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Nighttime Potty Training for Five-year-old

QUESTION: My daughter is five-years-old and she still wears a diaper at night. About a week ago, she began to have bowel movements in her diaper. She has no stomach complaints. I am worried and frustrated; however, she is too embarrassed to go to the doctor. What should I do?

ANSWER: Your daughter is feeling embarrassed about her "accidents" in the night. This is reason enough to help her complete her potty training.

  • Cut out any late night snacks. Request that she try to use the toilet two hours before bedtime and immediately prior to going to bed. This will give her an opportunity to recognize body signals before bedtime and achieve self-regulation.

  • Do not use a diaper at night. Although you did not intend it, continuing to diaper your daughter for bedtime and expecting her not to have "accidents" may be sending her a mixed message. Since she does not appear to be ill in any way, why not simply solve this together?

  • Talk with her. Suggest trying to send her body a message to either wake up to go to the bathroom in the night, or wait until the morning. Your gentle assurance that she can learn to do this will no doubt be greatly appreciated! Active problem solving will also ease your own frustration.

  • Give her some facts. Talk to her about the sphincter muscles in the anus and the urethra that give us warning signals that we need to go to the toilet. These muscles can help us tell our bodies when we want to let go of the pee or poop and when we want to say "no, not yet, wait a little while." You may be surprised to find that she responds well to this idea. Point out that she is already doing this in the day, so the two of you are simply building upon what her body already does so well!

  • Be prepared for nighttime awakenings. If she wants to get up in the night, assist her in doing so. Suggest to her that she can get up, use the toilet and then go right back to sleep. Be sure the way to the bathroom is well lit and easy for her to navigate. If necessary, agree to a time to wake her up and accompany her on a bathroom trip. Consider this strategy a kind of "jump start" for her own biological clock and awareness of her own physical cues to use the bathroom. She may learn to awaken herself prompted by physical signals, at first, before being able to hold her bowels until the morning.

Naturally, if you continue to be concerned, consult your pediatrician. Consider a phone consult with your doctor to describe the problem without scheduling your daughter for an extra visit outside her normal well care, unless your doctor suggests it.

The great likelihood is that your daughter simply needs a little more direction and guidance in this area. Comforting as it may be to believe children will naturally guide themselves, reality bears out that some children need more help developing self-regulation than others. This is true with many things other than potty training. Individual children mature differently.

Consider leaving the diaper behind at this point. Help your child focus her energy on completing her potty training. She will feel better about herself as she gains mastery in this area. Leaving her on her own with this risks the potential for hurting her self-esteem. She may also suffer ridicule from others who may not treat her "accidents" as kindly. Good parenting skills sometimes include a gentle "push" in the right direction.


Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing in prenatal and family development. She trains professionals in her prenatal counseling model and is the author of An Easier Childbirth, Birthing Normally and her latest book, Making Healthy Families. Her articles on family relationships appear in professional journals and she is an oft-quoted expert in popular magazines such as Woman's Day, Mothering and Parenting. . She also serves on the advisory board for Fit Pregnancy Magazine.

Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.

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