Ditching the Nighttime Diaper

Hi there,

HELP! I nanny two girls, ages 5 ½ and 4, full time, 5 days a week. The older girl has been fully potty-trained, day and night, for years, no problems there. The younger, however, has been daytime potty-trained for about a year (and she regressed to having 4+ accidents a day, right in front of the toilet when I started working for them 8 months ago, but she had never been away from her mom all day before and it only lasted about 2 weeks), and is still in diapers/pull ups at night. She’s itty bitty (33lbs) so they switch between diapers and pull ups, since she can fit into size 5 diapers or 3T-4T pull ups. No matter what she’s wearing, the family refers to it as a diaper, and that’s exactly what she treats it as. Currently, she’s in full-blown diapers. Her parents are sick of buying diapers/pull ups for a 4 year old and we’re all working together to try to figure out how to help her move forward with nighttime potty training. She rarely has daytime accidents and sobs when she does, because she thinks its gross being covered in pee and she has to change her own clothes and help clean up the mess (so she has some accountability and learns that she is responsible for cleaning up any and all messes that she makes, no matter what it is! And don’t worry, all she has to do is help wipe it off the floor and throw the paper towels away, I’m not making a 4 year old scrub floors like Cinderella).

**NOTE** We’ve tried going without a diaper or pull up at bedtime, and after 3 straight weeks of washing her bedding and jammies every single morning, they put her back in diapers. That was months ago, but she wakes up wet every single day so they aren’t willing to try again until she has some dry mornings.

We (her parents and I) all recognize that no matter how ready WE are for her to be nighttime potty trained, she just isn’t ready; she wakes up wet 7 days a week, no matter what. However, that isn’t the issue. We’ve recently come to the realization that she’s peeing in her diaper while she’s awake, and it’s causing it to get too full and leak all over her bed and jammies (gross). She goes to the bathroom right before bed, but they eat dinner only 45 minutes before they go to bed (7:15 bedtime), so she often has to go again after she’s been in bed for a while. She and her sister both know that they may not get out of their beds to play in their room, but they know that they can always get out of bed to go to the bathroom, no matter what time it is. She doesn’t, though, instead opting to lay in her comfy bed and pee, and then doing it again while she’s sleeping (or maybe she’s waking up, we don’t know. She wakes up during her nap if she has to go to the bathroom, so she may very well wake up at night too. She naps in undies because she has NEVER woken up wet after nap). She also pees in her diaper in the morning after she wakes up, often telling me while we’re getting ready for the day that she peed in her diaper during breakfast because she didn’t want to get up and go to the bathroom. (Yes, she eats breakfast in her wet diaper…thats a whole other thing. I’ve suggested taking it off of her right when she wakes up so she CAN’T pee in it, but I don’t get there until right after breakfast so that’s out of my hands if they decide not to.) By that time in the morning her diaper weighs about 10lbs and reeks of pee, because she’s peed in it probably 4+ times since she put it on the night before. So gross.)

At this point, we know for a fact that she’s taking full advantage of the diaper she’s wearing and using it as such, being lazy and peeing in it instead of getting up to go to the bathroom. Do you have any ideas about how we can discourage this behavior, other than going cold turkey again, because she clearly isn’t ready for that? Again, we’re not trying to force her out of pull ups or diapers at night, we’re trying to discourage her from peeing in it while she’s awake. We’ve thought of getting a baby monitor so she can call for Mommy or Daddy to come to the bathroom with her, but the girls share a room and she’d wake up her sister if she were laying in bed yelling for her parents, and her sister wouldn’t go back to sleep if that happened. (Her sister is “high spirited” and NEEDS 10-12 hours of sleep or we all suffer, so that is not an option.) Any advice would be really helpful; we are at a loss (and are also REALLY tired of washing bedding for a diaper-wearer almost every morning), please help!

The first thing that needs to happen is putting an END to that whole “letting her eat breakfast in a wet diaper” thing. I keep rereading your letter and getting completely baffled as to the reasoning behind that. She should not be leaving her bedroom in a diaper, full stop. It’s INCREDIBLY counter-intuitive to the problem you’re trying to solve, given the observations you’ve laid out, not to mention absolutely HORRIBLE for her skin. AHHHHHH NOOOOOO.

I’m usually a big tub thumper for NOT getting too hung up on nighttime training — I’ve written time and time again that day and night training are two separate processes, and a child should never, ever be rushed or shamed over an inability to stay dry at night. It’s physiological milestone, and not something that can be forced simply through sheer will on the child’s (or caregiver’s) part. And plenty kids don’t hit the nighttime milestone until their preschool years, regardless of how early they potty trained during the day.

