Child having several accidents a day

[awwbiscuits]

Not the piss troll, I'm completely out of ideas and genuinely worried for my daughter.

Dd is now 5 (just). We had a hard time potty training and it took 3 goes to work. She stopped having accidents overnight on her own very quickly after that. Since then she's been quite sporadic with her potty training in that she will sometimes have no accidents (less likely at home) and other days have several accidents a day.

She does withhold poo and I spoke to the health visitor about this, read the Eric website front to back, and spoke to the GP about movicol. This did help somewhat with her going for a poo but the wee accidents have continued. She does it almost every day at school and hardly at home so I thought maybe it was a school thing as it started a while after starting (she was brilliant at nursery). At one point the teachers suggested she was doing it on purpose to get out of tidy up time but then conceded that she actually probably had a medical problem (this was when she was really constipated) as she was wetting herself just after having gone to the toilet and at different times a day. They were getting her to go to the toilet every hour. We've tried charts, we've tried giving her a lolly at the end of the school day if she doesn't do one. We've tried bigger toys etc after getting x amount of days with no accidents. We've tried ignoring it.

However this has continued in to the summer holidays and I'm just wondering where the hell i went so wrong!!

I haven't given her any movicol since the heatwave as I was concerned about her being dehydrated but I will be going back to giving her 1-2 a day.

To today: Just now she was outside with dh who was playing football with her, he said 'do you need the toilet?' She said no. He said 'dd go to the toilet please' and she said 'I don't need the toilet!' And then proceeded to wet herself. I know we need to rephrase things instead of asking her but even when you tell her to go she will still argue (while jiggling about) that she absolutely does not need to go. There is definitely an element of not wanting to miss out on things, but she even does it when just sitting on the sofa or doing boring stuff.

I just reached the end of my tether and I really just don't know what to do - I'm out of ideas. I've started a new chart. I've had a big chat with her about it and i said how it can't feel very nice to have accidents all the time and she said 'no, I still feel happy!' I said yes but it's all wet and smelly and she said 'yes, but I'm still happy!' She agreed to a chart, and agreed to going to the toilet every hour even if she doesn't 'feel it' and that she wouldn't argue with us about it. I told her I didn't want her to smell of wee all the time.

She's going in to year 1 in September and I'm terrified she's going to be the pissy kid!

Some disclaimers:
I am 36 weeks pregnant tomorrow however this has been going on WAY before the pregnancy so I don't think I can blame the pregnancy for it although it may be a contributing factor now?
She does not enjoy school particularly, or at least says she doesn't want to go to school until she gets there, then she's fine. She doesn't like the 'academic' side of school - ie she doesn't like doing phonics. But loves the creative side of it.
She is a really confident kid, hardly ever anxious, but not forced to be confident - she surprises me all the time with how bold she is.
I don't shame her at all because I had experiences with my own mother shouting in my face and making me wear a nappy and sending me to bed when I had an accident - I am unsure how old I was but I remember it clearly so must have been old enough and now im an adult I can be pretty certain I had uti's a lot with no treatment and i am embarrassed to this day about her doing this to me. So I am really aware of making dd feel bad about herself or embarrassing her.

Constipation takes a long time to be properly dealt with and wetting because of confusion over the sensations about needing wee/being compacted are often an issue.

I think once the constipation is properly long term sorted the you can tackle the wetting issue.

Sorry OP I have no advice but my 4 year old is exactly the same. I guess the only difference being her trained so well and so easy. In the last 6 months he is wetting himself a lot. It is incredibly frustrating especially when we ask him if he needs to go and he says no and then one minute later wets himself. So sending solidarity!!

I was that child. I wasn't reliably dry in the day until I was 7. It took until I was 40 for me to be diagnosed with an overactive bladder and medicated. It changed my life overnight.

It could be that at the moment you ask her, she doesn't need to go, but a minute later she does but like I was, couldn't hold it.

I'd have another chat with the gp or continence nurse.

How do you know when the constipation is sorted? She started going every other day which was a revelation for her.

I feel so embarrassed going back to the HV and gp. I feel like a huge failure.

Thank you for the solidarity @Rosebud1302

This must be very stressful for you. My advice would be to go back to being very structured with toilet times, as if you were just beginning toilet training. So she has to sit on the toilet every 20 minutes or so for a couple of days, then extend to 30 minutes, then 45. I wouldn’t extend it to anymore than hourly.
It will have to be non negotiable. Obviously she will be resistant, you will need to keep repeating a brief explanation that you are helping her to be a big girl and ready for year 1.

