To punish DD every time she wets herself.

[sleepdeprivedby2]

DD is five years old and still wets herself multiple times a day, in the last 6 months she has been dry for 2 days!

I am at my wits end as we have tried absolutely everything to help her, star/reward charts, lots of praise for going to the toilet etc etc, you name it over the last 2 years we have tried it. The only thing we haven't tried is a consequence for being wet!

We are currently waiting for a paediatric referral but this has been cancelled once, so I am not holding out much hope.

The main crux of the problem is that she just doesn't care about being wet, going to the toilet is an inconvenience which she puts off and off. She will wet her pants and still not go to the toilet!

Normally I just ignore it as much as possible and then send her to get herself changed but I am completely fed up of her whole attitude towards it and her determination not to help herself.

We have bought her a watch which vibrates during the school day (every 1.5 hours) to remind her to go, but she just ignores it, puts it in her bag or leaves it at home! Every day when I pick her up she has had at least one change of clothes and is usually wet again and she smells really bad!

Tonight at bath time, she got in the bath (with her 2 year old brother) and stood and wee'd in the bath rather than go to the toilet less than a meter away. I took her out the bath, put her on the toilet and told her to sit there whilst I refilled the bath at which point she started screaming at me so I calmly picked her up and put her in bedroom and shut the door.
Two minutes later she comes in the bathroom "mummy it was a bad idea to put me my room because now there is poo on the floor".
At which point I explained that her behaviour was completely unacceptable, told her to go to the toilet, walked out the bathroom, cleaned the carpet and went to play with her brother.

I know everyone says to ignore the bad behaviour and praise the good but as you can see it's just not working!! There are no real consequences to her wetting herself, we send her to get changed and she plays in her room still in her wet clothes or puts one of her princess dresses on.

So do we give her a consequence every time she wets to make her realise that this is not acceptable or do we continue to ignore through gritted teeth and hope she is dry before her tenth birthday.

Thanks for reading

My dd was a bit like this. She would be enjoying doing something or concentrating on something, and simply didn't want to stop. My mum recognised it as I had been the same

I did the don't make a fuss thing. So would just change her clothes and then she could get on with whatever it was. Didn't say much, just "come on, let's get you sorted".

If she hadn't grown out of it then I would have gone to the gp, but luckily for us, it didn't come to that.

I do sympathize with you, op. It is exhausting and worrying, and the washing piles up, and there are floors and carpets and sheets to clean and it gets completely overwhelming.

Have you tried the suggestion upthread about rewarding for sitting on the loo for a little while? Then rewarding for sitting and doing something and so on. It'll take time, as I think you will need to spend a week at least on each stage to get the hair firmly set, depends on the child of course, and you know her best, but I would say not less than a week on the early stages. Well, at least you might feel that you are doing something positive about it while waiting for the referral.

It's not a punishment, so you could chat to her, or read to her, but keep it relaxed, while she's there. That could help improve her 'relationship' with the loo (I might be talking idiocy here, but I'm perfectly OK if people tell me I'm barmy, so don't hold back!).

I haven't read the whole thread but I disagree with those saying there must be something fundamentally wrong. My dd1 is 4.5 & behaving exactly the way the op is describing. She just doesn't care. She is a normal, happy, sociable child. By ignoring the wetting she gets the idea that it is ok. Reward charts just made her start lying & not wanting to tell us she was wet to get her reward. I have no idea what to do.

I have been to the drs, she has been tested for a UTI. The eneurisis clinic turned down a referral on account of her being too young for it to be an issue.

I'm interested to read people responses though am getting cross at those I've read so far criticising the op. it's v hard to know what to do for the best and what works for one child may not work for another. I think the most important thing to understand that while it is undesirable, it is perfectly normal.

ERIC ERIC ERIC! cant remember what it stands for, but google them, they are brilliant, you can talk to an advisor on the phone and they will help you enormously. (it might be Enuresis Research & Information or something like that)

My oldest was like this, went through all the tests for UTIs etc, nothing physically wrong, but she just couldnt hold it in and didnt seem bothered either (I was bothered, and I was pretty crap at seeming unbothered tbh).

