So stressed about urine accidents.

[Whoareyoumyfriend]

DS1 is 5.5 years and nearly finished with his first year at school.

Today at a family party he had damp pants and shorts 5 times over the day. I sent him each time I noticed he was damp but he shows very little initiative.

School want him dry by year one because they have no additional adult in the afternoon.

Half a term to go and I'm so worried about it 😫

Have you tried a reward chart? We did this with DG as she was inclined to wet herself and we suspected she wasn’t paying attention. Gold star chart and small presents after three dry days focussed her mind no end!
Worked for dry nights too as she was happy to lie in bed, fully awake and leisurely use her nappy. Very laid back child.

I might need to try. Previous attempts at a reward chart haven't worked as he doesn't seem to understand them.

He also said this week that he knows his needs a wee when he is wet.

This is a really good website about continence issues. www.eric.org.uk

My boys could never be bothered to go to the toilet until it was too late so would rush and often have accidents. However it sounds like there maybe more going on with your DC.

Have you spoken to GP / school nurse etc

I hear ya. Our 6 year old boy still has accidents, always when engrossed in something.

Last couple of months he's stopped doing it with anyone except us, so there's a bit of progress.

All I can suggest is you or another appropriate adult reminds him regularly and insists he goes

Damp as in wet himself or more like he rushed going to the loo and didn't fully finish so had a small damp patch?

Both would probably be a 'fear of missing out', 'having too much fun and sees using the toilet as a waste of time' situation but it would change your conversation and approach.

Wetting himself - you'll need to proactively remind him to go to the loo regularly to make sure he doesn't get caught out

Rushing - you'll need to reinforce making sure he's fully done and has dried himself off before pulling his pants up.

Well school will just have to live with it if he’s not, that sounds like a them problem, not a you problem. I work in a mainstream secondary in a deprived area and we have some SEN kids, kids with difficult home lives who still struggle with this - it’s fine, they have spare clothes as does school. My dd struggles with this too. She needed medication as her muscles weren’t relaxing enough to let all the wee out. School very supportive. Please don’t feel stressed - you are one of many parents who go through this.

What are his bowel movements like? Urinary incontinence / urge incontinence is commonly caused by stool that is backed up in the rectum and intestines which puts pressure on the bladder.

Tell tale signs can be constipation/hard poos or runny poos which is overflow poo going round the blockage.

Bowels are ok. Although he does have to rush to the toilet when he needs a poo and has an accident maybe once a week.

When I say damp I mean he will do a dribble of a wee. But to be truthful if we don't spot the dribble he will rarely self initiate a toilet trip for a wee.

I think yesterday he self initiated twice and stayed dry with those. Plus the four sets of wet clothes where I didn't catch him in time.

We are waiting for support from the school nurse. I don't put my stress on him but I'm just so wound up over the whole thing

Well school will just have to live with it if he’s not, that sounds like a them problem, not a you problem

Well yes, except there will be no one to monitor/help him get changed because the teacher will be teaching 29 other children. Schools will do their absolute best but, like the NHS/fire service etc, they are operating on massively reduced budgets and skeleton staffing.

OP, we have had chn like this in Year 1 and even 2 at our school. The parents are always encouraged to seek medical advice to see if they can determine the root cause, and then the KS1 teachers do their absolute best to help but without being able to magically produce additional adults it really is a struggle. We in no way blame parents so please don’t worry about that!

What are his bowel accidents like?

DS is 9 and after years of this and finally getting referred / scanned we've discovered he has a tiny bladder due to an overactive muscle that's squeezing it.

Apparently it's quite common.

Before we got our referral, they put us on a 'bladder expansion' exercise which might be worth trying as usually works with people without the muscle issue.

He had to drink a large amount of water but in 1 go / over max 10 minutes - every 2 hours. Idea being it would all go into bladder and stretch it over time. Looked up amounts and for 5 year old it's 180ml and 6 year old is 210 so maybe go for 200ml.