However, in this case, we’ve got a child who wakes up during naps to pee. That’s a big flashing neon sign that physically, she IS actually capable of staying dry at night. She IS ready to night train, albeit maybe with more support/structure than she received before. Maybe the previous attempt was just barely premature and she’s made the developmental leap since. Obviously, she’s probably not entering a full deep sleep cycle during a nap, but her brain is waking her up, which is what it’s supposed to do. So even factoring in an accident while she’s REALLY deep sleeping, I join you in your suspicion that there’s really no reason she should be peeing FOUR PLUS TIMES in an overnight diaper without making it to the bathroom at least once or twice. She’s making a deliberate choice to pee in the diaper, and that’s a habit that needs to be broken, pronto.

Now, if you were this child’s mother and/or present at night, here’s what I would suggest:

1) Limit her liquid intake in the hours before bed. Two hours is typically the guideline, so the late dinnertime is a challenge. She can still be limited to no pre-dinner drinks and then one drink with no refills. One sip of water before bed, at most, followed by using the toilet.

2) Wake her up after a few hours and take her to the bathroom. Usually around the time parents go to bed, it’s a good idea to rouse a night-training child for one final pee to get the bladder empty before they enter deep sleep. So around 10? 11? This increases the child’s chance at “success” the next morning, which can then be celebrated/praised/rewarded, hopefully making the child want to repeat that success the next night and eventually start proactively getting up on their own.

3) Wake her up in the morning before she wakes on her own and GET THAT FREAKING DIAPER OFF AS SOON AS HUMANLY POSSIBLE OMG WHAT ARE YOU DOOOOOING?

4) Give her an incentive NOT to pee in the diaper. Right now, she’s just like, “eh, whatever, this is easier.” She doesn’t care that she’s wearing a “full-blown diaper” or that it’s uncomfortable or gross or whatever. This is a child who needs some motivation. This can be a daily sticker chart, with a reward she needs to earn via staying dry multiple days in a row, or a prize box she can pick from each morning if she’s more of an immediate gratification type of kid.

I know you said your goal is not to eliminate the nighttime diaper, but I counter that that’s actually a pretty reasonable goal for a four year old — particularly one who IS showing signs of nighttime readiness. You don’t want to push, but you do need to encourage. And it sounds like this family instead just grew frustrated, threw up their hands and gave up on the concept completely. Understandable after three solid weeks of wet sheets…but instead of the child sorting it out herself, the lack of encouragement/motivation about staying dry is creating bad habits that might not magically go away. (Barring some peer pressure/playground shaming from other kids if they find out she still wears a diaper at night, I’d predict. Which can be pretty big motivation for an older child, but also something most of us would rather avoid, if possible.)

Since the last cold turkey attempt was months ago, I’d PERSONALLY try it again, with a waterproof cover, spare sheets and pajamas in a handy spot. (I mean, she’s overloading the diaper to the point that you’re washing sheets anyway.) Break her of any and all “I don’t want to leave my warm comfy bed so I’ll just pee here” habits REAL QUICK LIKE. Limited liquid intake, a regular bathroom trip a few hours after bedtime, and I’d try to get in her room a little bit before her regular waking to rouse her and take her to the bathroom. Lots of praise and an incentive program when she succeeds. If there’s still no success after about three days, okay, back to a pull-up/diaper but keep EVERYTHING ELSE the same to at least minimize the number of times she pees in it.

But this is not my child, or yours. So I’m not really sure what YOU can do here, unless the parents are willing to take advice from you and commit to putting that advice into action at night and first thing in the morning. Because it sounds like this child is not really be well-served by all the inaction. (WHY IS SHE EATING BREAKFAST IN A WET DISGUSTING DIAPER THAT YOU DON’T WANT HER WEARING IN THE FIRST PLACE NOTHING ABOUT THAT MAKES SENSE MY BRAIN IS HURTING.) I understand previous attempts were frustrating and there was a need to focus on her daytime regression first, but it sounds like this isn’t one of those times where backing off completely isn’t helping, and perhaps could be making the problem worse.

I don’t want to sound overly hard on these parents — lots of us can tell similar stories about attempting potty training before our children were really ready and failing pretty spectacularly. But then you try again, in a few weeks or months. If at first you don’t succeed, and all that. Good luck on helping this family ditch the diapers!