Pee Accidents
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Sept 2008
My 4-year old son is potty trained but adamantly refuses to go to
the bathroom whenever we ask him to try. Sometimes he will hold
his pee for 7 hours or more, hopping up and down, running in
circles, etc. but still says he doesn't have to go. If we ask
him just to try before getting in the car for a long trip, he
won't do it -- even if that means he doesn't get to go to the
party, zoo, etc. We have tried all kinds of games to make it
more lighthearted and appealing, or more ''his choice.'' He will
go on his own if the timing is right, but not when we ask, and
the result is occasional accidents. I know this is fairly common
and probably just another way to test his power . . . but what do
I do? I end up sitting around the house all day, trying to
reinforce my ultimatums, while he calls my bluff.
Never ever ever never!
I suggest you start making sitting on the potty part of his daily
routine. Don't tell him he has to go, just that he needs to sit
on the potty and try to go. Let him read a book, read to him,
give him a game to play with, so that he'll sit there and relax.
By daily routine I mean at routine intervals in the day: when he
wakes up, after eating breakfast, before lunch, before rest
time, after dinner, before going to bed. But especially anytime
he does what we used to call ''the pee-pee dance'' LOL!
Also, don't show him how exasperated you are, or upset, angry,
etc. Just tell him matter of factly it's time to try and go
potty and he has to sit there for 2-3-4-5 minutes before going
anywhere. When you see him ''dancing'' just say, ''Oh I see you are
feeling like you have to go potty, so now is the time to try'' and
let him know he has to sit/stand there for 2-3-4-5 minutes
regardless of whether anything comes out.
What does his preschool teacher suggest?
Good luck!
Stephanie
Believe it or not, this one is easy.
Stop asking him if he wants to go!
For that matter, you should stop ASKING your child if he wants to
do much anything. Especially since your child seems to want to
resist, it's time to teach him that there are rules and ... you
just do them. Trust me on this. When my child was 4, I totally
changed my parenting style. I had to.
So you say: ''It's time to pee.''
He says ''I don't have to.''
You say (consulting watch) ''It's 11:20. It's time to pee. Give
it a try and perhaps your body will surprise you.''
It's important to STOP saying ''Jonny, I'd like it if you would.''
or ''Jonny, would you like to'' or ''Jonny, could you...'' because
even though this may sound odd, each of those statements gives
the child permission to NOT listen to them! Stop giving your
child an ''out.'' Be extremely direct. ''You need to X.'' ''It's
time for you to X.'' If there's a problem, give them a choice: ''X
or Y.'' And then stop there.
While it's nice to teach babies and small children to say please,
when a child gets older, and especially if it's a child that is a
resistant child, it actually does the child a favor to REMOVE
ambiguity. If you want them to do something, you say ''You need
to do X.''
Being very clear helped my son a lot.
Rules are good to learn
It sounds like you are already doing something similar so I'm
not sure if this will help but here's what I do with my very
independant/often stubborn 5 year old. When I tell her to go
and she says ''but I don't have to'' I say ''that's fine if you
don't need to use it just sit on the toilet. If you don't pee
that's fine, just try.'' She usually sucks her teeth or does
some other completly rude response but then goes to sit on the
toilet and nine times out of ten she goes pee. If she doesn't
that's fine. I, like you, stand my ground about using the
bathroom, but my thing is about her trying/sitting. If she
doesn't use it that's fine, she just has to try.
Hope this helps. Good luck.
M
We have the same issue with our daughter. I think the thing to do is
just let them control when they want to go to the bathroom. It sounds
like with your son it's turned into a major control issue and probably
the best thing to do is back off and let him go when he wants to
go. Accidents are annoying (especially on carpet!), but not the end of
the world. And an occasional accident sounds better than what you're
describing. Also, you could buy a portable potty so if he refuses to
go before leaving the house, only to have to go half an hour later
when you're not near a bathroom, you can just whip out the portable
potty. At some point, I'd like to have the policy we go to the
bathroom before we leave the house, but in the meantime the portable
potty keeps it from mattering too much. (BTW, the Fisher Price brand
one is great.)
Sarah
My 3 1/2 year old has been almost potty trained for like 8 months
now, slowing moving toward 100% (not counting nightime of
course). But I havn't had him refuse to sit very often.
What one friend suggested to us was not to ask if he ''needs'' to
potty. But simply say it is ''time to potty'' and take him into the
bathroom and sit. Then you can say ''hey, look, there is potty in
there!'', or ''oh well, nothing there. Maybe next time''.
Eventually, it will become routine and they will relax. Good luck.
Bryan
It sounds really challenging! And it sounds like it's become a big
power-play
between the child and his parents.
My suggestion would be to neutralize the emotion of it. We found
success using a
timer that went off every hour. When the bell rang, it was potty time.
That helped
separate potty time from my authority. The other idea I had was to
combine it with
a sticker chart -- positive reinforcement. So every time that he sits
on the toilet
and produces, he gets a sticker. Once he gets x-number of stickers, he
gets a
special outing with a parent or a toy or something special.
Good luck.
