How to proceed - nearly 4, not a single success!

[Claennister]

My daughter has been a late developer in every area, she's just started to really talk in the last 5 months, she walked at 22 months, so we know to expect most things later than average. The problem we now have is that she is growing out of all the nappies and things, children's incontience products cost an absolute fortune and the procedure for getting them issued by the continence service is just painful! Most it involves patronising lectures about why we have not trained her and giving her "encouragement".

Thing is, she needs no encouragement whatsoever to sit on the toilet, she'll sit there till kingdom come several times a day, but after about 5 minutse (incidentally, what is "long enough to void" cos we have been told she should remain on the toilet "long enough" but NO indication of what this magical timescale actually is!!) she becomes distressed not at the sitting but at the fact nothing is happening. She will poke at her bits and say it's not working, she simply cannot get a wee out.

We have had several tries at training, putting her into pants for days at a time, but all the manuals basically say the same thing - once they have done a wee in the potty give them a sticker and they will want to do another one. But after 3 days all we achieve is lots of puddles. They say that by day 3 you should have "more hits than misses" but our tally by that stage is always 100% misses and 0% hits, so how are we meant to move it forward? I can sit her on the potty, but I cannot show her how to open her sphincter!

I also hear that normal activity is to need to go about every 2 hours. That's nothing like her, sometimes she will go overnight dry, other times she will wet fully (enough to come through a size 6 pair of nappy pants) twice within the hour. Often it's as much as every 15 minutes, then we get 3 hours of nothing, followed by a wee and another 40 minutes later. Advice on that one is take her to the doctor to see if she has an overactive bladder, but the doctor's response is pretty much that she will get there when ready or (different doctor) keep going with pants and everything will magically fall into place. Just how many days are we meant to go with 100% accidents before we think hang on, this is not working?

This is not sustainable for us, she outgrew her washable nappies and we decided not to get new ones because she'd be potty training soon - and 2 years on we are still buying nappies with a monthly nappy bill of about £40, it's killing us!

What on earth do we do next? She attends two nurseries with conflicting advice also, but at the end of the day what else can we do but sit her on the toilet? If nothing happens then nothing happens. We spent 2 days putting her on for 5 minutes every 15 minutes on a timer system - not a single drip in the potty.

I really understand your frustration, but if your daughter is such a late developer, I think you need to be a bit more patient where potty training is concerned. It's such a major thing for her to learn, and so much needs to click before she masters it that she just might not be developmentally ready for it.

A very good HV told me not to stress about potty training, because no four-year-old turns up on their first day at school in nappies - her point being that they all get there in the end. You still have another year before your DD goes to school so you have plenty of time for her to get the hang of it.

BTW, bribery might help - one of my friends made a chart for her three-year-old, who was extremely resistant to potty training, and told him that every time he did a wee in the potty he would get a star, and for every 10 stars, he would get a Chuggington toy. Within a week he was potty trained (they'd spent six months before that tearing their hair out).

who have you seen about it so far? has a physical cause been ruled out?

I would really love to have a physical cause ruled out, but any time I mention it to anyone I always get told she will get there in her own time and don't stress. I am not stressed about her not being trained, but I am stressed that we cannot find a nappy to fit her without leaking (and I mean several leaks a day, not the occasional nappy failure) and I am stressed because we are spending more on nappies than we are on food, and we simply don't have the money, we are sliding into debt on the cost of nappies alone. Now that is a stress!

I am more than happy for her to train when she is ready if they will list her for paediatric incontinence pants, but they are either supposed to do a toilet assessment (which includes assessing for overactive bladder and nerve problems) or they are supposed to say training is not appropriate and then issue some products. We are being told don't train her but fund your own incontinence pants. Paed pants are £7.99 (excl delivery) for 18 pairs, and she wears 6-8 pairs a day. When we can no longer get her in the size 6 we are going to have to give up eating to pay for the nappies.

I am waiting till after her birthday next week and am trying to work up my courage to march in and insist they do a proper assessment. All we ever get told is to do star charts and things, which makes me scream, she already WANTS to wee, she just can't, so upping the ante by saying she can have a treat only if she pees is just going to distress her even more. If you were told you could have a million pounds if you can sit on the toilet and suck your wee back up out of the toilet, would that help you do it? Or would it just make you more upset that you were being asked to do the impossible every day?

