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Daytime wetting in 4yo girl

Our health visitor has referred us to our enuresis clinic, but I was wondering if there was anything I can do while we wait (3 months...)?

A bit of background -

When my daughter was 18 months old, I noticed that she was waking up dry every morning, so I started putting the potty out and taking her nappy off. By 19 months, she was out of nappies day and night, although she needed my support to use the potty of course. I was always there to help her and remind her.

As she got a bit older, she would have accidents, but I always put it down to regression - we moved house 3 times in 6 months (it was crazy!), and then I was pregnant and had a baby. The baby is now one year old, we are settled in our home (I will never move house again!) and she is happy at nursery school.

But the daytime wetting hasn't stopped. I've recently come to realise that the regressions haven't actually been regressions at all - I have always been there to remind her and help her to the toilet, and the times when I've been busy with the move or the baby have been when she's wet herself more because I haven't been reminding her as much.

I think she's always struggled with this, but I have masked it through my support/reminders.

I also don't think she recognises when her bladder is full. I think she knows she needs to wee, but it's not consistent, and I have witnessed her sitting on the floor and urine just sort of poured out, and she didn't even react? There was no conscious effort to urinate, this was obvious.

It's confusing, because she does sometimes take herself to the toilet. She does sometimes tell me she needs to go. She isn't constipated, and never has been. She will take herself to the toilet for a poo, no problem.

I'm starting to think that she might have some sort of physical issue. I really don't know where to go from here. She has been quite poorly recently, and I've resorted to putting her in pullups because she just couldn't get to the toilet, and I couldn't ask her if she needed a wee because she was sleeping so much. All of our sofas have been soaked by her accidents. I'm going to have to replace our furniture, but can't do that for a while yet! I fear that keeping her in pullups is making this problem worse, but she's constantly wetting herself - up to 5x day.

I feel terrible for getting cross with her, but I have in the past. It's so frustrating. I have been dealing with this for her entire life, practically. I know that treatment isn't often recommended for under fives, but she's been out of nappies for so long and this has gone on since the beginning, surely that needs to be considered?

What can I do now, to help us cope until our appointment?

What can I say at our appointment for them to take this seriously? I'm so worried we'll be brushed off until she's five and in full time school.

Help!!

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I could have written your post word for word - including the part about 3 house moves in 6 months!!! And no, I'm NEVER moving again either!!! Sadly I am also in your exact situation with my youngest daughter daytime wetting.

Like in your case, she has never been dry and has now just turned 5. Every area is different but where I am (Leeds) I was pretty much fobbed off by everyone until she turned 4... The Dr then referred us to the hospital for reflex and developmental checks - all fine, kidney and bladder scans (fine)...once anything serious had been ruled out we were then referred to an eneurisis specialist, this was in June last year. We are STILL waiting now....

Luckily school have been incredibly supportive (I can not fault the way they have handled it all). The school nursing team are also helpful, or at least they are trying to be, at the very least they are a sympathetic ear, which I need some days.

Currently the "plan" while we wait is: drink as much as possible during the day.

She is taken to the toilet every 40 minutes throughout the day (she still generally has at least one accident a day)

Ensure that she has changes of clothes available.... and, recently for school productions or events where I know it will be hard for the teachers to keep an eye on her, I've been putting incontinence pads in her pants to just help minimise any mess...

A slightly worrying turn of events is that literally just since Christmas we have suddenly started having poo accidents too which are starting to tip me over the edge sanity-wise... I am hoping that this is just a temporary thing and she will snap out of it... The wee is bad enough!! She has never done this before so I have no idea why it's suddenly started!!

But ultimately the current thought, of me, her teacher and the school nursing team is that she probably has an overactive bladder. Apparently there is medication for this, but we really need to wait for this appointment to come round.... If and when that ever happens.

Sorry for the essay... I feel your pain...

Xxx

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Commiserations! Our poor daughters. I hope your appointment comes through faster than you think.