School were a right royal pita, asked me to come in every time she wet herself - nipped that one in the bud by explaining, in writing, that if she had a physical problem it was hardly fair and we were waiting for NHS referral, and that if it was attention-seeking then mum turning up in class with 3 yo in tow would hardly be unobtrusive.

Then we had the long summer holidays at the end of Reception, and she just stopped. I think it is a combination of mental, emotional and physical maturity - if you're lucky, they come together early 'enough' to make you think potty training is a doddle, and if you're not.... my sympathies OP, it is very hard but she will get there.

Sorry, I should correct that to may be perfectly normal.

My DD was the same - tried potty training a 2.5, 3 and 3.5 with no success, star charts worked but as soon as we phased them out and she wasn't being rewarded she wasn't bothered and started wetting again.

Eventually the summer before she started in reception I got serious, I told her that although she wasn't bothered wetting yourself is germy and smelly and every time you do we will need to shower off.

From then on every time she wet herself i made her go up to the bathroom and stand in the bath whilst I showered down her bum and legs with lukewarm (not cold but not pleasantly warm) water to 'wash the wee off'. Within two weeks she was dry every day.

It worked because she didn't like the showering and because she realised it was quicker to just go to the loo and back to her game rather than have the lengthy rigmarole of showering.

I'm not sure how this works with being at school - maybe blitz it at half term? Ruling out medical issues and assuming your DD is a stubborn and un-embarrassable little person like my DD I'd try it. Good luck!

Op - I am sorry that this is so difficult for you and your daughter. I don't really have any personal experience to offer, but do have a few thoughts.

Firstly, the fact that she seems unconcerned about it at school makes me wonder if actually she has built an emotional wall around the issue, in order to stop herself getting very upset about it. Most 5 year olds do know when they smell, and do comment when other people smell. I wonder if in refusing to "own" the shame/embarrassment of smelling, she has just decided to ignore the whole issue and pretend it doesn't matter to her.

I do have a couple of ideas about how I would deal with this, but if I am honest I would probably not do anything until she has been checked out by a specialist and medical/physical reasons have been ruled out. If she really genuinely is unable to help herself then any action you put into place will be ineffective and frustrating for both of you. So I would check that out first.

If it turns out that there are no actual physical reasons I would be inclined to take the following actions: require her to sit on the toilet for 5 mins or so (or until she does a wee/whatever, if that happens sooner) every hour and a half - no matter what else is going on. If it is the middle of a birthday party - tough, she still goes. This means that she will get used to things being interrupted by going to the toilet, and that if she wees on the toilet her fun will be interrupted for less time than if she doesn't, iyswim. Offer a small reward for compliance.

If she goes to the toilet and "performs" without prompting then offer a bigger reward - to encourage her to go of her own volition.

I would be tempted to also stop taking changes of clothing with me, when going to the park/play places/etc, so that if an accident happens then she will have to stop what she is doing and come home. I really wouldn't do this unless I was CERTAIN that there was no underlying physical problem though- - but if she just needs encouragement to understand that weeing in a toilet is good and only stops the "fun" for a couple of minutes, whereas weeing in your clothing stops it completely, then it might help.

Good luck - and I really would push for that appointment.

Sympathies OP, it must be so wearing but also worrying not being quite sure what underlies it.
I have no experience in this area but just wanted to mention when you said about her standing up in the bath to wee rather than go to the toilet - this does sound like she is getting some sort of validation from the attention, because you can wee sitting down in the bath and noone would be any the wiser - but she wanted you to know she was doing it. So I don't know how to handle it but the strategy of removing interest and attention from the behaviour seems reasonable.

Also, though, 5 is still quite young and a full day of school plus after school club etc is probably quite long and strenuous - is there anything you can look at in terms of getting more sleep or even rest and quiet time?

Good luck - I expect to be dealing with this with my own daughter in a couple of years as my sisters and I were all prolific pee-ers!

OP - I just want to send you some sympathy.

