At the end of my tether with 4.5 yo weeing in knickers almost daily

[Bumperlicious]

DD1 is 4.5, well, actually she'll be 5 in June. She was very reticent to potty train in the first place, only deigning to sit on the potty at 3. But she cracked it pretty quickly but for the past 9 months or so she has been having almost daily wee incidents, though it does tend to go in phases. It preceded starting school by quite a few months, and hasn't shown any anxiety about school so I haven't put it down to that.

She does go through phases of being dry so I know she CAN do it. We have tried sticker charts and reward jars, ignoring it, getting cross, removal of privileges (currently no TV). Nothing seems to work.

She has been tested for a UTI but is clear. Dr had no advice but tried to get us a referral to an enuresis clinic but they refused on the grounds she is too young. Sometimes it is just a case of not getting to the toilet on time so is only a little bit. Sometimes, but rarer it is a full on wee accident. This is at school, at home, anywhere. She very rarely owns up to an accident, but will admit it when asked. Though when we were doing a reward chart she started lying about it so we swiftly stopped that method. Punishments aren't really bothering her either. She's just says "I didn't want XYZ anyway".

The school aren't being particularly pro-active about it, but aren't making a fuss about her doing it. Invariably they don't know she has had an accident as it is only when I ask her that she admits it. They are trying to encourage her to go regularly but there is only so much they can do.

She is not even CLOSE to being dry at night, and shows no inclination to even want to try. In every other way she is pretty advanced for her age, socially, verbally, her literacy is great (just including this in case people suggest other factors).

I just have no idea what to do for the best.

Bump :)

You could be talking about my 4 year old son!! He's bright, very advanced next to his peers. He just wets himself very often. I think he may have an overactive bladder as he hops on the spot and has a very urgent need to go. Then it is just a tablespoon or so. It's very stressful, and like you say, they won't do anything medically til he's 7.
Have you heard of the charity ERIC?? For childhood continence. They were very helpful. Worth seeking their advice maybe?
Good luck. I'll spare you a thought as I do my next load of never ending washing!

My son is nearly 6 and still wetting himself approx. every other day, sometimes more often. After numerous trips to the gp, help from ERIC, lots of support from school nurse (none of which were of the slightest bit of use), we got a referral to a paediatrician. He's been on toltolderine for about 6 months now. It helped significantly to start with but it seems to have wained recently, even though dosage has been increased. However we have become lack on other exercises that we were told to do and the paediatrician warned that we must not become complacent. We are meant to do stream interruption exercises and wees on a regular basis. We do this as much as possible but we both work and thus we are not there as much as would be ideal and as things got a bit better, I think school have forgotten to remind him to go too.
My advice would be to insist on a referral. I was at my wits end but at least now I do believe that one day we will get there. I can't see it being resolved possibly for years, but if we can take small steps forward than that's good to me. Before the referral, we would have 5 'accidents' or so a day at the weekend. He was a better at school but it was still worse than it is now.
Btw, the paediatrician said that we should not put sanctions in place or even expect him to respond to the special reminder alarm watch that we got him from ERIC. Ds knows that alarm is going off (it vibrates) but consultant said he's too young to actually do anything about it.
I have just set up for his second lot of medication to be taken at school because after school was proving too late (he'd already wet himself by then). Ironically the policy is that he has to remember himself to go and take it...... If he remembered things and acted on them independently, we wouldn't be in this situation.
Finally my ds has no other issues either. Doing ok (for a boy) at school, bit under confident but pretty straight forward otherwise. He's also wet at night but frankly I couldn't care less about that at the moment. It's fairly common - just look at the night nappy sizes stocked regularly in all supermarkets.
Good luck. If your dd is anything like my ds, you'll need it along with lots and lots of patience.

one thing to consider is that a build up of poo can press on the bladder and cause wetting. warning symptoms can be excessive night wetting, needing more than 8 wees in a day or more than one per hour or having damp patches.

the first sign of a problem in our DS was the wetting which eventually much later progressed to soiling too but it took years before they realised the cause as he did not display any obvious signs of constipation to us ie no straining and has never passed a hard stool.

Just a week on medication for the constipation and all day wetting had stopped and he was dry at night without pullups whereas before this he was leaking through pull ups every night.

Also meant to say that DS had phases of being dry in the day but that was either due to supreme effort for a bribe as it would take him far more effort than another child or because there was less pressure on bladder at times due to build up of poo so it did not mean he could be dry all the time. OP this certainly does not prove that it is behavioural.

Hello pooandmorepoo. So glad I found this. Our DD has never been dry for any more than a week or so a time since potty training in late 2010 when she was rising 3, but she mastered poos within a few months. She was also dry most of the time last summer, but I think regressed again when we had a lot of stress in our house due to losing a good friend and me having a MC. She is now 4 and for the last 10 weeks has been having poo accidents as well as lots of wee accidents and is soaking wet overnight. We have started on lactulose as a result of me calling a pharmacist late last week and we are going to see GP tomorrow. I've not seen any obvious signs of constipation with DD, apart from her going from a once a day girl to a three times a week girl, iykwim. What medication was your DS given?

Movicol - it is fantastic... but you may need large dose intitally to clear out any build up of poo and then possibly continue on it for a long time, if you stop too soon the symptoms can return.

Please expect the GP to dismiss any suggestion of this as most only consider it if the child is straining and passing very hard stools. It is widely misdiagnosed. There are lots of other symptoms listed in the NICE guidelines for both childhood constipation and night wetting, some of these you may not think to mention as people do not realize the link.

For example not just damp patches, frequent weeing during the day (more than 8 a day or more than one an hour), excessive night wetting, poor or inconsistent appetite, behaviour can be affected in some causes depression others listless, anger or irritability, low iron levels when blood tested etc etc

Let me know what the GP says. Happy to help further

This is my experience with DS2. He was 3. He asked to use the potty and he was dry for a couple of months. Then we got some kittens and I think he was a bit put out by this as when I explained they were baby cats he shouted no and got very cross. Almost immediately he started having "accidents" but never when he was at kindergarten. The next 6 months were testing. He would have many accidents every day. Some times we were getting through 7 pairs of trousers a day. I asked the HV for advice and we tried: ignoring the accidents, getting cross, reward charts, getting him to clean it up himself, going out to choose pants. Nothing worked. One day he sat on the couch did a wee, looked at his Dad and said look Daddy I did a wee on the couch. The last thing I wanted to do was put him back in nappies as I thought this would be a bad idea. Well one day we went to the science museum. He was dry all day, asked to use the toilet. Perfect! Well we walked through the front door, he looked straight at me and had an " accident" on the doormat. And it hit me that he was totally in control of his bladder. So the next day I very calmly explained to him that 1. he was a big boy and knows when he needs to wee 2. That for big boys wees belong in the toilet not on carpets, trousers or sofas 3. If he didnt want to wee in the toilet that was absolutely fine but that meant he had to wear a nappy as it was just too much work for Mummy clearning it all up. He wasnt very happy about wearing nappies again but we put one on. He used the toilet every time after that and we never had another accident again. 2 days later we agreed the nappies were no longer needed. He is such a lovely boy but also has a very stubborn streak. But it did take me 6 months of trying other methods before I resorted to nappies.