To be concerned about DD’s apparent incontinence?

[BrickSeal]

DD is 6.5 and been potty trained since 3. Never been dry on a night, still wears a pull up to bed.

She consistently wets herself every single day, often twice, three times a day. Doesn’t matter if we’re at home, out or if she’s at school it seems to always happen.

DH thinks she’s lazy, I can’t believe any kid would voluntarily sit in wet pants, especially at school. Sometimes she says she knows when she needs to go but is too busy, sometimes she says she doesn’t realise.

I don't know what to do anymore.

I’ve got a referral for bladder and bowel but will take 12+ months.

I’m worried she’s going to get bullied at school.

DH thinks she need micromanaging when with us and made to goto the toilet every hour and a bit of ‘tough love’.

I think it could be medical or a ND trait (she’s often very ‘scatty’ and a real daydreamer), possibly ADHD, and she needs us to be patient.

YABU - I need to give tough love
YANBU - Sounds like she’s ND and needs support

I agree that very few children would pick this out of choice. I do however think you need to go down the micromanaging route of hourly prompts until you can get this sorted to try and save her further embarrassment. Perhaps ask her teacher if they can subtly do the same?
Are you able to take her privately to get this sorted? This is something I’d happily go into debt for to get on the way to being sorted as quickly as humanly possible.
Poor you and DD. It must be a nightmare!

Is she constipated at all? Sometimes being constipated can cause bladder incontience as it's squeezing the bladder.

Has she ever been consistently dry in the day?
You say potty trained since 3 but that contradicts her wetting in the day.

Tough love - no, absolutely not. Micromanaging to get her in the habit of going (in lieu of a reliable sensation) - yes (until you can discover the cause)

I don't think you need to give "tough love" but I don't think going to the toilet ever hour is necessarily a bad idea. My daughter was given some strategies like when she's finished on the toilet, stand up for one minute and then try to go again to make sure the bladder is completely empty

you prob have but have you checked she has not got an infection as its very hard to hang on when you have one of those.
as someone said if she is constipated that wont help
also she has said that she knows she wants to go but is busy i think she is true for children of that age. they get involved with things and something 'boring' like urination gets ignored. you need to make her get in the routine of going for a wee before she gets involved in things like playing etc. try to help her get used to weeing at certain times like before meals break times before leaving the house etc. i think she probably does not understand about a routine

Have you spoken to the health visitor? We still get some accidents after potty training 1.5 years ago and my daughter is 4 and they provide a lot of support, will come and do a visit with all the strategies etc. Also I presume you have seen the doctor for the referral as they should check for a medical cause such as constipation etc.

She did get dry in the day in the sense she wasn’t having a nappy on. We had the odd accident but it’s turned to daily accidents in the last year or so.

We were advised a routine and rewards

She’s not constipated - she’s regular and it’s not hard for her to go.

My daughter was exactly the same. She ended up on 2 different meds, until the problem sorted itself out.

At night she was on Desmopressin, which is a version of the hormone that stops you weeing in your sleep
In the day she was in Oxybutinin, which managed her overactive bladder.
Also the tube between her kidneys & bladder was very short, which added to the problem. Now all ok.

She was never lazy. School were very good, she had spare clothes, and wipes, so she could get changed if she needed.

Before the Oxybutinin, she used to her a lot of UTIs.. the symptom weren’t what you would imagine, no pain or tingling (like cystitis), but an inability to control weeing, so she would end up wet.

Your husband needs to read a few books, before offering his opinion.

Try to get a sample of her urine in a sterile pot (your GP surgery can provide one) and hand it in to the GP's receptionist to be tested. She may have a urine infection.

I agree with PP ask GP to prescribe oxybutinin and give it a try. Made a huge difference for my DD. She had an overactive bladder, it would spasm unpredictably causing accidents. Oxybutinin is a mild muscle relaxant I think. Resolved the problem almost overnight for DD and she took it for a few years then grew out of the problem.

Bedwetting can be caused by sleep apnoea. If she's showing any other signs of that it would be worth considering.

Sorry I missed that it's daytime too.

Have you actually tried ensuring she goes to the loo very regularly? You could start with hourly. When she is dry all day you can try 1.5 hours etc. It is possible that you can train her into better bladder control and awareness.

If she can’t stay dry for, say, 2-3 hours then she does need medical attention. I’m sure you’ll be asked for a diary if you do consult a doctor so you may as well do this.

Also ensure she drinks enough, empties her bladder fully and have her checked for a UTI.

With my son we bought a watch ( Eric website) it buzzed against his wrist ( no one else can hear) to prompt him to go to the toilet . We set the times to match breaks and lunch at school.

This flowchart from ERIC (childhood continence charity) https://eric.org.uk/childrens-continence-pathway/flowchart-daytime-bladders/ is helpful for understanding possible pathways for issues. I would have a look through the site and see if anything would be helpful.

My experience with my child is that it is not a choice.... but is complicated so tough love does not help with either bladder issues or with self-esteem. But clear support and scaffolding can help with the practical problems that can occur with incontinence. Making a plan together can be helpful - your child will know what they can manage and can't manage and may surprise you!

She needs prompting to go to get her into a routine, I'd discuss it with the school it maybe she's not wanting to use the toilet or is afraid to ask to use the toilet .

You need proper advice and also check she's not suffering any abuse, either at home or elsewhere. Sounds very much like a medical condition and your DH sounds a right dick. He will not be helping.

Gosh you could have written that about my 6.5 year old. Potty trained since 2.5 but would have tiny accidents every day...not enough for her to leave a puddle and we'd only notice when she either smelled of wee or at the end of the day getting undressed. She'd never tell us. She would say she didn't notice but we never really got to the bottom of it. Never ever dry at night, would completely fill a pull up. My 4 year old was dry at night from 2 and has never had an accident so a crazy comparison.

My husband is a GP and has always been blase about it saying she's just a bit slow in that department and will get there. He was adamant it was too early to give her drugs.

And all of a sudden last week she said she wanted to try sleeping in knickers and she's had 4 dry nights in a row and completely dry knickers in the day. It's almost like someone flipped a switch, absolutely nothing we did.

I really hope the same happens for you. She may just be a bit slow like my daughter! Lots of luck!

Regardless of the reason she does need regular reminders and needs to be going to the loo very frequently even when she doesn't want to. Was she ever reliable with toileting or is this just a continuation from when she was potty trained?

Speak to ERIC.

https://eric.org.uk/

Lots of good advice on there until you can call them

Assume been treated for uti?

I think wearing the pull up is not a great idea she has perhaps become accustomed to it.