This is one of the most common questions I get, and the answer depends entirely on the child's age and where they are in the treatment process. For a three-year-old, pull-ups are fine. For a seven-year-old in active alarm treatment, pull-ups are working against you. The same product, two completely different recommendations.
The case for pull-ups (younger children)
For children under four or five who are not yet in treatment, pull-ups are perfectly reasonable. The body is still developing the overnight bladder-control mechanism. There is no learning process to interfere with. The child stays comfortable, the parents stay sane, and nothing is lost by waiting for the body to mature.
The case against pull-ups (older children in treatment)
For older children who are in active alarm treatment, pull-ups are counter-productive. The whole point of the alarm is to detect the first drop of urine and condition the brain to respond. A pull-up absorbs that first drop before it reaches the sensor. The alarm never fires. The child sleeps on. No conditioning happens, and weeks of treatment yield nothing.
If you have committed to treatment, you have to commit fully. Plastic mattress cover, fresh sheets each night, the alarm in place. The first two weeks are the hardest. After that, the dry nights start to appear.
The case against pull-ups (older children NOT in treatment)
This is the situation that worries me most. A child of seven, eight, nine, still in pull-ups every night, with no treatment plan and no end in sight. The pull-up has become a permanent solution to a problem that should have been solved years ago.
The message a child receives is clear. "We do not expect you to be able to handle this." Over time, this costs the child self-esteem and motivation. The child becomes defined, in their own mind, as the kid in pull-ups. Even when treatment is not currently feasible, I encourage families to avoid pull-ups as a daily long-term solution. A plastic mattress cover and a daily sheet change is a better option.
The one exception
Sleepovers, summer camps, family trips. These are situations where the social cost of an accident is high and the child deserves an insurance policy. A pull-up for those nights is appropriate, and I tell families openly that it is fine. It does not replace treatment; it manages a brief social risk.
What I tell parents
If your child is older than five or six and still wetting nightly, the better path is treatment, not another year of pull-ups. Read more in our FAQ.