Help! Toileting nightmare

[jayceemum]

I've never posted here before so excuse me if I don't use the right terms etc. DS1 is almost five and started school. He's loving it and seems to be picking up everything quickly and he has lots of friends and so on. But it's all overshadowed by the fact that he's never been successfully toilet trained and I'm out of ideas. I've done everything the doctors and health visitors have advised. I've been patient, I've not made a fuss, I've rewarded him, I've gave stickers and star charts. Then I've lost patience and I've shouted, I've tried to talk calmly as he's a smart boy and there seems to be no good reason for him to just not bother going to the toilet, and even now his little brother (age 2) is fully toilet trained and it makes no difference. He's been given medicine to improve bowel movements and I nag him to drink more (upon the advice of HV). He doesn't care that he's wet and he always has something better to do than go to the toilet. It's beginning to rule our life. If my husband asks how his day has been I tell him in terms of how many accidents he's had. He's been mostly ok at school but I know he's been dribbling as his pants and trousers smell when he comes home. I want to see a specialist as I feel he has no bladder control but they said that it's a toilet training issue until he's a bit older and then they will accept there might be something else. It's been 2 years and I feel like I've had no proper support only comments like "you obviously started him too soon" so that's overall very unhelpful at this stage. I'm becoming so frustrated and cross with him because he is a smart boy and now I feel that me being upset by it has contributed to the fact that he doesn't tell me when he needs or if he's had an accident but even when I gently suggest he goes to the toilet (when he's holding himself and dancing about) he always refuses, wets himself and turns it into a big deal. Please, if anyone can suggest anything other than another star chart?! Sorry for a long rant!

[Itscurtainsforyou]

I'm so sorry, that must be very stressful for you.
My son is 6 and still wets the bed - completely different to your situation obviously. When mentioned to the GP he said that 25% of boys weren't continent at his age at night. So it makes me wonder if more have similar problems to you than we realise. He's also had a few instances where he's wet himself st school because he's been too engrossed in what he's doing. Is it worth going back to the GP to get a second opinion?

I'm not sure what to suggest, is it worth getting school involved and making him go to the toilet every hour? That could reduce the likelihood of accidents and might get him to focus a bit more?

[TheEmperorsHat]

We found a marble jar reward system more effective than sticker charts. Two jars, yours has marbles, his is empty. I stuck a label on DS2's that says '1 marble = 1 sweet, 3 marbles = extra bedtime story, 5 marbles = local trip out, 10 marbles = small new toy. That helped a little.

Other than that, look for reasons the toilet is unpleasant. Is it too cold - is he cold sensitive? Is he worried about falling off? A stool/taller stool may help. Does he hate hand washing? Might prefer alcohol hand gel. Does his usually lovely mummy/daddy/other suddenly get stressed at toilet time? (God knows I do - hiding it better helped us lots!)

Lastly does he definitely know that he needs to go? Took me ages to realise ds2 hasn't joined the dots between him doing the toilet dance and me making him go. I had to spell it out - I'm not convinced he has normal sensations to let him know.

We made a rule for when he goes and this routine helps too - he has to go at wake up, break time, lunch time, after school, before tea and before bed. If he complies he gets a marble or other bribe. It is mostly habit now and I'm kicked/battered less often en route to bathroom.

If he also has constipation, we have found chocolate crispy cakes made with all bran very helpful! Not too big though or the effect is excessive..

[jayceemum]

Thank you. I'll try marbles for a change, sounds like a good idea. He doesn't dislike the toilet as such it's just the idea of leaving a toy/tv/whatever he's doing. I do know I need to try and remain calm but it's just so frustrating. And I am back to the doctor next week again. I'm sure it's maybe more common than I realise but not many Mums are quick to admit it which does make me feel like I've done something wrong along the way and let him down.

[user1474026214]

We have a 5.5 year old son with the same problems and we have made huge headway in the last few months because we realised that it was an engrained behavioural problem which would take time to change, rather than a developmental problem smaller children face.
So we taught him what poo and wee were by looking at books about the digestive system. And we were really honest as he is old enough to be reasoned with. We told him that his body would suffer if he kept holding in his wee and poo/that people would think he smells if he kept letting them dribble out. He agreed he did not want this.
We worked on toilet refusal first. Whenever we told him to go to the toilet, he had to, even if nothing came out and we would go with him. We turned it into a bit of a game where we would race each other to get there & tell jokes whilst he was on the toilet. If he refused, no TV for the day. We had to follow through with this a couple of times (I know you're not supposed to punish, but this isn't the same as a toddler who is learning, it's a 5 year old in the habit of refusing).
When we had done this for a little while, he occasionally said he needed to go and stopped needing us with him. Then we upped our expectations and said that we expected him to go without prompting more or no TV. He did. Not always, we reminded him sometimes too but there was more of a balance. Again, we had to follow through with no TV a couple of times.
He regresses every few weeks and we have to start it all again. But behaviours take a lot of repetition and time to change.
I work with kids and know that this is quite common problem. Don't blame yourself. We are happy with where we are now compared to where we were 4 months ago when he was wetting himself twice a day or holding onto poos until they just came out. Best of luck, you will get there!

[Linpinfinwin]

I found the school nurses a much better route than GP. My child was referred to enuresis clinic straight via school nurse in YR and was given medication after first appt there, I think because we'd already been given lots of good advice by school nurses and it hadn't worked. Get the phone number of the school nursing team from the school office. My child was diagnosed with an overactive bladder. She could stay dry for a few days on a sticker chart by trying very, very hard so the charts appeared to work, but she was weeing 12+ times a day and it just wasn't sustainable long term. She needed help to last longer between wees. Constipation magnifies the problem significantly so avoiding that and monitoring poos are mainstays of treatment. Drinking water is, in turn, an important part of that.

I do know where you're coming from. Some people blame the parent for starting too early, but my mum and grandma think it's my fault for training too late. They can't all be right, can they? Ignore any comments from people whose children trained in a week or two - their method obviously worked for them but in parenting no method works for every child. Sometimes it takes a lot longer. We don't blame parents of late walkers or crawlers, but somehow toiletting seems to attract "experts" who know better.

[Kariana]

Two things stand out for me in the post, the fact that he's mostly ok at school, which suggests he's physically capable and the fact that he will refuse to go, wet himself and turn it into a big deal. It really sounds like the attention this is getting is a big part of this learned behaviour.

The poster above (with the username user147...) has some excellent suggestions. I think if you can see he needs a wee then you are the parent and you need to march him to the toilet, not let him refuse. You can then reward/praise if a wee happens in the toilet. He's probably reached the stage that consequences are appropriate too. I would follow user's advice and see if you can make headway like that.

[jayceemum]

Thank you for suggestions. We'll definately take them on board. We have an appointment at school nurse next week as Dr wanted to refer him but can't without seeing school nurse. We've made the realisation this week that when he does go to the toilet he isn't emptying his bladder fully and if we ask him to try a bit more there is always more there. I think that's why there are constant small accidents as oppose to larger ones. We definitely need to take time to get him into the habit of going to the toilet and not just having a super quick pee and getting out of there. At the moment we often have to physically pick him up and drag him there which isn't ideal so I think we need a new game plan to encourage that. I completely agree that this has now become an engrained behaviour and not just a phase and that's why all the standard advice for training a 2/3 year old isn't enough anymore.