Can I just be really, really blindingly clear:

I really, really genuinely don't care if she potty trains when she is 5, 10, 25 or 90, but she needs something to wear while the process completes. And we need for everyone to be in agreement, not for 50% to say don't do anything and 50% say put her in pants and magic will happen. I can only do one thing, I can't please everyone.

But bring it up and everyone says I need to be patient - I am patient, I don't care, really I don't, but I care about the fact that my poor child is being soaked through several times a day and twice at night because baby and toddler nappies are not right for her and we cannot get affordable paediatric nappies. She is tired, I am tired. Potty training is no magic answer, but I do need AN answer.

This is just exactly like when she had a cows' milk allergy and was refusing to breast feed, and the doctor's response was "carry on breastfeeding her" because he refused to prescribe a hypoallergenic formula. Did he think there is a way to make a child breastfeed when they don't want to? I think this doctor has never met a real child.

I have no advise but i can feel your stress at the cost and the uncertainty and i think you are putting everything very clearly. Well done on being calm - i know i would fail on that front.

I hope someone with some experience of this comes along and eases your worries.

Good luck

I'm so frustrated on your behalf - I have had this at a smaller scale with DS (who was 3 in April and has only just got it). Got MIL ec saying "just put him in pants" - when we did that he weed on his pants.

However, pampers and huggies sell disposables for older children, I definitely saw some in boots the other day as I was surprised to see the age range on them was 8-15 years! Obviously they are intended for night time but they're just pull ups. Don't think they were as expensive as the ones you mention, and also assume they are sometimes on offer and you'd get points etc. I assume your DD has grown out of the size 6 nappies?

What worked for us - feel free to chuckle cynically as I used to - what works for one never seems to work for another.
We had our first real success (as opposed to one off wees) when I put him in pants (as instructed) and sat him on a towel (with a disposable changing mat on top) for the inevitable accident in front of the TV. As I knew he would he wandered away from the towel but then went back and weed directly on it! After he did it again I started encouraging him to use the potty / toilet and it went from there.

Do you encourage her to use the toilet or potty? I can see why you'd want to go straight to the toilet, but maybe a potty in the room she's in might help?

can you see a different GP? have you seen a paed? if not then demand a referral to one and to the eneuresis clinic too if you haven't already had that done

is it totally out of the question to pay privately to have her checked over?

these are very expensive, but i know someone who used them who said they wold easily contain a big wee from an older child. again, it's the initial outlay to buy them tho isn't it. and it's not a cost that YOU should have to bear

i could understand them saying wait if it was wetting the bed, a LOT of children just don't get that for a long time. but during the day too, i think that this must be fairly unusual??

Seriously - pampers and huggies do them! Or am I missing something? Or are they just as expensive?

If you are having no success whatsoever, even though she seems to understand what to do, she just cannot physically do it, I would think there was a physical cause.

I would keep a diary of exactly what you are doing over three days, and then take that to the doctor and try and get a referral to an expert in continence or a paediatrician.

oh and I think this needs to be put together with her late walking, late talking etc. I do think you need a proper referral.

absolutely agree with belgo

Can you let her run around with no clothes on (or a skirt with no underwear)? It might help if she knows there is nothing there to contain anything?

Does she still have a cows milk allergy? This might have an effect on the erratic wetting pattern.

Has dd any sensation when she wees, can she tell you after or even during that she is wet? It's a shame weather-wise that you couldn't have her knickerless in the garden so that she can see as well as feel the wee when it comes out, and then begin to associate the feeling just before that means a wee is coming. I think if she feels no sensation when weeing you have a good case for a referral.

Have you considered a bit of role play with a dolly that wees in a potty, or her watching other children wee in potty or toilet? Or running taps?