Do not feel embarrassed your child most likely has a medical condition as the root cause!

@Mabelface this is interesting. Were you dry at night? My son is always dry at night which surely means it can't be that, right?!

It really is :( I will try that but I'm worried at how she will feel towards school if I use it as a reason if you see what I mean?

Trying my best but just can't quite figure out what it is, and it makes me really sad that teachers/my mum/dh think she's being manipulative. I just don't think she would do it!

@MissyB1

Being dry at night is about your body producing enough of the correct hormone to super concentrate your urine.

She's been dry at night since just after she was trained and it is extremely rare that she wets her bed. She may have the odd night where she's not woken properly but I can count them on one hand.

It's interesting that you had issues yourself as a child. Did you mention this to the GP? I think it's time to go back to them as it has been going on for a while.

You're saying that you feel 'shame' that she is not successfully toilet trained - do you think this could be linked to how your mother made you feel as a child?

It's also important that you advocate for your daughter with the school. It is not uncommon for school staff to view toileting accidents as a behavioural issue, when there a variety of possible causes. Would 'training pants' - ie fabric pants with some element of absorption be a possibility for her to wear at school whilst you deal with any medical issues such as constipation.

If she's at school now, the School nurse team may be able to support.

It might be helpful for you to keep a diary of poo/wee - detailing times/what she's doing when she has an accident and regularity or not of poos. This might be useful for when you contact the GP.

I wasn't dry at night until 14 when the hormone decided to kick in one night and I was dry from then on.

@willingtolearn it probably is to do with that, but also I feel like I've tried all the techniques I can think of and I'm stumped. The communication with school has been difficult to say the least, they don't really communicate well at all - and it's difficult to get anything other than a few seconds conversation at the gate when I drop her off. Also dd tells me nothing about school, at all. Can't answer what happened exactly when she has an accident but then they don't tell me either I just find the wet pants and trousers/skirt in her bag.

I also didn't get a face to face with a gp as it's almost impossible to get a face to face with them so I explained as much as I could over the phone and tbh it was with a difficult gp (you don't get to pick!) so he just said give her movicol and come back if it's not worked but it is such a slog trying to get through to them it is really difficult.

I don't know. I feel like this should be easy and it is not!

You sound like you're doing a great job, going through different methods to see what is working/ what's not working.

I can understand the urgency with your new baby and Year 1 rapidly approaching.

I would push for a formal meeting with the school to voice your concerns/ agree on a plan of action that is consistent between you.

Before this though you really need to push with the GP to get an appointment whether face to face or e-consult. Don't be put off by there only being 'emergency' appointments - this could be being caused or exacerbated by something fixable like a UTI. They need to rule this out as well as other physical issues such as constipation. You've done what they said - you've given the movicol - it hasn't worked so you need to go back at them. You might need to keep going back at them.

For Year 1 a suggestion might be dealing it in a purely practical way and removing any emotion from it. Make her responsible for dealing with accidents herself, not in a 'your fault' way but so that she can solve the issue herself and feel capable.

Talk to her about what she needs to do if she has an accident - you could give her a small printed card to pass to the teacher if she needs help to maintain her dignity.

Put a 'kit' in her bag with spare underwear, scented bags and tissues or wipes if necessary. Make sure her new teacher allows free access to the toilet and understands why this is necessary.

She's still young so this might just sort itself out over the summer especially if constipation is part of the problem - now's the time to crack that and you often need to keep going for longer than you think with movicol to keep things soft and painless every time for her.

Best of luck!

Our oldest was like this until 6. He knew what to do, but got so engrossed in activities that he priprit8sed that instead of going to the bathroom.

We thought it would never end! But at 8 he never has accidents anymore.

I think its more common than we think.

I agree with the PP you need to make absolutely sure she’s not constipated. The GP should’ve examined her to see if she’s obviously impacted. I’d even consider doing a disimpaction during the Summer holidays. I’d definitely be giving her a minimum of 2 sachets of Movicol a day. She needs to be doing a poo every day and it needs to be soft. You can check the Bristol stool chart to check whether they’re as they should be.
I’d get her a watch from the ERIC online shop that you set to vibrate every hour so she can go to the toilet at school each hour. I’d be telling school you want more communication to make sure they’re dealing with it in the same way you are at home.
I’d ask the GP for a referral to the continence team, they should be doing this at her age anyway. In my experience they’re brilliant. I’d also make sure she’s drinking enough for her age. Her bladder needs to be stretching each day so she feels the sensation to wee and to strengthen to muscles.
I also agree sending her to school in a big girls pull up for now would be sensible.

