My daughter is 3 ½, toilet trained and still sleeps in a crib
(until we can go out and get a new bed). Recently, we had our first bedwetting incident. Now, when it’s bedtime, my daughter will ask to go to the washroom several times before lights out. She asks if she will have an accident when she is sleeping. I remind her that this is the last pee before lights out and that I am going to sleep now too. She cries and I'm afraid she really has to go. Every time she tells me she has to go, she does (a doctor has ruled out infection).
How do I deal with this new behaviour?
Carmen G. emailed us at expert@sweetspot.ca, and our pediatrician, Dr. Karen Dockrill, answered.
This is a very complicated but common situation for young children. It is probably best to answer it by addressing the individual challenges described.
At 3 ½ bedwetting is very common for both girls and boys; however, in this case it sounds like an unusual event after an extended period of dryness. A urine infection has been ruled out, and now the little girl seems to be experiencing anxiety around having another “accident.” There are several options to address her fear.
At this age, providing her a way to have control of the situation is most helpful. For example, if she goes to the washroom on her own during the day and, assuming a safe and illuminated path at night is available, she can be given the privilege to go on her own at night. For many parents the path to the washroom involves coming into Mom and Dad's room and waking them to accompany her and then straight back to bed. When a child comes to your bedside at night, it is best to assume they need to pee and to take them to the bathroom. The crib is a stumbling block for this independence. You could decide to put the mattress on the floor to allow the little girl her independence and/or or make a fun day of it and pick out a new bed to bring home.
The anxiety around the accident may be heightened by any adult upset relayed with the bedwetting incident. Changing a wet bed at night is never a wanted task but is best addressed with reassurance about “accidents happen sometimes, let's clean up and change the bed” without relaying negative feelings to a child. Self-esteem can be negatively affected if children feel less of themselves about having accidents.
The change in behaviour at bedtime also reflects anxiety about the accident. Reassurance that accidents happen and keeping to the usual bedtime routine and allowing one callback only is the best approach. Be sure to talk her through your understanding of her fear, and how you will be helping her deal with her anxiety and accidents, should they occur.
Dr. Dockrill has been the Medical Director for Maternal and Newborn services in two Ontario hospitals, in addition to being Director of several Level II and III neonatal intensive care units. After leaving hospital-based practice in 2004, Dr. Dockrill founded Mom and Baby Depot Health and Family Resource Center in Whitby, Ontario. For more information, visit www.momandbabydepot.ca.