4 Year Old - Wetting Themselves - Advice PLEASE

[JustaboutcopingMum]

I am just about going out of my mind with my 4 year old and wetting herself.
We potty trained since 2 1/2 and we haven't gone a full week without accidents.
We do reward charts, reminding, no reminding, praise, no praise. None of it works.
Now school has started it is even worse and almost everyday she comes home in the schools spare clothes.

We have done urine tests to make sure she doesn't have a UTI.

She wets the bed every night too.

Has anyone got any new advice? I am going out of my mind with worry, concern and i'm also losing my patients!

Does she tell you when she's wet herself? Does she seem to know it's coming? Does she hide to do it? Are poos ok?

It's so frustrating!

If she wets the bed she needs a pull up - she can't help that she hasn't yet started to produce the hormone that suppresses urination.

Firstly put her in pull ups at night so that you're not dealing with a wet bed. It's normal for a 4 year old not to be dry at night.

I would speak to your GP about the daytime wetting.

A discussion with your GP might be a starting place.

My daughter was similar. She was eventually diagnosed with an overactive bladder. Forget night time for the moment, keep her in pull ups. Try not to get angry, it's really not her fault, but I know how hard it is changing sheets several times a night for years!
Ask your GP for a referral to an Incontinence Clinic, mine have me some really helpful advice eg keep fluids up, sitting back to front on the toilet to make sure bladder was fully emptied. Check out the Eric website, it's v good too.
Slowly but surely she improved. At about 8 years old she started taking a synthetic hormone (desmopressin?) to reduce her nighttime time urine production. This worked great and within 6 months she was dry at night.

Hi
The GP has been useless, just referred me to the ERIC website. Which is great advice but I’m worried she has an over active bladder.
It’s like she suddenly needs to go!

Tattychicken how did you get referred? Did you ask your GP?

Thanks for all your replies it’s just nice to speak to someone about it :)

ERIC website is great. Other things:

Constipation is major cause of this. Increase fibre and use lactulose. Have her sit on the toilet for 5 minutes morning and evening (don’t guess - use a timer).

Make sure she’s drinking LOTS of water.

Get her to spend 10 seconds more on the toilet after a wee, and to go to the loo immediately after an accident. The idea being that she should completely empty the bladder each time.

Our consultant also suggested measuring output of wee, to make sure bladder was exercised. That’s something you can only really do at home, but if you get a couple of weeks of lockdown then it would help!

I don’t know you’d get a referral for a 4-year-old, we had to wait until DC was 7, but that might be area specific.

Cross-posted! Try measuring output and get her to aim for more each time (ie hang on a bit longer, squeeze more out). Doing that was a turning-point for DC, but was definitely a lockdown project rather than something you can do at school!

Yes we got referred by the GP, initially for a bladder scan then to the Incontinence Clinic. I saw the GP when she was she was about 4 and it took about a year to get the first appointment. She was eventually discharged at about 9.5 years.

This might be a silly question but how can I measure how much she is weeing?
I’ve got a week off with her next week so this might be the perfect time to practice lots of water, extra time on the loo.
Is it worth me giving her weak squash she make her drink more?

We had constipation issues when she was 3, which was causing her to wet herself. She was holding the poo in, and soiling was a huge issue. But now that’s all resolved and she goes regularly. So one down, one to go!

Squash, particularly black currant isn’t recommended as it can be irritating to the bladder & make them wet more.
I guess you could get her to use a potty & pour it into a measuring jug? Or a basin held in the toilet, ut that might be more of a faff.
A potty at least should get her in a good position to empty her bladder.

Sorry, I should say, I do still give weak squash, but avoid black currant.

I’d definitely put her back in nappies for night time.

Following this as I'm in exactly the same situation with my 4 yo DS. Health visitor suggested bladder training and if not next step is incontinence team...
I hadn't considered an overactive bladder which does sound plausible!

Has anyone suggested she might just be distracted? My dd was exactly the same, and the only problem was she was too engrossed in whatever activity she was doing that she didn’t want to stop doing it to go to the toilet. So, she pee’d herself.

She did grow out of it, but it was hard going. Even now at nearly 8 she’ll leave it to the VERY last moment to go, and quite often has to go a few times in a short space of time as she’s in such a rush to return to her activity she doesn’t empty her bladder (pelvic floor of steel 😂). Her p1 teacher thought it was hilarious she would tell her that she had definitely emptied her bladder - clearly the message was strong. 😂

Sorry, back to you. Definitely pull ups at night - why strip a bed you don’t need to? If she pees through the pull ups, it can be an idea to do waterproof sheet, sheet, waterproof sheet, sheet so that if there is an accident in the middle of the night everyone is getting back to bed as quickly as possible.

Dr’s don’t tend to go down the medication route until at least 6/7. My ds had desmospressin for night time wetting and it worked like a charm alongside an alarm.