Apparently the culture that kids sip constantly on water throughout the day has stopped the big drink at meal times / when thirsty response so bladders aren't getting stretched.

I've also seen I need to try to give him larger amounts of water. The quantities are helpful, thank-you. I'll start tomorrow.

It's really tough because we are at an absolute loss with him.

Just to add his younger brother is dry and has been since he was two. Never has an accident he's 4.5 now so I really do feel it isn't me

Bowel accidents are generally hard to describe. Not hard but you can shake it into the loo

I would contact ERIC for advice. They are the UK children’s bowel and bladder charity.

If I were you I would try to get your GP to support you in doing a Disimpaction regime to clear out the bowels and see if that makes a difference.

A Parents’ Guide to Disimpaction - ERIC

A good Facebook group to join is “Daytime Wetting in Children & Teens”.

And if you do end up doing a Disimpaction, definitely join the “Movicol Mummies” Facebook group.

Thanks all for your advice. We sought medical support. Confirmed no constipation and no uti.
We've been following all of the advice on eric and the school nurse.

Yesterday he came home with two bags of wet clothes. Yesterday I was disproportionately upset about it. He will be going into year one not dry.

It just feels so intimidating and frustrating and I'm exhausted by it all

Have you been referred to the specialist continence nurse? They may have more suggestions. Did they consider any other medical cause? I hope things start to improve for you over the summer. I remember when I had three ds still in nappies and multiple wet beds and I was worn down by the amount of washing.

I think it's just the regular school nurse. School nurse is in the health visiting team they had when they were little.

Imo there's not something quite right. He doesn't even do "the jiggle" when he needs to go. You know when they are busy playing and don't want to leave their activity?

So for now the school nurse says we have to give him money every time he urinates.

Sorry to harp on about the possibility of constipation/fecal loading, but doctors are notoriously bad at missing this. My daughter's was totally missed until she went for an abdominal xray which confirmed she was backed up up all the way around.

I agree with the PP - you should definitely ask to be referred to a continence nurse... they are so much more clued up than most GPs and paediatricians.

When did the continence problems first start?

I completely agree about pushing for a referral to the specialist continence nurse. Our GP referred us, although by the time she had signed us off she did say it was much harder to get a referral than it was.

He's literally never been dry. We are 100% on pantless dryness (ie letting your toddler run around naked when initially training) but haven't quite made the step to being clothed and dry. This week we had 2 wet bags Monday, one Tuesday, none Wednesday and one today. And maybe one accident per evening. I think it's classified as intermittent urinary incontinence.

Genuinely don't think there's any constipation. He's regular. Good texture. No masses or swellings. Totally flat belly. No tummy ache. He never withholds his poo.

He is hypermobile which I believe can impact dryness. He also has reflux so the hypermobility must be internal too.

As parents, we believe that over the next year or two he will qualify for an autism diagnosis. There are enough signs and issues there although he's managing at school with minimal support

At my wits end this week. Accidents every single day. Although we haven't had an accident yet today which is good.

I just don't know what to do with him.
Don't need advice this time. Just emotionally off loading. A few weeks left of term and it looks like he's going into year one not dry

I’m sorry. We have continence issues and sometimes it’s just so much. Particularly the washing.

Do go back to the gp and ask for a continence nurse referral. Ours is great. I’m not convinced the school nurse’s advice is appropriate.

If he doesn’t jiggle, he is probably unaware his bladder is full. Have you tried prompting him to go at regular intervals throughout the day?

Also star charts do sometimes work for children like this - even though, logically, you wouldn’t expect them to work if the child’s unaware the bladder is full. I guess maybe they are a bit aware, but the sensation of a full bladder isn’t as strong as with other people? The star chart incentivises them to focus on what they are feeling.

Can the school nurse refer him for a urology review? I have a friend who has two children with significant incontinence, she receives DLA because of the extra attention and help they need, also you may be able to access support from local parent carer organisations. Just a heads up that incontinence can be a disability and not behavioural.