One of my DCs was very late to train, and I had some brilliant help from a friend of a friend who was an experienced paediatric nurse. Perhaps when you have the paed reappointment, you could find out if there are any local services you could access. We concluded for DC that there probably wasn't sufficient recognition of the need to go, and so regular sending to the loo, even when no signal, to "let out whatever's there" helped. Regular over distension makes it harder to recognise the natural cues.

Punishment doesn't help a physical problem. A bit of "natural consequences", eg finding clean clothes, being responsible for washing herself after an accident and putting wet clothes in a (lidded?) laundry bucket, can be a suitably dull incentive to encourage her to avoid the chore by being dry. Especially if you can muster the strength to stay boringly matter-of-fact about it.

I was a little concerned that what you described in your post (pooing in the floor) could be construed as a dirty protest. This is quite a different thing. Do you think it might have been?

OP - we are going through a very similar situation with DS. He sounds a bit like your DD in that if he really really wants to he can go through a whole day with no accidents, but if there is no incentive he doesn't care. He doesn't mind being wet and we have often picked him up from school with a poo in his pants, which from the state of it has clearly been there a while.

We've spent a lot of time talking to teachers about it (he improved slightly when he started year 1 but seems to have gone backwards a bit lately), we've talked to HVs and doctors. Just after Christmas we eventually saw a paediatrician at the hospital who was really good with DS, examined him, chatted to him about everything, but said he couldn't find any obvious problem - he's been checked out for UTIs, etc. He gave us some medicine which should help if DS has an irritable bladder, but it hasn't made any difference. We have an appointment next week for an ultra sound scan on his bladder and kidneys so I will let you know how that goes.

Keep pushing to see a paediatrician because the one we saw did say that even if they don't find a physical cause they will be able to help if its a psychological issue. Although I'm not sure what they will suggest.

I completely understand you feeling as though you should punish her - I feel the same and have told DS off about it and then I feel awful. But sometimes it does seem as though he just does it on purpose. Its really difficult after spending all your time washing and drying pants/trousers/sofa cushions/etc to keep calm and not make a big deal of it.

Its also difficult because we can't leave DS at parties or to go to his friends' houses after school because I wouldn't want other parents to have to clean up after him. I thought that might bother him but he just says that I can go too and help him change his trousers if he has an accident - he's quite matter of fact about it.

Anyway sorry for the long post which probably isn't even helpful- but just wanted you to know you're not alone. Going to pick DS up from school but will check back again soon.

OP PLEASE READ THIS AND THE POST BY DANDELION

We had similar situation to Dandelion but it became far more serious. Our totally incompetent paediatrician who is luckily no longer working misdiagnosed the faecal impaction and told us it was behavioural. Unfortunately she had actually decided it was emotional due to our having no attachment to our DC and raised child protection concerns but kept this secret from us! This was due to us having complained about her inability to treat our DC. We were referred on to a team at CAMHS who accepted her views and then tried to make all evidence fit this scenario and they would not consider a medical reason. This was despite our DCs being bought up in a loving 2 parent household where children were never more wanted or loved. For example a symptom of faecal impaction is no appetite so we were being accused of not feeding our DC.

Luckily we eventually managed to get a medical diagnosis from another paediatrician and with medication our DC immediately gained bladder control both day and night. Unfortunately due to misdiagnosis DC will have to be on medication for years and we will certainly never regain trust in professionals or get over the total lies and accusations made to cover up for a medical complaint.

Please dont assume if a child seems happy to sit in wet or even soiled clothes or appears to be doing it deliberately that it is medical. Our DC had 10 plus accidents every day and was happy to sit in wet clothes and told us, teachers and HT that going to the toilet was a waste of time but we now know that it was just frustration/upset/anger at not understanding why there was a lack of bladder control. Once on medication the accidents stopped.

As dandelion states you will feel very guilty if you assume it is behavioural and it turns out to be medical. This condition is extremely widely misdiagnosed by the medical profession so even if you are told by the first that it is not medical please dont just assume they are correct. I have spent over a year researching this condition and all the symptoms and procedures that should be followed for our negligence claims. Professional research says 95% of children with soiling accidents will be for medical reasons, just need to check the stats for wetting. It is rare to be behavioural and more likely to be for children who have had great trauma. Even if it is not faecal impaction please dont assume it is not medical.