Rachel
Why not just let him go on his own without reminding him? Sounds like a
power
struggle is going on here. He's old enough that if he does have
accidents, he can
change his clothes and ''clean up'' after himself. Of course, you'll
have to follow up his
cleaning. But, put it all back on him and see what happens. Not going
out on a fun
adventure is not really a natural consequence to not going to the
bathroom when you
need to, so he's not making the connection in his mind (or he is and
he's just testing to
see if you're for real.) In either case, no one's winning.
When my 4 year-old says that he doesn't need to go potty, I
usually sympathize and make a big deal about how I really
understand that he doesn't need to go, but that he must do it
anyway (before bed, bath, or before we leave the house), whether
he needs to or not. If he says he just went, then I also say I
understand and that's great, but I need you to do it again,
because I know that ''I just went'' can mean he did it 2 hours ago.
Susan
I posted a reply to a similar question last week. when my now 4
1/2 year old used to say he didn't have to go and then later had
an accident, i would tell him that if he didn't at least try or
if he had another accident, it meant he still needed to wear a
diaper. also, if we say he can't do something or go somewhere
until he actually tries to go to the potty, we mean it. even if
it means not going to the zoo, etc. we try to do this early
enough so that we are not rushing to go to some event and this
way it gives him some time to ''change his mind'' about really not
caring about the event or trying to go to the potty. he rarely
has an accident now.
no pee in pants!
There are three things you will drive yourself insane trying to
get your kids to do: eat, sleep and use the toilet. My advice
(on all three) is to back off -- WAY off. I did EC with my
youngest, and giving this strong-willed firecracker of a
toddler autonomy over her toileting was one of the happiest
(accidentally smart) decisions I ever made. I tell my older
child (5 y.o.) at the table, ''You are in charge of your own
tummy. If you want a sticker, you need to try one bite of each
thing on your plate. After that, you decide how much you want
or need to feel full. If you don't eat enough, you will have to
wait until the next snack/meal'' If she eats three bites, that
is her choice. You can try something similar with your potty-
striker: ''You are in charge of your own body. If you feel
peepee or poopoo, you can take yourself to the bathroom and let
me know if you need help. You can earn one sticker for your
sticker chart by keeping your undies dry all day.'' There is no
punishment for accidents, just lack of reward. Doing a sticker
for the day instead of each trip to the potty allows you to
step back since you will only need to keep track of accidents,
which are easy to spot. In short, he's trying to drive you
nuts, and it's working. Simlply remove yourself from the
equation (don't worry, he will find something else to drive you
crazy when you guys get over this!). When we were doing EC, we
had all kinds of waterproof pads. You may want them for the
carseat, rugs or sofa if that helps you relax and give him
space to assume the independence he is craving. Hope I don't
sound harsh -- I almost stuck a fork in my daughter's eye
before I learned to leave her alone at the table! Live and
learn. :)
Happier Hands Off
If I were you, I would completely let it go and let him go when he feels
like it.
With my son he it was a control thing and also fear of the toilet. The
problem was
more with poop than with pee. He ended up with a constipation problem
and a
leaking problem. He is 6 now and does go on his own but he still leaks
stool without
knowing it sometimes. Its from so much practice of holding it in. Your
son will have
accidents and maybe he still needs pull-ups. He will figure out on his
own that it is
more comfortable to not be wet. This is better then the physiological
problems that
can develop down the line.
been there
My advice is let him have the occasional accidents. Just pack a
change of clothing with the assumption that it will happen, so
you will be prepared. (And try to get emotionally prepared too!)
If you are nonchalant about it and just tell him, ok well you can
always go when we get 'there' if you need to, then the power
struggle will be diffused and the accidents will eventually annoy
him enough to be an incentive to go more often.
logical consequences are your best weapon
Oh my gosh...this used to drive me absolutely insane!!!! You
can't make them go pee. It's the one of the few things they feel
they have control over. These are things I tried: a
chart....after three times of going pee when I asked he got a
reward. It worked once. I let him pee in the yard. (This worked
great for us.) I changed the wording from 'going' pee to 'do you
want to try?'
But, it passes, it really does. He'll have accidents and get
tired of changing his clothing.
mom of boys
First you have to un-do the power struggle this has become.
It's worth continuing to work on getting him to go pee because
there can be long-term effects on the urinary system from
holding it in too much. I would start having regularly
scheduled potty time every 3-4 hours without fuss. Simply at
these times (either by the clock or by event -- pre or post
breakfast, lunch, etc) he sits on the toilet for 10 minutes.
He can either get up after he pees or after it's been 10
minutes. No struggles, no rewards/punishment, no attention, no
nothing but 10 minutes on the pot. Hopefully after some time
of this he'll decide there's no point to holding on. My
daughter has held it in up to 12 hours rather than use a scary
public potty, and frequently insists she doesn't need to go.
But she has to go to the pot when we say, and when she does she
usually pees.
Many people had good takes on this and suggestions. One thing I
can add, that would work with many different approaches, is to
eliminate the word ''try,'' which implies one needs to make a
special effort, and will either succeed or fail. Instead, say
''check,'' which is about finding out what your body needs at the
moment.
R.K.
I agree with all the advice so far, both about backing off and
not letting it be a power struggle, and also about not making it
always up to them. Sometimes they have to sit on the potty,
whether they ''go'' or not. One thing my daughter enjoyed was when
I would say, ''You have to sit on the potty now, but I don't think
you have to go. I bet ''no pee pee''. What do you bet? Who do you
think will be right?'' (Of course I only did this when I was
pretty sure that she did have to go.) Then when she went pee, I'd
say ''You were right! You win!'' Sometimes she would even take my
hand and lead me to the bathroom saying, ''I want to be right. Do
the betting thing.''
