Potty Training Regression - Should We See a Doctor/therapist?
Updated on
May 12, 2012
N.K.
asks from
Miami Beach, FL
9
answers
Hello, I was browsing through previous posts on this issue, but I didn't see anyone posting about an older child having these issues, only toddlers. My daughter is a few weeks shy of turning 6 years of age, and for the past month or 2, she has been consistently peeing herself. This not only happens at school, but also in her aftercare program, and at home, especially at night.
She never had a problem with going to the bathroom on her own before, but now, her clothes are always in plastic bags from peeing them, and that's only when she gets to the aftercare and she can change, because in school, they are not allowed to change (they wear a uniform), so she will literally sit in a moist skirt all day. I should mention that she's not one to dress herself, and in the aftercare, the older girls help her change, but she would not be able to have this assistance in school as the teachers are very clear about children having to be potty trained and self-sufficient in the area of wiping, etc., so even if I were to send another uniform in her backpack, she wouldn't bother with changing into a clean uniform.
We have discussed this peeing issue with her teacher, as we thought the teacher was making her wait to use the restroom, but that's not the case, the teacher lets her go as soon as she raises her hand. I thought maybe she was having trouble zipping and unzipping her skirt, but even with elastic pants, where all she needs to do is pull them down, she will still pee herself.
She has the same issue in the aftercare. I thought maybe it has to do with her wanting to play with her friends so badly, that she ignores her body and then it's too late and she's sitting in a puddle of pee. Some of the kids have noticed and told her she smells like pee. My husband thought that maybe she likes the feeling of warmth sitting in pee provides her, and if she realizes it's unpleasant, by hearing it from others, she would realize it's filthy/something to be ashamed of having on your body and she would make an effort to go to the bathroom. This hasn't helped either, nor has "letting her sit in her pee for hours", which apparently has helped other kids feel uncomfortable enough to exercise more self-control. I ask her why she peed her panties and she will say "I don't know", or "I was playing" or "it was just an accident", but it is happening daily, and multiple times a day as well! I don't mind doing laundry daily now, but we have to change our evening plans several times when I pick her up because we can't go with her having wet pants. I have offered to reward her if she can keep dry by buying her a toy or taking her out for a dinner date with me, and she will say "ok, I won't pee my panties", and I have faith that she will really will try to make more of an effort by the way she looks me in the eyes, but in the end, she still does.
At home, I take her to the bathroom at night before she goes to bed, yet maybe an hour or 2 later, she will wake up and the bed is wet. Sometimes she's awake and asks for water, and by the time I return with some water, there's a wet puddle on the bed. I told her we will need to go back to Pullups because she can't keep peeing herself but she says they're for babies and she doesn't want to wear them. My in-laws are upset about the peeing and concerned, they think something sinister may have occurred. She has been told by us several times that no one is to touch her "down there" unless it's mama or grandma wiping her, or we're in a doctor's office and they're doing a check-up with us present, and same goes for being naked, yet she hasn't had anything to tell us. My in-laws are pressuring us to do something to address it, like grilling her with more questions or going to a psychiatrist.
I am out of ideas, except asking her pediatrician for advice or taking her to a therapist, which is what my husband has suggested we do to see if there's some psychological motive behind it. He thinks maybe she sees it as a bonding experience or wants individualized attention from an adult while in the bathroom (helping her wipe and get dressed again) and if she doesn't receive it, then she ends up peeing herself, or maybe she completely forgets she needs to pee. I honestly don't know what motive there may be, and I don't think anything "traumatic" happened, as otherwise, her behavior is the same as always. Do you think taking her to a therapist is the best/only solution or do you have any suggestions as to what else we can try? Have you dealt with this before, and if so, what was causing your child to regress as if she/he had never been potty trained? I'd rather try to solve this on our own than force her to wake up earlier so we can sit through expensive therapy sessions before she needs to go to school. Thanks in advance, sorry for the loooonggg post, and no snarky, judgmental remarks, PLEASE!
PS: FYI - The school bathroom is always lit up, and the aftercare bathroom is literally steps away from the kids' play area/homework assistance area, so it's not that she's scared of the dark, or has a long distance to travel.
