Tata night nappy!

How you can finally have a nappy-free child at night.

Once your child is potty trained during the day, you might be getting impatient about the everpresent nighttime nappy.

As with potty training, finally achieving dry nights requires patience and can take much longer than anticipated.

A toddler’s body does not really “tell” him that it is time to wake up for a wee yet. He will eventually learn to control his bladder and bowel, as this is part of normal childhood development, explains Dr Iqbal Karbanee, Cape Town based paediatrician and CEO of Paed-IQ. The key to a successful transition is giving your child enough time to reach this milestone comfortably, he adds. “There is great variation in the age at which a child drops the nighttime nappy. “A significant number of 5-year-olds are still not dry through the night. The whole issue requires a very individual and sensitive approach. Remember that each child is different,” says Dr Karbanee. When your toddler can control his bladder for a number of hours during the day, and you notice a dry nappy for seven mornings in a row, try to give the night nappy a miss, and see what happens.

MANAGING EXPECTATIONS

Your tot should not experience any stress around this, feel pressure to perform or feel bad if he doesn’t succeed at first – he can always try again. This transition is a big deal, and external pressure from you will only heighten his anxiety. Understanding that it is completely normal for your toddler to need a night nappy for a while (even until the age of 4), will help you to manage your own expectation and those of others in the family.

HANDLING THE TRANSITION

The first step in getting a child to sleep through dry is to ensure they’re off the bottle, Dr Karbanee says.

Only once that has been done, and daytime potty training is going well, losing the night nappy is a possibility. About two hours before bedtime, don’t let your tot drink any more liquids. This is done in an effort to limit the need to wee during the night.

AND WHEN EVERYONE’S REALLY READY

• Make sure your child has paid a visit to the potty or toilet before bedtime.

• Encourage your child to use the toilet as soon as they wake up.

• If you have a mobile potty, place it next to the bed, so that it is easy enough for them to make a wee in the potty when the urge comes at night.

• Use a pull-up nappy that is easy to pull down if you’re concerned.

• Use a waterproof sheet or linen saver under your toddler’s regular sheets to minimise clean-up time after little accidents.

• Have clean, dry linen and pyjamas on hand for when accidents happen (because they will).

• Have a night light on in your child’s room (to help make it easier to see if they need to go to the loo during the night). • If your child is not a very light sleeper, consider doing a “lift” (where a child is placed on the toilet – half asleep – and encouraged to wee) at around 10pm to decrease the chance of accidents.

DEALING WITH REGRESSIONS

Regression is normal – especially if something unsettling has happened like moving house, the arrival of a sibling or changing schools.

So you expect your toddler to have one or two accidents along the way. Comfort your little one when an accident happens by talking about it calmly and assuring them that oopsies are normal. Never tease your child about an accident or bed wetting. Stay patient and comforting for as long as it requires.

“There are two types of bed wetting,” Dr Karbanee says.

“In the first and most common, the child has not yet learnt to sleep through and so has not yet been dry. In the second, the child has had a period of being dry at night of at least three months, but then starts wetting the bed again at night.” The second type (often triggered by stress or infections) is called secondary enuresis and requires attention by a specialist.

WHEN TO BE CONCERNED

If a child is still wetting the bed past the age of 5 years, a doctor should be consulted for an examination, so that any infection or other potential problems can be ruled out, explains Ann Richardson, nurse, midwife and author of Toddler Sense.

“If the muscles of the bladder are affected, medication is prescribed in some cases to aid muscle control.” Some children actually have a deficiency of antidiuretic hormone.

“This hormone concentrates the urine, reducing the amount of urine in the bladder so that it does not overflow while asleep,” she explains. ●