Good luck!
April 2004
My almost 4 year old has started peeing her pants everyday, just when she's
with me. I started by ignoring it because it's happened before over the past
year, i.e: when her brother was born, later when he was in the hospital, when
I've had work trips, etc. But then it happened a few days and then would
stop.
This time it's been fairly consistent for the past month. Everyday when I
pick her up from preschool, she's wet. Then sometimes even after we are home
she pees her pants. Once, during her brother's nap, while I was playing
Candyland with her, I looked over and there she was peeing her pants. I've
taken her to the doctor to rule out a UTI. I assume it's a cry for attention
given that her brother is going through advancements and she gets quite
jealous of the attention he gets. But I do try to spend time with her that's
just her time.
But I'm getting tired of this. So I decided to start removing favorite toys
each time she wets. So this week she's lost Barbie, Groovy Girls, Candyland,
art projects and scissors, favorite stuffed toys, and I've stopped putting her
to bed with bedtime stories and songs. So this morning she peed all over her
room. So obviously this isn't working.
She has known how to go potty for almost 2 years now but periodically gets
into these wetting phases. This is the longest one of these regressions has
lasted.
So now I've put her in her brothers diaper which she seems quite excited about
actually and I'm at an absolute loss. I don't know whether to go back to
ignoring it and just keep telling her to change herself. She doesn't seem to
care about losing any of the favorite toys.
I'm really tired of the extra laundry and not knowing where I can take her and
if she'll pee her pants or not. I've tried the ''time to go potty'' and
pretty much she'll go if there's a bribe as in...can't go to the park unless
you go potty but then we'll get to the park and she'll pee her pants (20
minutes after going potty at home).
She knows it upsets me and it does upset me, it's making me crazy and she
seems to enjoy that power.
Any suggestions? I thought things would get easier the closer we got to four,
which all of my friends and relatives keep telling me is the magic age.
tired and frustrated
One of my four year old twins has started wetting again also--
not as frequently as yours apparently is, and I think it's more
that she just is so busy playing that she puts it off until
it's too late. Have you considered putting her back in pull
ups for now? It sounds like you're going crazy trying to deal
with this. I'll bet if you just use pull ups, praise her when
she uses the potty and ignore it when she doesn't, this
behavior will stop. I don't think taking toys away/punishing
your daughter will have positive effects. I would stress how
glad I am to have a ''big girl'' as well as a baby, because there
are so many things a big girl can do that a baby cannot. So--
my advice is get a box of pull ups, and just relax. This too
will pass.
another mom
My heart goes out to you; it really does. My son's been trained
since 2.5 years and has had quite a few accidents lately (though
not on the scale of your daughter's accidents). I think the key
is to keep it from being charged. Try to hide your disappointment
and frustration (and I know too well how very hard this is), and
consider putting her back in pull-ups for a week or two. I
suggested this to my son (as off-handedly as I could), and he
seemed a bit shook up and has had no accidents lately.
I suspect your daughter wants to feel like the baby in the
family, hence ''she seems quite excited about actually.'' Let her.
I suspect taking the 'power' away and letting her be a baby for a
bit will get old for her quickly enough. Plus, if she's in
pull-ups, you won't have as much laundry nor need to change her
wet clothes. Nearly a win-win, with the downside being the cost
of pull-ups.
Good luck. As I said, I know how darned frustrating this can be.
My son was just this morning lamenting a book I threw away that
he had peed on in the bathroom. (sigh)
Jennie
Thank you all for your advice so far. I'm the person that put the original post up
and what seems to be working for the moment is I did continue to take a toy away
each time she had an accident but I also spent more alone time with her. I've also
had her help a bit more with her brother.
In any case, we've only had one accident in 5 days and she was devastated when I
took her favorite Spot book away. So I'm still spending time reading but her
favorite book disappeared and she was not happy.
She's also asked where some of her toys went and I told her, remember, you peed your
pants and they disappeared.
So she's making the connection.
until it happens again......
I didn't catch your original posting, but read about how you've
chosen to deal with your near 4 year old potty accidents, and
I think you should take care when punishing potty issues.
Taking toys away for an accident is punitive, and it will
likely give your child a negative feeling about the potty,
which I know you don't want, as it will ultimately create more
issues (mental and physical).
Possitive reinforcements are always a better, and healthier,
choice for children.
For instance, a pat on the back when your child rememebers to
use the potty goes a long way. I know from experience (I have
a 4 and 2 year old) that it can be very frustrating to go
through steps over. Regression is tough on a mother, and
you've already potty trained your 4 year old. But, try to be
patient again, and give possitive rewards for getting to the
potty. ''You remembered to use the potty every time today!
Great Job'' would feel so good to hear, that your child will
want to hear it again the next day.
If you use a reward system, give a sticker everytime she
remembers.
A child this age who is having accidents is generally having
them for 1 of 2 reasons. (1) attention / regression (in this
case, my advice is...give attention -- possitive attention.