UPDATE AS TO SUE'S QUESTION: Thanks for asking about the vomiting issue. We took her to a specialist and she was diagnosed with acid-reflux. He put her on prescription Prevacid for a few months, and we also stopped giving her dairy. Ever since she was a baby, she had trouble with both breast milk AND formula and we had to put her on Alimentum, because that was the only formula for delicate stomachs that somewhat reduced the amount of colic. I had a sensitive stomach as a kid myself, so I guess she inherited that! She now drinks some dairy on occasion but not often, we try to give her almond milk or soy milk instead. She does vomit if she's too active, jumping, or in the car for a long ride immediately after eating, even if we try to drive slower and step on the brake sooner. She's vomited maybe 2-3 times since this school-year started, which isn't bad at all, considering it used to be constant. She may also have consumed something that was not fresh, as some other kids in her class were vomiting that day as well after drinking from the same batch of milk containers. She's not a picky eater at all, she eats fish, octopus, chicken, sushi, Mexican food, Chinese...anything pretty much, so I'm glad we got the vomiting issue under control.
Well, we took her to the doctor on Monday as this had been bothering us, the doctor ran tests on her urine and said everything was negative, so I honestly am not sure what to think (not sure what other tests they would need to run for overactive bladder, etc). I read somewhere that kids with PANDAS start out this way and I am worried, but the doctor doesn't seem to be (we did not mention PANDAS to the doctor, though). The doctor just said to bring her back if she feels discomfort.
The doctor thinks that everyone caring for her should make more of an effort to make her use the bathroom, whether she wants to or not. Yesterday, she peed in the van of the afterschool teacher, and although I felt somewhat sorry for the woman and her vehicle, considering she knows my daughter has this issue, it was a bit neglectful on her part to not make my daughter use the bathroom BEFORE putting her in the van, so she shares part of the responsibility. This is what I am starting to do: before we get in the car, even if she says she doesn't need to pee, I sit her on the toilet (there usually IS a good amount of pee, actually). When we get to a restaurant/relative's house, again, I sit her. If she won't go on her own, I will take her and make her go everywhere that has a bathroom, and hopefully this will solve the issue. The night time peeing is very rare, it happens maybe once every 2 months at that, I always take her before putting her in bed and if I am still up at 2 or 3 a.m., I will take her again. If her night time peeing starts to worsen even after taking her to the bathroom before bed, then I will get a night time bed wetting alarm for kids. This is supposed to condition the child to immediately go to the restroom once the alarm is going off.
I am a bit upset that my daughter reports to me that her school teacher tells her to hold it or pee her panties (although I do doubt the latter, what teacher would tell her student to pee her panties?), she says when she has tried to get up and go on her own, the teacher says "get back in the classroom". I told my husband to tell her she must not let our daughter hold it under any circumstances, and in fact, we will see if we can work out a schedule with the teacher that forces her to use the restroom every hour or 2, and hopefully this will prevent it.
My husband thinks that if she really is telling her to hold it, that it may be for purposes of getting her to build her bladder muscles to learn to hold it, but I think it's wrong, especially knowing the end result is she ends up in a puddle of pee and stinky all day, plus she's getting red down there because unless someone notices she peed because her navy skirt looks darker and changes her, she won't say or do anything about it (probably out of embarrassment).
The aftercare teacher thinks I am too lax and need to discipline her every time she pees her panties, but frankly, I am not into spanking, whipping, pinching, etc. in the first place, and especially if the child may have a legitimate medical condition that can be causing this. What kind of example does that set? That any time you have a medical issue related to incontinence you will be punished physically? I find it cruel and unnecessary, and I find it can lead to trauma.
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A.C.
answers from
Columbus
on
My very first guess is that she might have a large amount of stool inside her and it's causing the pee incidents. The main culprit of toilet training regression is constipation--the compacted poop is pressing her bladder. If it's been going on long enough, her body stops sensing the need to pee/poop. Take her to see her pediatrician, and please don't guilt her or make her feel bad--she probably already knows she smells and the kids are making fun of her/saying she smells bad. She needs her mom and dad to love her no matter whether she's having accidents or not. An xray will show compacted poop if its in there.
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S.H.
answers from
St. Louis
on
very 1st thing which jumped out: she doesn't like to dress herself & she has friends help. At age 6, this surprised me! I cannot imagine her not being self-sufficient.
When you couple this with the incontinence/behavioral issues, my vote is for seeking immediate assessment....1st thru a doctor & then really keeping a therapist in mind - if you don't see immediate success.
& I'd like to go back to 2009 when you posted about her vomiting/carsickness over a several month period. Did that ever resolve itself? Does she still do this? Are there other possible benchmarks of behavioral issues that perhaps you are overlooking, as being the "norm" for her? Please really think about her behavior on a daily basis - all of this will help the doctor with his assessment. Peace to you & Good Luck!
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K.B.
answers from
Philadelphia
on
Take her to the doc and have her checked for a bladder infection or the like and talk to them first. Rule out physical problems first. I wouldn't rush to a psych right off the bat because she's wetting. I would be angry at the school for allowing your daughter to sit in a urine wet skirt! That's unhealthy! If she's having a medical problem then she should be allowed to change her clothes one way or another. But take her to the doc to see what is physically is going on and do it right away.
