Is it normal for a doctor to recommend unpottytraining?

[Newishmom]

So just a basic overview my sister's daughter got potty trained over the Christmas break started having accidents again we went to go see her GP and he recommended unpotty training as her letter has not developed fully and she will continue on having these accidents throughout her life is this normal?

Yes she's had testing before the times that I manage to force my sister to bring her into the doctors @Seeline

Op Is English your first language, is it possibe you've miss understood the GP?

But I think I'd go back and ask for a referral for psychological help and a referral to urologist too.

I don't think I'd accept a child will be in nappies because they haven't been potty trained, esp if they were clean and dry for a year before you got them.

Im guessing could it be a blockage in the bowel putting pressure on the bladder?

I'm sorry it's kind of hard to understand my gp it good fully well be a blockage but the doctor said hey would be easier to unpottytrained and try to repotty train her but it could be she might never be trained again @Needspaceforlego

There is a difference between a child who has physically lost the ability to control their bladder/bowel and one who for whatever physical or emotional reason is no longer able to use the toilet.

Given the timeline I would strongly suggest that it is the latter.

Different situation but when my daughter started school she went from having no accidents at home or at nursery to having daily accidents at school and after school club. It took a while to get to the bottom of it but it all stemmed from not seeing teachers and staff at school as safe people. This meant she couldn't ask them when she needed the toilet and she didn't like going past the bigger kids to take herself in after school club. She also wouldn't go preemptively which meant when she did need to go she didn't have much time to get to the toilet.

She did some work with a teacher which made her a safe person who she could ask. She was given a card where she could point to different needs without having to physically ask lowering the communication barrier and we have worked at home on her going to the toilet frequently even if she doesn't initially feel like she needs the toilet. She's went from frequent accidents to no accidents in the third term. It took a while for the school to see it as a communication issue and not a continence issue. They were at first insisting we needed to talk to the school nurse or GP. Within a month of them treating it at a communication problem she was dry again!

I'm not saying it's communication here but just using it to highlight that there can be situational reasons that once identified can be worked on.

I mean it's definitely not communication shell tell me when she needs to go but two seconds later she'll start peeing or pooing I'm going with theory that is far more neurological I wouldn't really mind but like I have to get her to school next year @Superscientist

If she’s been through trauma it’s most likely psychological.
She def needs therapy.
Not the same, but my daughter had bad constipation as a toddler/young child and the hospital referred us to a specialist nurse so your niece really needs to see the correct service - I hope the social worker can do this. She won’t be in nappies forever.

good luck

It's just worrying I wouldn't mind changing her but like school won't do it and I don't want the teachers to have to do it @Cattyisbatty

This was part of the issue my daughter was having by the time she would actually get to needing to go she was already on the edge of going which meant there was very little time to get to a safe person and then to the toilet before having an accident. We have been working on this at home too, getting her used to the earlier cues of needing the toilet. Nearly every time we get her to go to the toilet before leaving the house she will go but every time she will tell us she doesn't need to. Same with poos of we get her to sit on the toilet with her feet raised she will poo but she is always adamant she doesn't need a poo!

Have a read into introspection, some children struggle with recognise the various different internal physical feelings associated with needing to go to the toilet.

I'd really start with behavioural and emotional strategies.

Honestly it's a simple issue I don't want to be one of those parents teachers don't like because they send them in in nappies @Superscientist

I've never suggested putting her back in nappies! Even through all of my daughters accidents we kept her in knickers, she went into school with a spare set of clothes in case of accidents. She started school with a toddler diarrhea and food allergies diagnosis both of which can impact the notice she gets for needing a poo. So we were planning for accidents before the issue with the teachers arose.

Teaching every need is a multifaceted approach it can seem like using the toilet is a simple thing but there are lots of factors.

You need to understand what the toilet is for and why we use it - if they were previously dry this they already know
You have the ability to recognise when you are about to wee - sounds like they already have this
You then need to learn to recognise the signs so that you can get to a toilet without having an accident. This can be where some kids start to struggle. - it can be they don't recognise early cues, it might be that if distracted they don't pick them up
You then need to be able to get to a toilet - physically getting to the toilet is one thing, feeling comfortable going into the toilet room is another. We have plug in sensor lights so the path to the bathroom lights up as you walk past so she can see and she has a stool so she can reach the toilet light.
You then need to be able to sit and relax the muscles to wee/poo in the right place. My daughter is very small for her age, despite being 5.5 she's only the size for a 3 yo so she needs a stick on seat to make the toilet seat small enough and a stool to put her feet on.

That's the process but things can complicate it. If you are frequently having soiled accidents you are more likely to develop a UTI which then makes it more likely to have wee accidents.
If you are feeling tense or stressed you will struggle to wee you might only release the pressure of wee and not empty the bladder. Resulting in needing more wees, losing their sensation of a partially full bladder meaning it's only when it's really full you have that signal to say you need a wee. The more desperate you are the less time you have to get to the toilet.
If you are anxious and worried you might have to work yourself up to asking for the toilet or going into the bathroom these eats up into the time between your brain saying "I really need a wee" to your body going "I can't hold this in any longer"
If you are constipated or previously have been constipated the bowel expands and you lose the sensation of a full bowel and don't know when you need to go.

My daughter is now in y1 and I would say that there were a handful of other students in reception that had the occasional accident and there was another girl that had frequent accidents in the first term. My daughter had a good second term and rarely had an accident but once the warmer weather came and the school upped the water they were getting them to drink she started having accidents again. This was when they started lowering the barrier to communication and she's not had an accident since. We had more of an issue with the school changing her than they had but as long as the frequency of accidents was dropping we were less worried.

We have worked on language too, so the teachers would ask "who wants to go to the toilet before PE" rarely would she say yes, they now tell her "you need to go to the toilet before PE". They used to do forest school outside and would be told "go to the toilet as you won't be able to there" she took this to mean that you aren't allowed to ask to use the toilet and not that there wasn't a toilet readily available. They now say "there isn't a toilet where we do forest school so go before hand so you don't have to come back to the school". Like a lot of 5 yo she takes words quite literally!

hope all went well with the social worker.

my four year old will still say that he has a tummy ache and then realises a bit later that he needs a poo, so lots of children do not perfectly recognise lower level urgency. It sounds as if your niece feels the urgency feeling, but not the earlier ones - whether that’s because there has been a lot going on in her life that has meant she doesn’t register it, because she clenches certain muscles all the time or any number of other issues. Her nerves will have to retrain, certainly, but I don’t think that it is possible to say that a child who has not had any consistency in training those muscles up to now will be incontinent for life. There are children with disabilities who train late naturally.