Reread some potty books with your kid, like 'Once Upon a
Potty', and tell them how happy you are to have a 4 year old
who is using the potty so much -- don't mention the mistakes,
just the successes)
Another reason for mistakes (2) attention span. Some kids at
this age have a real hard time separating themselves from their
play. for these kids a playful reminder is very helpful. Talk
to them about listening to their bodies, give them
a ''potty''watch (everytime any hand gets to, say the 4, check
in with the potty). This option actually works great for both
cases, as it also gives special (possitive) attention to the
child.
Please don't give your child negative feedback regarding their
body functions. We want to raise our children to feel happy
with and love their bodies and everything they do. If adults
don't use kid's body functions against them, they will not
learn to use them against others (like peeing just to tell you
she is angry).
AS
I would welcome replies from anyone who has had experience with this
problem...
When my daughter turned 4, 6 months ago, she started wetting her pants
several times a day, and she has not stopped. I've tried not nagging her
for several days and I've tried reminding her several times a day --
neither works for very long. I've had her tested twice for urinary tract
infections (both negative). Until very recently, she hasn't seemed to even
mind being damp or wet, but recently one girl in her preschool class
mentioned that she should wear training pants and she related that to me.
My pediatrician mentioned medication, but I am very much against that
except as a last resort -- especially since I suspect that it is a control
thing. My daughter refuses to stop playing, watching a movie, etc. until
she can barely walk. It's quite obvious. Also, she is very headstrong in
a quiet way and I think it is her manner of taking control. But, we are
debating whether to send her to kindergarten in the fall and I'm not sure
whether peer pressure would make her stop or be devastating.
Has anyone had this experience? I would welcome input either on the Digest
or personally. Thanks.
Stefanie
My 4 year old son recently went through a phase of this a few weeks ago,
though it didn't not last as long as your daughter's. It didn't seem to
upset him very much, in fact he rarely noticed, or he noticed but didn't
mind the wet clothes. It mostly happened on weekends, and I honestly think
that he would forget (actually ignore it) because he was so wrapped up in
whatever he was doing. After a couple of weekends, we figured out (with
his help) that he would try to hold his pee because he didn't want to miss
out on anything. We gave him the option of training pants, which he
considered and then rejected. We also tried to downplay it alot and
explain how he could stop or "pause" playing and then come back to it. We
were able to illustrate this most effectively with his videos, by teaching
him how to pause a tape all by himself, go potty, and then come back and
start playing it again without missing anything. (I'll never forget the
look of astonishment and understanding when he finally understood that
possibility!) After another couple of weeks (and of course, with continued
reminders of "now would be a good time to go potty") he seems back on
track. [We're still working with him on the idea of going potty before we
go out (especially in the car), but he's stubborn and sometimes tells us "I
can hold it," but that's a whole other issue.] I think you're right, it is
partly a control thing, but I also think that 4 is still pretty new to the
whole potty thing. We also suspected with my son that it was also partly a
regression which we've noticed before (the regressing part) before some big
developmental stage.
Good luck and hang in there! Hopefully, your pediatrician will rule out
health issues.
Natasha
I also have a 4 yr old and find the best strategy for bathroom use is a
firm announcement several times a day ("It's time to use the bathroom")
rather than posing a question (the always ridiculous: "Do you need to use
the bathroom?" - my son has never said yes to this one) or suggestion ("You
should use the bathroom" - and the power struggle begins). Sometimes just
the above announcement works but is usually followed by: "I don't need to"
from him and "Just try" from me. If a battle ensues, I drop it - it is
definitely a losing one. Unless a good bribe is handy "Well, we can't go to
the park until you do."
Ellen
Since it seems obvious to you when your daughter needs to use the bathroom,
enforce a bathroom break where possible: turn the movie off or interrupt
play with a guarantee that she can continue when she returns.
I also make a point of having rules about bathroom habits: "We use the
bathroom before we go to bed, get dressed, eat lunch, etc." This way it
isn't so much a power struggle between us, just following the rules (which
alot of 4 year olds are very attached to). He doesn't seem to hold me and
his dad or his 9 yr old brother to these same rules so I have the sense
that he gets it somehow and understands the rules let him save face about
being told what to do all the time. Note, my son is generally an easy going
guy so this strategy might not work for some.
I would ask the teacher's at your daughter's school for some help too; i.e.
asking them to have her use the bathroom several times a day in a low key
way. This certainly isn't an unusual situation and a good teacher will have
some strategies that work without shaming the child in front of her
peers: gently reminding her to use the bathroom frequently; having the
child change her own clothes privately (sometimes taking the time out from
play is an incentive for cooperation); positive reinforcement, etc.
Wetting pants: My daughter was out of diapers for about six months
at age 3+, and then regressed and needed diapers again for more than
eight months. I think it was a combination of things, but that
control issue was a big part. One of her preschool teachers
said that maybe when she was first toilet-trained, she responded
positively by "performing" well, which is different from doing it
from a deeper self-motivation. One is internal, the performing is
behavior for others' approval.
Nancy
One of ours did something very like this, even to the refusal to stop what
they were doing and take care of things, and didn't fully resolve it till
age 7, despite scoldings, understanding talks, rewards, nothing, you name
it. I think it is partly a power-struggle thing, maybe even within the
child him/herself, and partly just overall immaturity (though it does
indicate admirable powers of concentration and a long attention span!). We
finally quit racking our brains over it and said, "You're wearing pull-ups
to school until you get this under control, and by the way this is your
problem, not ours," and eventually s/he did.