There is a website called pshhealthcare.org.uk who sell Upsey Daisy continence garments for children up to 12 yrs. They do padded knickers that hold up to 215mls at around £7 a pair, and other things. They also have a continence advisor to help you choose the right products. I think they might be expensive initially, but save money in the future being washable, and I reckon they would have a good value when sold on. You could probably boost them a bit with bamboo inserts if needed.

No real advice , sorry .
I only wanted to say that with my DD star charts etc, NOTHING worked (you would not believe what I offered to buy for my DD as a bribe, ridiculous money , I was desperate )
There was nothing at all physical it was about confidence and emotion with her . She knew exactly where to go and would even take her much younger cousins and even help them wipe their bottoms. No way could I get her to wee or poo in anything other than a nappy until she was ready.
My DD was as Belgo described she knew it inside out but couldn't do it, but NOT due to a physical problem it was like a mental block.
When ready she giggled and said I can do this now, I am big, weed in the toilet was so proud of herself and was dry day and night from that first visit to the toilet.

I tried everything that the mums on here advised, praise , stickers , sweets etc but honestly she was just a child who needed to find her own way with this.
Suspect your DD might be the same, so demand your GP takes this seriously and you get support or issued with nappies etc that she needs.
I firmly believe that with some kids it is psychological and they just need time.

In fact my DD was so switched on she was reading the Biff and Chip books from her much older cousin and spelling 5 - 6 letter words effortlessly . She was more than capable of understanding what was required re toilet training .She even told me once that she was different from the other children and needed to go in her nappies to be happy !

I wish you luck, it will be resolved but I do know how stressful it can be.
I think that you are correct in trying to sort out the practical aspect and the rest will follow in time.

I really sympathize as I am going through the same thing with DD who is four years old. My dd does have some speech issues but is more than ready for toilet training.
She can pull her trousers and pants up and down, sit on the toilet and get off herself, wipe herself with toilet paper, wash her hands on her own etc.. absolutely everthing EXCEPT release a wee. She even sat on the toilet today saying "I want to do a wee" but nothing came out. .
I am beginning to wonder if it will ever happen. I put her in pants but she just ends up weeing in them. Thankfully now only about 3 times a day as she does have good bladder control.
She even plays with her toys and puts them on a pretend toilet so I have no doubt that she understands what is required of her.

Have you tried claiming disability living allowance for extra toileting costs you incurr with your DD. It may be worth a try or maybe contact your HV to see if your DD is eligible for free nappies?

Babbi - can I please ask at what age was your DD toilet trained?

Also, another strange thing with my DD is she seems to be night time trained - I always thought day time training happened first but obviously not!

I have no idea how the various bedwetter pants are supposed to work, cos we have tried them all, and they all failed to contain a single daytime wee. Underjams? Pointless. Huggies pull-ups? Slightly less pointless but still leaky. Pyjama pants? So comically too large that the wee came out through the leg holes.

She's skinny but wees a lot, so bigger bedwetter type sizes the wee comes out the legs, nappies are not for wees that big. Just now we are on pull-ups with an adult incontinence pad stuck in them, which seems to be working pretty well for now, hurrah! It is at least a bit cheaper. Also found out that nappies and pads should be removed from the plastic 24 hours ahead of time to allow the padding to expand, which I never knew. So far only one flood.

Even if she's naked the wees seem to take her by complete and utter surprise, she just stands and watches fascinated that something is coming out. We are going another round with the health visitor next week to try to put the point across again, no we don't believe she has some terrible undiagnosed internet illness that we demand they do expensive tests for, but neither do we think a star chart will make her magically pee.

Some mums have found that using an extra waterproof wrap or pants helps with leakage from disposables when worn over the top.

IMO, you need to have all physical causes ruled out, and the fact that you say dd pees a lot makes me wonder. If your gp isn't helpful you are entitled to a second opinion.

Certain drinks can, in some children have dramatic effects on urination, e.g. milk, hot choc, fizzy drinks inc. sparkling water, cola, blackcurrant cordial and some fruit juices. They can over-stimulate the kidneys to produce more urine than normal. Could you trace two pees 15 mins apart happening after a drink of blackcurrant for example. I'm just trying to help you reduce the flooding, if you need to eliminate certain drinks from dd's diet, so be it.