Children’s” sleep hygiene for good info.)

These changes can improve and sometimes even “cure” a child’s bedwetting problems. As with Little Sister, she may not be completely dry (let’s hope for it), but she may have a decrease in the volume of urine at night and can go from a big pull-up to a concealed panty liner! Sleepover time!

If you’ve exhausted these options and the engine oil is still leaking, speak with your mechanic (pediatrician) about your concerns. There are medications that can be helpful and again, for most children, it won’t be a long-term problem. Ride on!

– Whitney


About the author:

Whitney Bartley, PT, DPT is a CAPP-Pelvic Certified physcial therapist specializing in the treatment of pelvic floor dysfunction in pediatric patients. She practices in Arkansas, where she lives with her husband and two wonderful children. She’s a fun-loving, Southern gal who is passionate about serving her patients and advocating for children with bowel and bladder dysfunction.


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