Peer pressure was not a big thing in kindergarten. I think few
kindergartners have toilet training so well under control that they can
afford to tease their peers! This may be a sign, though, that she's not
ready for kindergarten--she'd be not-quite-five when she started, and that
can be hard for a kid--not-quite-six is far easier.
Teacher pressure is another thing. If you decide to send her to
kindergarten with this unresolved, you should certainly get the teacher's
input. Kindergarten teachers have enough to do without daily mop-ups.
John
re four-year old girl wetting pants -- I recently went through what seems
the very same situation with my four year old girl. Also went to the
doctor, no infection. It seems that it may be a similar situation --
they're just too busy with what they're doing to take the time to pee. We
made it a policy that she at least had to try peeing before we left the
house, every two hours, etc. We also went the "big girls don't pee in
their pants," and "your friends are going to start thinking it's yucky if
you're peeing in your pants" routine. The results were not immediatate,
but she's gone back to using the toilet -- I'd say it took a couple of
months or so before she cleaned herself up. Good luck.
Andrea
June 2002
Hi,
my 4.5 year old daughter has periods of time when she pees in
her pants when she laughs hard. There are a lot of times when
she wets the pants like 10 min after she's been to the bathroom.
She is not a bed wetter and this does not happen at preschool as
far as we know.
We tried rewards, punishments etc but she says that when she
feels she needs to go she had already wetted the pants. She
knows this is bad.
Any ideas ? Thank you.
A puzzled Mom
Please, you must not punish your child for this! It is not her
fault, she cannot control it and it happens to many children and
adults. I had this problem as a child, and so did my mother.
Thankfully, she was sympathetic to my embarassment. We both had
immature kidney and bladder issues and I have an extra ureter
between my bladder and one kidney that gave me a variety of
problems as a child which resolved as it grew and matured. Talk
to your pediatrician and see a good urologist such as Joel Piser
at Berkeley Urological. I'm sure there are a variey of causes
for this and most she will outgrow. In the meantime, shame and
punishment will not help.
I would not! punish a child for inadvertently peeing! No kid
wants to wet himself deliberately. If you have ruled out organic
causes by consulting a board-certified pediatric urologist, try
teaching your kid to do kegels. Seriously, it can help
tremendously with incontinence. Finally, the muscles responsible
for voiding or not voiding will strengthen as your child matures.
Punishment for accidentally peeing can scar your kid--maybe she
will start ''holding'' her pee, which can give rise to a host of
medical problems.
Go easy. G
If your daugther had been an adult, I would suspect weakened
pubic floor muscles and suggest Kegel exercises. That could
still be your daugther's problem. I would have a doctor check it
out. By the way, Rudolf Dreikurs, in ''Children the Challenge'',
says that punishment never works for elimination problems; it
only makes the situation worse.
Fran
Not only did I pee my pants when I laughed too hard as a kid, I
still do it as an adult! I also wet my pants when I vomit, jump up
and down too hard and sometimes when I run. I really can't help
it, and my husband is a very, very funny guy so it can be a real
problem in public.
Its my bladder; it is weak and overactive, and I've tried
medication (my grandmother actually had surgery on hers to solve
the problem) but now I just tie a long-sleeve shirt or jacket
around my waist and keep an extra pair of pants at the office.
Medication just made my mouth dry and made me sleepy. I also have
learned to squeeze my legs shut tight and even press on my crotch
with my hand to keep the urine in if need be.
If this doesn't work and I pee my pants, everyone is usually
laughing pretty hard anyway, and in a great mood, and we just keep
laughing, even about the pee.
I remember peeing in my pants once as child at a slumber party (we
were crank-calling late at night) and the host refused to let me
borrow some pjs and I was a bit traumatized by that but I don't
remember any lasting effects from it.
Feb 2003
I am trying one more behavioral approach to dealing with my 4.5
year old son's wetting problems, but if this doesn't work, I am
advised to look into a possible medical problem. The nurse in my
pediatrician's office has informed me that to look into this,
first a urine analysis is done in the pediatrician's office to
rule out urinary tract infections (which I know it's not, since
this problem has existed for a year and half and my son would be
pretty sick by now if he had a uti!), and if that's clean, then
we'd go on to a urologist. She said she thought the tests they
would do would involve catheterization, the thing I am most
looking to avoid (hence not exploring a medical condition
sooner). My question is twofold: 1) Does anyone have any
experience with bringing their young child to a urologist, how
did you prepare them/help them cope, and are there alternative
ways to looking into this problem other than through a catheter
(say, ultrasound, MRI etc.)? and 2) If, god forbid, we have to
go through with the catheter, do you think I can convince/hold
out for my son to be at least sedated if not put under
completely? The nurse told me this is not usually done, but my
son has sensory integration dysfunction and impulse disorder, and
at his age, this is not an experience he'd forget, I fear, and I
don't want to put him (or me) through it, if it's medically
feasible to avoid it or at least make him unaware of it. Thanks
for any help
Susan
Dear Susan,
My son is 9 months old and has urinary tract anomalies which
have required many tests. Already he has had 7
catheterizations. I understand your hesitation and fear. I
cannot give any advice on preparing your older son for it but I
must say that I have been amazed at how quickly and easily the
tube is inserted and have been suprised at the flexible capacity
of the opening of his penis.