K. B
mom to 5 including triplets
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S.L.
answers from
Boca Raton
on
I used to do this as a child and it was because I would get a lot of bladder infections. I was constantly getting them and having to take medication. My mom talked to someone at school and I was allowed to just get up out of class to go to the bathroom without asking. Check on that. I remember my sister (who I love and have always been very close to) making fun of me as a child because we shared a room and she had a friend sleep over and she said "I won't let my friend sleep in your bed because it smells like pee!" I was hurt and embarrassed and remember it now, 40 years later. So if other kids are commenting, she may remember that forever. I hope you figure it out. You sound like a terrific mom!
P.S. I wouldn't let your in laws (or you) grill her now - she's too young and suggestible at her age. You might just confuse her about things.
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B.D.
answers from
Wichita
on
Wow, that's a difficult situation. Kudos to you for keeping your composure. First thing I would do is take her to the doctor and make sure she doesn't have a health problem. Maybe she really is trying her best but her body is cooperating with her. If everything checks out there, it may be an attention issue. Negative attention is still attention. What I would do at that point is if she wets herself wordlessly hand her new clothes and a towel. If she's making the mess then she needs to clean it up (consequences of actions) and if you don't talk to her at that time she learns she does not get attention. Make sure to praise her when she does make it to the toilet. Then she'll associate peeing in the toilet with positive attention and wetting herself nothing but a mess.
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C.M.
answers from
Chicago
on
Start with a doctor to rule out any physical problems. It could be a bladder issue or a food allergy. From there the doctor can advise you if a therapist is necessary. Her brain may not be getting the physical message that she needs to go. It would be horrible to punish her for something she physically can't control because of a body issue.
Try putting a pad in her underwear like you'd use for adult incontinence and send some with her so she can change it at aftercare. She may not be able to help it, and shaming her or making her sit in wet panties may actually mentally damage her.
Good luck!
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B.G.
answers from
New York
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I would definetly seek a professional for this issue. The pediatrician or a primary doctor. There may be more than what is going on at school. I would have a talk with the principal. There may be bullying going on in the bathroom or somewhere that's why she doesn't want to go. Maybe the teacher could walk her to the bathroom or she should have a buddy with her a buddy system. The teacher should make it a good thing a positive thing and reinforce bathroom time several times during the day. The school should call you if she has an accident. That is ridiculous that she is sitting in a wet skirt. That is not healthy and probably painful. With the urine burning her legs. If they don't then your daughter should go to another school that cares about her. she may have a bladder infection. With all of that peeing she might have an infection there. Check see if it is red She may not be even wiping correctly.
You should start with one doc at a time. I would give her all the love in the world and not yell at her if she pees.. I would look into the Daycare. Get an exact schedule of what they do with her there. I would go visit the day care on a randomn day and go in there and see if she is upset or if she is in the corner or acting strange. I will also want them to have a schedule of when she is going to the bathroom. Your paying these people they should do there jobs and look out after your child. I would not grill her. She is only 5 years old. A baby.. I would start over put different potty's around the house. Put puzzles and books next to each of them. When you go to the bathroom bring her and take your time. If she doesn't go look in the potty and make believe there is something there.
I think she is also lacking attention maybe... Maybe.. or someone was making fun of her. I would kiss her and hug her and tell her it is ok that she had an accident and she won't do it again right. I would use a lot of positive in there.. Also, About the acid reflux i would get a second opinion on that.. I would see a allergist and get a food pric test and it will tell you what foods she may be allergic too.. so early to put kids on any type of meds.. Just some advice. Good Luck I have two girls i would make this a very very sensitive subject.
Barbara G.
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M.C.
answers from
Albuquerque
on
Sounds like she may have developed a urinary incontinence disease like OAB (Overactive Bladder). My childhood friend had this problem. She was prescribed medications to help control bladder spasms and she was able to keep control of it - with some bedwetting at night.
You may want to mention this to her doctor and see if they can test her for it.
Best of luck!
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D.P.
answers from
Sacramento
on
I'd take her to the doctor as soon as you can, it may be a bladder issue that she doesnt have control of, if everything is ok medically then see about psychological help. If the pediatrician feels she need psychological help waking her up early or having to take time from work shouldnt be your main concern trying to get her the help she needs should be. Sounds like you have good relationship with inlaws? Maybe they can help get her to therapy sessions, if need be. One step at a time, start with pediatrician and go from there. Good Luck and I am sure everything will be fine for you and for her! :)