You had medication for her constipation which is a direct cause of wee accidents. Now she's having wee accidents. Yes some of it might be laziness etc but you can't just stop and start it and think it won't affect her.

Why would the movicol make her dehydrated? Unless it's causing diarrhea and I'm assuming you'd have mentioned that the movicol isn't dehydrating her. And if it's hot, give her more liquids.

I am sympathetic, DS is 7 and on movicol and senna. He had constipation for a long time without us knowing (poo'd every day) and he wasn't dry until he was nearly 5. It was a huge worry but he absolutely HAS to have his meds and probably will long term. Don't think of them as medicines to wean off, but a long term solution.

How would she feel about nappies or pull ups? I'd get the medicine going, wait for that to kick in and see how she goes. If she's having deliberate accidents, I'd consider going back to pull ups unless she'll like it

@WestIsWest there's no point you deciding how much movicol a random kid should be having, esp without any reference to how much she's currently having. Two sachets a day would give DS diarrhea. Great the first day to clear him out but he has half a sachet a day or else he's too loose.

Thanks for all the suggestions.

She's got nappy bags, and about 3 extra outfits/pants in her school bag already. I'm not sure what they do if she has an accident at school. I think I will email them and ask for help.

I think she would be very upset if I suggested nappies or pull ups to her and I'm wary of doing something like that to her and setting her back further. I don't want to take away her confidence or embarrass her like I felt.

I don't know why I thought she would be dehydrated, she did have loose poos in the beginning because she was having 2 sachets a day. I feel a bit silly for that now as maybe I've put her right back to the beginning again.

Will she just be on movicol forever then? I feel like I've really let her down. It's hard though because we did the Eric sweetcorn test and it was 2 days before it came out so in line with what they said so I thought maybe I'd done the right thing.

This is really hard :( I just don't want kids to start taking the Mickey out of her, or for her to smell. It's already embarrassing enough for me to keep saying 'dd do you need the toilet?' All the time in front of people (despite doing it quietly, she argues with me loudly!) - not that she knows that yet but I'm sure she will soon start to be embarrassed by me. In fact my ILs joke that her name is 'first name do you need the toilet last name'

There’s no reason to think she’ll be on Movicol for ever, but even if she is, it’d be better than her having toileting problems. If she had asthma she’d need inhalers, this is no different really.
With my DC I just take her to the toilet. I take her hand and don’t mention where we’re going. Sometimes I carry her. She complains less if I do that, once we’re there she seems to realise for herself a lot of the time that she does need the toilet.
Please don’t be so hard on yourself. You’re trying your best for your DC with the information you have. I’ve found information from HCP’s has been very mixed.

The OP said she’d stopped it and would be going back to 1-2 sachets. With that in mind I gave my opinion and suggested checking the Bristol stool chart to make sure the dose is right.
OP also said it’s hard to get to see the GP. I was just trying to be helpful and I’m sure OP is bright enough to know to reduce the dose if it caused loose stools. Although OP’s DC may be impacted and the GP may suggest a disimpaction which will require very loose stools, once they’ve done a proper job examination.

I’d also be telling your in laws to quit with the jokes. It’s not funny for your DD.

I think maybe I'll try and make it a bit more fun. She's already got bubbles for blowing on the toilet, so maybe I'll find something else fun as well. It's so hard, you don't want to make a massive deal out of it yourself but she's having so many accidents that I have to really.

Also, with the ILs we don't see them very much, but if they do again I'll ask DH to tell them that's enough.

Might she sit on the toilet if she gets a couple of smarties afterwards? Whether she does anything or not, she just has to sit there for a couple of mins.
I’ve resorted to allowing the iPad to watch something at times, while she sat for 5 mins.
I also used absorbent cotton knickers for a few weeks with my DD. Better than pull ups in terms of them accepting to wear them. I didn’t even tell her they were absorbent I just told nursery. I think they were from the ERIC website. At least then she’s only need her underwear changing, not her trousers as well.