The best advice I can offer is to see a pediatric urologist
instead of a general urologist. Not only are they more adept at
working with small bodies but they also have access to the
appropriate sized tools. Their offices are decorated in such a
way so as to make the children more comfortable and their
personalities are more suited to working with small children.
An ultrasound is one of the tests used to find problems (we have
had a number of them) and may indeed be a good first step.
Then, if an irregularity is uncovered at least you know that
having some of the other tests which do require a catheter are
really necessary.
Best of luck to you.
I think the advice you got about consulting with a urologist sounds
very extreme for a four and a half year old who is wetting his pants
or wetting the bed. It is not that uncommon even in children twice
his age - see the advice on the BPN website. If I were you,
I would get a 2nd opinion - I think it's been quite a while since
bedwetting has been considered a behavioral problem. Everything
I've read in the last 5 years says it is an inherited hormonal
deficiency that they eventually outgrow.
a mom
August 2006
My 4.6 year old boy has been semi-potty trained for about a
year and is still having accidents (pee pee only) almost
daily. They usually happen because he is busy at play and
doesn't want to get up to use the potty. Sometimes it is one
accident and sometimes up to 3 or 4. He doesn't want to wear a
diaper and often times gets very upset when I ask him to change
his wet pants. He is also a very picky eater (almost no fruits
and veggies) and can be rigid, stubborn, and has occasional
tantrums. Most of the time he is sweet and loving and plays
well on his own for long periods of time. Is the potty
behavior and picky eating a 4 year old thing? He was a very
sweet and easy going baby, then became more challenging around
18 months, peaking around 3, now getting somewhat easier
going. Any advice would be great
frustrated mamma
I learned this one for our sons care giver: when ''do you need to go
potty'' is met with a no she says, ''Let's try, you might be
surprised.'' and when they do go she asks ''Were you surprised?'' It
has had a good success rate. Helping him develope physical ques may be
of some help too, i.e.,setting a timer for every 2 -3 hours or so as a
reminder to check-in for himself when he is absorbed in self-play.
Our son has night time accidents from time to time, I try and remember
to have him empty his bladder right before bed & acknowledge his
fustration when he has an accident and not put any energy on it
pam
I just did a bunch of research related to this regarding my almost 6yr
old daughter - definitely check out the pee accident relationship to
constipation. I recently picked up some edible fiber tablets (they are
relatively natural, not chemical, and are orange flavor - one of the
flavors my daughter will tolerate) and some chewable acidopholis
(doesn't need to be refridgerated like most). Next I'm adding in
magnesium to her diet (found a fizzy drink that's pink lemonade flavor)
that will soften her stool. It's kinda working - her constipation is
less and we're also working on a 'potty' schedule - 5 minutes after
every meal or snack. In order to get that going, I put a library of fun
books in her bathroom for her, right next to the potty on a stool at
arms reach.
If this going on longer, take a look online at a diagnosis called
''enuresis'' for more info on what might be a bit further down the
line...
I also got on a yahoo group parent board that discusses these issues
with children - it's been *very* reassuring!
Best of luck.
Anon
May 2009
I have a 5 year-old boy who still has pee accidents, sometimes
several in one day. He had a urine test at his pediatrician's
office and he does not have a UTI. I think that he gets
engrossed in what he's doing/playing and doesn't always hear
the signals that his bladder is sending to his brain. We have
a star chart and rewards for dry days that he gets to choose
himself. This definitely helps. I also think that he will
probably grow out of this as he gets older. I am looking for
other suggestions for things that we might be able to do to
help him to hear what his body is telling him now. He will be
starting kindergarten in the Fall and I am a little bit worried
about him getting teased by other kids for having accidents at
school. Thank you.
Molly
Start worrying when he's 15, but for now, don't even give it
even the smallest bit of thought or worry. Don't even expend
the energy required to read the rest of my post.
sean
This is highly unlikely, but....is it possible your son is having
seizures? Loss of bladder control often follows a seizure.
We didn't realize that our son was having absence seizures until
his kindergarten teacher noticed them. Absence seizures often
last only a few seconds, where the child just spaces out. They
are ''absent'' for a few seconds. So they are quite subtle, esp.
if you don't know what they look like already.
Now that our son's seizures are under control, he no longer has
accidents. I feel horrible about all the times I nagged or
scolded for wetting his pants, when all the time it was the seizures!
Now accident-free
My son also went through a long phase of peeing in his underwear - not a big
accident, but enough to have to change his underwear and sometimes his pants. I
found that he was just holding it far too long and wasn't responding to his body
signals. He said he did not even know he was peeing ... we would just see it in his
underpants, etc. Since he wasn't noticing it, rewards for dry days, etc. would not
work and would simply be the wrong approach since it did not seem to really be
within his control.
The best solution just seemed to be to teach him to pee at routine times throughout
the day. He went upon waking, again before school, as soon as he gets home from
school, once in the afternoon, and again before bed. I did not make it an option, he
just goes whether he feels he needs to or not. Turns out that he realized that his
body did need to go, even though he wasn't feeling the signal, and I think this made
him more sensitive to his body signals. I wonder if he didn't think he needed to pee
unless he felt that ''emergency'' signal, and now he feels the less urgent fullness and
now recognizes that this is the time to go. I remember him often being surprised at
how much urine he would produce and we would remark that it looked like his body
really needed to go even though he didn't feel like he did. Over time, this method
caused him to be more sensitive to his body signals, and I think it is good to teach
routines about the bathroom - i.e. using the toilet before you leave the house.