If your paediatrician appointment does not find anything I would go private for 2nd opinion for speed as time is important before teasing starts at school as my DC was called stinky from year 1 and had no friends and it was heart breaking to see.

Am happy to help anyone further

Does she ever just go to the toilet? You say she was toilet trained at 2.11 so I wonder what has caused the regression. Is she dry at night ever?

Agree with medicalmis, my DS(5 at the time) had faecal impaction but was misdiagnosed by 2x GPs, the first hospital doctor specialist, then a consultant who is Head of Pediatric Surgery. Fortunately the consultant decided to rule out a rare form of spina bifida before going down the behavioural route and the xray showed my DS was fine but had two blockages in his gut. (Cue lots of prodding DS then a grunt when he found the blockages). It happens.

I'm not saying your DD has a medical reason but it'll save a lot of guilt for you if you rule out any medical reasons before trying punishment.

OP, if I were you I would be at my GP's insisting on a referral to a consultant paediatric urologist. If your GP doesn't know one I would ask him or her to contact the local leading urologist for further advice about to whom to refer. Your dd needs this referral as a matter of urgency to rule out physical problems. You need to establish how long it will take her to be seen and insist it is chased as a matter or ugency.

FWIW your dd sounds a lovely, resilient little girl and I am sure this will be resolved but you must stay firm over referrals and make sure they happen. I would have no hesitation in asking for the name and address of the local PCT if you don't get any joy from the GP and tell the GP you are going to write to them to seek an indication of who she shoudl see and how long it will take.

Thanks everyone, I am unable to MN during the day as life gets in the way

In some way it is comforting to know that this is not that uncommon because a lot of you seem to be going through the same thing. I regularly visit the potty training board to see if anyone else is going through this but it is full of posts about 2 and 3 year olds not 5.

dandelionss and medicalmisdiagnosis, thanks for your posts. Your experiences are what I am afraid of, most of the time her behaviour indicates that it is behavioural but then there is always this nagging doubt that the behaviour is just her defence mechanism and she really can't do it because of a physical problem.
I have considered impaction as we have had some poo issues recently as well as wetting but she has always been a very regular and rapid pooer.

pranma she has been in pants since 2.11 but has rarely been dry since then, we have had good periods where she only wets occaisonally and bad where she is wet 5-6 times a day, but she has never been properly what i would call properly dry.

I completely agree with ticktock's post.

There seems to be more to this than just a toilet issue. What is her behaviour like in other areas?

I think people also can mirepresent the word "punishment" I use the word consequences to my childen and we can change behaviour either by using the "carrot" or the "stick" but more often a combination of the two. I think it will be hard to do without professional help.

In the meantime ( sorry if it's been said already) asking her to take responsibility for her actions ( such as cleaning herself, putting clothes in laundry etc) may be a useful first step.

My son is 5 and at this age there is already so much awareness of differences between children so I wonder why she is not feeling the distress of being different to other kids at school. The emotional connection to this may be more of an issue than the behaviour itself.

If there is no medical reason and it is just down to her being lazy and having no sense of embarrassment then you need to punish her for laziness and teach her shame. I can't imagine any child like that being welcome in other peoples homes and it can't be pleasant for anyone to use a seat that she has sat and probably pissed on. You need to make her understand that. Any punishment you give her will be kinder than the social isolation and bullying she will experience if this continues.

PLEASE dont listen to people telling you to punish for laziness and teach shame or even to use consequences. It is totally the wrong advice and no medical or childcare professional could support this. It may take years to get a correct medical diagnosis.

Research published in nursing times for example states 95% of children with soiling is caused by faecal impaction. If a child is one of the other 5% then they still need help not punishment as it will either be due to another medical condition or an emotional trauma.

The child will not show embarrassment either because it has become the normal or they are so embarrassed they dont behave in a way that we as adults think they should by being sorry but it is because they dont understand why they have no control and hence may make excuses or be defiant.

