Four year old accidents

[user1471523870]

I am looking for someone who went through the same.

My son has just turned 4 and, after having tried for a loooong year, he's now been nappy free for the last two months. However,

• he goes for a wee only if asked/reminded, which works well but he has accidents if we forget to remind him! He never asks if he needs the toilet
• he always goes for number two in his pants. He knows he should use the toilet and there are strong incentives for him to do so (he loves little presents and chocolate buttons!). He's annoyed he has a poo in his pants, but he doesn't seem to be able to do much about it.

Have you experienced this? Do you think it will get better before he goes to school next year?

Does he struggle to poo? Could he not be aware it's coming out if he's been constipated perhaps?

I don't think he's constipated. As a baby he would poo 2-3 times a day, and now he's settled to once and very very regular (sorry if too TMI).

I would double check constipation. My daughter had the same issue with poo accidents. she couldnt feel when to go because there was a hard lump of poo stuck and so she always felt like she needed to go even when she didn't. Read the Eric continence website. Even if kids are constipated, they can still do poos regularly. The soft stuff kinda squeezes round the blockage. You could try some movicol and see if that sorts it out, and make sure they are drinking plenty.

The "blockage" can also make it hard to tell when to wee too, so it would explain both.

Thanks for all the replies. To be honest I don't think he is constipated. He has never been before in his life, his stools are soft and he doesn't even get the 'pee in the toilet' part.
I just think he's either not bothered or he doesn't understand he can hold it when the urge comes (but he can hold a wee for longer than before as he's often dry in the morning).

Is this normal? I only hear stories of potty training when eventually the child asks for the toilet!

It would explain it indeed, but I would be a little lost in what to do next. His stools are soft already, there is no blockage, he's eating plenty of fruit, veg and drinks loads.
I can try Movicol but I fear the only result would be MULTIPLE accidents a day vs only just one predictable one ha ha!

It is not normal for a 4 year old to have repeated toilet accidents so unless there is something going on which you havent told us about in terms of his ability to understand or get to a toilet, i.e. a disability, then it is likely that there is a physical reason and the most likely one is constipation. Long term constipation Can lead to perminant damage to bowel control. If you are not confident in attempting a disimpaction on your own, which is what the NHS advises as the first line treatment, then I would make a gp appointment and ask for a referral to the continence clinic.

Thank you all again for the responses. I am sorry if I sounded I didn't want to hear your suggestions about constipations.
Perhaps I am not educated enough on the concept of constipation. What do you describe as symptoms of constipations, to make sure I get it right?

For context:
His stools are soft.
He never complains of any pains in his stomach.
He goes every day, at the same time. Sometimes twice a day.
He has 5-6 portions of fruit and veg every day.
He drinks lots of water or milk.
He is a very active little boy, who spends at least 3 hours per day in the garden.

What am I missing? Should his poo at this age be loose, so that just soft means constipated? Do four year old go like many times a day, meaning only 1 or 2 is constipation?
I am now very worried it could be some other physical problem. Will ring the GP in the morning.

Is there any potential SEN involved?
My autistic boy still has accidents at nearly six. He shows very little self initiative with toileting

No, I don't think SEN. He has great social skills, can understand/reply to any other instructions, he's speech is coming along nicely. We had bad terrible twos (not listening, very demanding, constantly on the go) but he's calmed down a lot.
He's a young four year old, as he was born premature. He shouldn't be four for another two months, but still I believe he's a little behind in that compartment.

I will investigate constipation better and inquiry our GP about it. Maybe he has it even if there are no evident signs. Worth a try.

My daughter never complained of tummy ache, ate loads of fruit and veg and pooed once a day. It was a soft poo but she constantly pooed in her pants. I tried everything bribery, and, I am not proud to say shouting) I gave her movicol every day for a couple of weeks and she passed a couple of hard poos and then was completely toilet trained and hasn't had an issue since. The Eric website says that giving kids laxitives as per the guidelines on their page will not harm the child at all whereas doing nothing could do. As I said, ask the gp and make sure they refer you or prescribe laxitives. It is the easiest thing to exclude first. Next avenues involve an MRI or ultrasound.

Just wanted to give an update, for the benefits of other parents in the same situation.
Straight after this post I asked a pharmacist for a remedy for constipation for my son, and she replied that there was nothing available over the counter, just to up fluids. I then arranged a phone call with the GP who just said to wait as it's still early stages and make sure he drinks plenty. To be honest, as also already said, my son drinks a lot of water and milk already.
Anyway, fast forward only a few weeks, he's getting on brilliantly with using the toilet for number 2s!
It all started a couple of weeks ago with an accident he was quite upset about (sorry for TMI, but it involves the bath....yukkkk). The following night I reminded him of the accident and asked several times if he needed the toilet to avoid that happening again. He wanted to try, and eventually succeeded.
A couple of days later he started telling me when he needed the toilet. Often we didn't get there on time, but at least he was showing he could feel the need.
Now most days he just takes himself to the toilet (and then announce the result of it quite proudly) or he tells us. We haven't had an accident for four days in a row!
Also, he's no longer wearing pull ups at night. I am a bit nervous about that but he doesn't want to wear them anymore and in all fairness he's been dry for ages.

I am SOOOO proud of him!

Brilliant. Glad it has been resolved.