Seems counterintuitive, but overriding having him listen to his signals for awhile
caused him to end up being more sensitive to his signals in the end. Now we are
always dry. By the way, we had a short episode of the same thing with poop in the
pants during his sixth year, and the same method worked. We developed a few
times a day where he would just sit on the potty and relax to see if he needed to
poop. A few weeks later, the issue was over.
I throw out poopy underpants
My now-8-year-old also had pee accidents in kindergarten and I
just wanted to reassure you that it is not uncommon. Several
kids in his class had an extra pair of pants and underwear in
their backpacks just for this purpose. My son was potty trained
by three, including making it through the night without ever
wetting the bed. There were few accidents in preschool. But when
he got to kindergarten he just could not get the rhythm of the
day down. He would wait until the very, very last minute to go,
even though the kindergarten had its own bathroom. Sometimes the
very last minute was when they were outside, or in the
auditorium, or some other inconvenient place. So he did not make
it in time to the toilet. For us, it really was just kindergarten
- he didn't wet his pants in 1st grade, and now in 2nd grade this
problem is just a distant memory. One thing that seemed to help
is his big brother telling him ''When your bladder says pee, don't
wait. Go now.'' I remember my son telling me ''I have to go to
the bathroom now. My bladder says pee, and like Joe says: don't
wait, go now!'' So it might be the same with your son - he just
needs a little trick to remember to go.
G
April 2009
My 5 yr-old daughter started potty-training at 2 1/2 years of
age. It has not been easy right from the start.
At 4, she was still having as many as 4 accidents on bad days.
Her doctor suggested that constipation which she often has,
causes the intestine to pressure the bladder causing drip
accidents - a kind of incontinence. The remedy for this was
drinking water and eating vegetables and fruit. She doesn't
drink much water, but eats good variety of vegetables and fruit.
This helped a bit with the constipation but the accidents continue.
Now at 5 1/2, I can explain the facts to her about digestion and
how a bladder works. We have talked to Dr. Lee, urologist
referred to us by her pediatrician. He seems to think that the
leaky bladder accidents were caused by delay in using the
bathroom, i.e. her bladder was stretched out by repeated
forgetfulness to use the toilet. His suggestion to fix this was
to have her use the toilet every 2 1/2 hours. She has been on
this 2 1/2 hour regimen for 3 months. This helped to decrease
the number of accidents, but has not helped her in knowing when
she needs to use toilet. If her teachers forget to get her to
the bathroom, she has an accident but these have not been the
drippy frequent accidents.
My concerns are that 1) she is going to kindergarten next fall
where the teachers will be more involved with teaching and may
forget to remind her to use the bathroom. Will an alarm
wristwatch be helpful in getting to the bathroom at the required
time? Or will this delay her independence in learning to use the
toilet?
2) her peers will make fun of her for needing reminders or
wetting her pants.
3) MOST IMPORTANT, by age 5, she should be feeling her full
bladder and be able to get to the toilet before wetting. Why
hasn't she learned to do this and why hasn't she learned from the
many accidents she's had?
4) LEAST IMPORTANT, but on my worry list is night-time training.
If she is not independently able to stay dry during the day,
should I bother her and me to wake up to use the toilet once in
the middle of the nite?
Has anyone had similar experience with toilet-training?
Thanks for reading.
Hi. I am sorry to hear about your daughter's pee accidents. I
am sure this is a struggle for you and her. Have you looked into
her diet? I have read and heard from friends many times how some
children are sensitive to certain foods and this sensitivity can
show up via incontinence. In fact, my 2.5 year old son, whom I
have ec'd since he was born and is nighttime potty trained, only
pees in his sleep if he's eaten too much bread or grains over the
course of a couple of days.
I remember reading about a teenager who overcame nighttime
incontinence by doing the Feingold diet, which removed some
specific foods, particularly foods w/ additives. A friend of
mine is doing the Specific Carbohydrate Diet w/ her son and is
seeing results re rashes and daytime incontinence. Please look
for Breaking the Vicious Cycle by Elaine Gottschall and /or Gut
and Psychology Syndrome by Dr. Natasha Campbell-McBride. Both
books discuss the effects of diet on gut health and give diet
recommendations for healing. Google SCD or scdiet to get started
now. Your daughter's constipation could be an additional
indicator that she is having bowel issues. The body will talk to
us in mysterious ways! Please don't try to just control the
accidents w/ a timed wristwatch! Something is interfering w/ the
signaling in your daughter.
I would also recommend seeing a different doctor.
good luck,
Nita
My son had the same problem. We realized he was drinking
gallons of water in the shower before bed. The accidents
haven't stopped completely but are way down now.
JodyT
April 2009
Hello,
My 5 year old son has recently started having pee accidents.