You can poo regularly and rapidly with faecal impaction it is called overflow so dont dismiss the condition. A child may have faecal impaction for years without you ever being aware that they have strained to pass a stool because they dont they only pass overflow because the impaction is blocking anything else passing.

Please trust those of us who have been in this situation and ignore these evil suggestions to teach shame.

Until you get to the bottom of why it's happening, can you accept that she has an issue and that it she will wet herself? Can she wear pull ups? You are not the only mother with a child who has continence issues so there are products available for older children. They may not be as discreet and grown up but they will give your DD some control and dignity.

Put her into nappies. She'll learn.

Pull ups may be a good idea actually. By the sound of it the fact she is wearing pants rather than a nappy isn't keeping her dry. And wearing pull ups may take the pressure off a bit and get her used to feeling comfortable for when she is ready to give pants a try. It's a shame they don't do discreet kids incontinence pants with odour control like they do for adults.

discreet pads?

my eldest brother had issues when he was a boy, he would hold on to wees and poos till he couldn't hold it anymore so would do it in his pants or hes been known to hide it, it was a strange habit he had but as he got older he seemed to get better at bladder/bowel control... i'm sure my dad said he waited for a dry day then bigged him up saying "look you CAN do it, i will give you X every day if you stay dry" he was dry within 2 weeks but carried on a little then gradually phased the bribes out

OP
I haven't read all the posts here as there are so many, I couldn't let this go by without responding. Sounds carbon copy of my DD
Total lack of care if she was wet or dry. Not bothered about smelling bad, nothing I said or did made a difference.
Took her to so many specialists, doctors etc etc.
My DD is pretty bright too. Have you noticed anything else at all? Personal space issues, too much too little. Not bothering about what people think of her? Clumsy? untidy? My DD had all of these symptoms but everything was overshadowed by the wetting.
Over time, years to be precise I read up, researched and tried to discover what the problem was. Then we found out, a fantastic specialist told us what I had expected My DD had aspergers syndrome. I am not saying your DD has the same, I am just telling our story. Aspergers can manifest in many ways. The wetting did continue, many children with AS just don't care and are not even remotely concerned about wetting, or the social issues surrounding it. My daughter took medication for .....deep breath......10 years to help with the wetting. Sadly when her periods started that gave us a whole load of new and unpleasent issues to deal with.
Now though my lovely DD is 16, due to take 12 GSCE's expected to pass them all. Her wetting issues have gone compleatly, she is just the same as any 16 year old. She is a very compasionate young woman, she went through hell and back as a kid, and now she is a wonderful support to other younger children who are just a little different.
I do hope you resolve your issues soon, but even if you don't there is always light at the end of the tunnel.

My heart goes out to you- esp. With some of the horrible things certain people have written. You sound like a very caring mother.

We went through an enuresis clinic for night time wetness (luckily that was the only problem we faced), for my 5 1/2 year old daughter, last year, which worked beautifully within 2 weeks. I thought she was lazy (not that I ever made an issue to her) because she used to wee in her pull up before she went to sleep, and would need to be reminded (sometimes a lot) to take it off in the morning- shed just keep weeing) but really who knows what goes through their little minds??- children are not little adults- they don't think like we do. And she did poo in it once or twice. (deliberately when awake- and yes I told her off). Maybe the few days of dryness your daughter had really took a lot of concentration and effort for her but she was really super motivated?

I hope I haven't trivialized anything for you at all- is not my intention, I just wanted to share as well so you can see it is a fairly common problem, just not one society talks about.

Good luck and don't blame yourself; you are doing the best you can xxx

Oh and ps my 2 year old son never cries when he does a poo in his nappy and would sit in it all day without complaining if I didn't change it.

You mustn't punish her - that would be so cruel. There is a reason why it's happening but just try to tell yourself it won't go on forever!

My totally NT 8 year old daughter was in pull ups at night in reception and still had the odd accident at school until year 1. Now, you would never know - she is like any other 8 year old. I remember that toilet training her at 3 was difficult because she didn't want to interrupt her play and would often not go when she needed to.