By the age of four, most children are daytime potty trained. They can use the toilet consistently without accidents while they are awake. These children may have accidents at night though. This can be because their bladder is simply not mature enough to hold urine for 10 or more hours and the urge to go just isn’t strong enough to wake them. In addition to limiting drinks before bed and waking the child to go the bathroom before you go to bed, some parents choose to set an alarm to remind him to get up and go to the bathroom in the middle of the night.
Some children will wet the bed past the age of five. These children may be diagnosed with chronic bedwetting or primary nocturnal enuresis. Bed wetting may be due to stress, change, a small or immature bladder, or a physical cause like a urinary tract infection. A physician can make that diagnosis and may recommend a bed-wetting alarm or medication.
To prevent chronic constipation, or encopresis, which can lead to repeated soiling of the underwear, nannies and parents can be sure that the child drinks plenty of water, has lots of fiber in his diet and avoids overeating binding foods like white rice and bananas.
Sometimes when toilet training is forced a child will learn to hold his bowel movements as a sign of control. Sometimes children will also hold their bowel movements when they don’t want to use a public bathroom or when they have a change in their routine.
If a nanny becomes aware of nighttime accidents in a child that is toilet trained, she should discuss any concerns with the parents.