I've noticed that this has coincided with the recent birth of his
sister and realize that kids often regress at the birth of a
sibling. These accidents tend to happen at school, parties or
during playdates -- not so much at home or when he is doing
something low key. When asked, he tells me that he is not aware
that he has to pee. My son has always had a problem disengaging
from activities to use the toilet -- he has a really hard time
stopping things that he is deeply involved in. Is it possible
that he really may not feel the urge to go?
I understand that this may be his way of reminding us that he is
still little and needs us. I'm just not sure how to handle this
in a way that meets my son's needs while also getting him to the
toilet in time. Will this just correct itself if we continue to
make special time for him and assure him that we know he still
needs us? Right now, we are reminding him with non-verbal cues
like a tap on the shoulder, as he is embarassed for us to
verbally remind him in front of his peers. But obviously we are
not there during the school day or other times to do this. What
makes matters worse is that sometimes I get really annoyed at him
for having accidents (and then I feel awful for showing him my
irritation) -- which doesn't help anyone! Any advice would be
most appreciated! Thanks.
anon
You are right that it is perfectly normal for a sibling to
regress after the birth of a baby. It will figure it self out.
In the mean time you should continue to remind him to go. Have
him go right before the playdate or party and depending on how
long it is, remind him to go during also. Non-verbal
communication is probably good as to not embarass him. He
probably hates is as much as you do! He just forgets, that is
why they call it an accident. Talk to his school and see if
they can make sure to remind him to go at school too. I am sure
they would understand that this is just a phase and be willing
to help him overcome it. Just be patient with him and you will
have to put some effort in just like when he was originally
potty trained and this too shall pass. I am sure it does get
frustrating, but showing your frustration to him may make
matters worse, so try your hardest to keep them to yourself.
Understanding mama
March 2007
My son is in kindergarten and regularly pees in his pants at
home, at school, pretty much anywhere, every day. After he
stopped using diapers (at over 4) he had occasional accidents. A
few months later the accidents became more and more frequent. We
have ruled out physical problems. We have tried a sticker chart
which he didn't seem to care about. If I remind him to use the
toilet he usually says he doesn't have to or gets angry at me for
asking. Right now, I'm trying not to say anything at all, to
just let him decide to stay dry. So far, no progress. Any
suggestions?
Tired of all the laundry
Is he doing this because he's lazy? You said you've ruled out physical
issues. Is it anxiety? Emotional issues?
One way, possibly, to stop is to make him do his own laundry.
Don't change him (I know, it's wet and stinky)...let him be wet and
stinky and if he can't stand it he can go change him self.
My now teen at one time would poop in his pants at an age when he knew
better, because he didn't want to bother going to the bathroom. I made
him change and clean himself and wash his soiled underpants in the sink.
That stopped REAL fast.
Good luck.
anon
Our now 12 year old peed in his pants til he was six and a half. We
worried about it a lot. Then he stopped on his own at six and a half
and there has been absolutely no problem since. Our son is a little
slow to learn some self regulation issues, but he is very bright and
does get it a little later than some kids. Other things he gets earlier
than other kids.
Good luck.
Once I heard a friend of mine telling her then 4-year-old that it was
time for a ''surpise pee.'' We've been using that term ever since:
''It's time for a surprise pee.'' ''I don't have to go.'' ''Well, see
what happens --- that's why it's called a surpise!''
AB
My now 9 year old son wasn't really and truly completely dry until he
was 7. Even though you have 'ruled out' physical problems one thing his
ped. suggested which did help was giving him a Metamucil cookie every
day (or maybe 2x day, I don't remember). He believed that my son was
having trouble sensing when he needed to go. An xray confirmed lots of
back up. It did indeed help but took a few weeks. The other thing
which kept him peeing (after having been mostly dry) was stress at
school. There was a lot more stress than we realized. For a variety of
reasons we eventually pulled him out and put him in an independent
school. He was almost completely dry after that. Anyway two things to
consider.
anon
My kid potty-trained himself early, and still had some accidents in
Kindergarten. The solution suggested to me was to take away his
''backup'' clothing in Kindergarten, and to tell him this: If he peed in
his pants, he didn't have clean ones to change into.
(I did sneak a set to his K teacher when he wasn't looking.) That was
it; he stopped. It turned out he didn't like stopping what he was doing
and he knew he had a backup. When he realized he didn't, getting to the
toilet was a higher priority. (The teacher also helped by noticing the
''potty dance'' and reminding him to go.) Jennie
August 2005
My 6 year old son is still wearing a pull up at night and has pee
accidents about twice a day. When I'm around I take him to the
bathroom and 15 minutes later he has an accident. Does anyone have
advice or is this something I should seek professional guidance
about...Thanks
Hi,
From a professional perspective, your concern warrants
intervention. There are a myriad of possible causes for your
son's situation. Most therapists will consider many factors
before determining the best way to resolve it. Whether or
not you choose to stay in dialogue with me on this issue, I
would ask you to document (for yourself) your son's history
around it. Ask yourself these questions:
What does your son's pediatrician have to say about the
situation?
When did you first notice your son wasn't progressing on
this behavior?
Did he ever have a time of particular regression on this
issue?
When and how have you tried to direct his bathroom
behavior?
Were there any particularly challenging moments or
incidents?
Does your son have siblings? (If so, what are their histories
and how might they have made any contributions [positive or
negative] to the situation?)
The answer to these and other questions will serve to guide
the course of intervention a professional will recommend.
I hope you find this helpful.
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