I wish there was a quick, easy answer to these struggles. :(

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My son doesn’t have this exact problem as he has always suffered with constipation, but when he was having trouble with a lot of wetting I got him one of those watches that vibrates to remind them to go to the toilet, you can set it to go off at particular intervals or at set times. I started off with every 45 minutes and then when he was dry I started to stretch the times by small amounts (without telling him as he always regresses if he knows there is a change)

I wonder if putting the going of the toilet into her hands might start to give her more control of the situation. Also have you tried getting her to double void (after she has done a wee waiting for 30 seconds then trying again)? This really helps my son and if I can get him to sit for longer he will do loads of wees which helps him stay drier for longer.

The watch we used was a wobbl watch and I got it on amazon.

These are just things that have helped us so hopefully they might help you as well.

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Thank you for the suggestions! I've never heard of double voiding, so we'll work on that. I bought her a vibrating watch, but I'm not sure how well it is working. She's had it on today but hasn't said a word to me if it's actually vibrating or not. It's not the brand you mentioned.

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I did have to be really strict with my son that he went to the toilet every time it vibrated whether he needed it or not, so I guess you could just see how regularly she is going. I slightly worried about making his bladder over sensitive but we had to do something and we were able to stretch the times out relatively quickly. He was getting so stressed and stubborn about everything it just helped to break the cycle.

Good luck 👍

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Me and my daughter are in exactly the same situation as you and yours. It’s been 2 years of continuous daily wetting which has gotten worse.... she can have Anything from 1-10 accidents a day. This week i finally saw a continence specialist who was tempted to start her on some meds for an overactive bladder (which I’ve been saying all along!!) but they’re a little reluctant to start before she’s 5. I feel like I’ve been swimming against the current with school/nursery and family for such a long time now - the specialist is sending a nurse into my little girls preschool and nursery to make a plan so we r then all singing off the same hymn sheet so to speak. I feel some relief in the sense that hopefully at least if we all stick to the same routine in time we can train her bladder to b able to hold her wees rather than continuously leak. We aim for a minimum of 1litre if fluids a day and intake her to the toilet every 1.5-2hours a day (nursery we’re taking her every 15mins!!!) whether she needs to go or not (yep this can b very hard work - cos she isn’t very keen to ever go but we have bubbles and balloons by the loo) we also have started double voiding aswell (a ballerina twirl after her first wee attempt) I have everything crossed that a month or so of sticking to this plan will hopefully lead to some kind of progress. I also have now started using some pads to catch any leaks and to save my sanity a little - I was worried if I used them then she wouldnt bother going to the loo at all but so far it’s seems to have eased my stress levels and laundry bill a little 👍 hope that there is some reassurance in my post ....... I found that jus knowing there r people in the same situation as us was reassuring. The nurse specialist I saw was quite positive that we will sort the problem xx

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Thanks so much for your reply. I will definitely try the double voiding trick.

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Hello - another person here in the same situation. What a sorry band we are! My little girl is nearly 5 and very similar to you. She has been diagnosed with an overactive bladder and we are on a medication for it. It hasn’t been plain sailing (see my reply to ‘poppymum’ earlier this week) but much improved. I’d recommend using the pads too, they really help everyone’s sanity. Drinking lots of water really helps us too but I find she is super sensitive to blackcurrant squash so that is not allowed.

To prep for the appointment I suggest doing a bladder capacity test where you get her to hold until she is busting and then measure how much she wees. Don’t worry about little leaks whilst she is trying to hold it. Do this test 3 times.

I’d also suggest completing an ‘in and out’ chart for three days (prob best at half term’ where you literally write down all her drinks in volume and measure time and volume of wees. Example here: evelinalondon.nhs.uk/resour... Get her to wee on a potty so you can measure output. If she ever has big accidents you need to weigh the pants and trousers. If you know the dry weight the difference in grams wet equates to ml of urine. But I wouldn’t worry about that for little patches. Just be able to say if it is a 50p wet or full knickers or down her legs accident.

In addition, start logging all accidents including time and size (as above) so they have as much information as possible. Also log poos. I know you don’t think this is related but the chances are they will assume constipation and rule out before anything else. Write down all poos and look at the colour (pale or dark), consistency and girth. They will also be interested in any really putrid smells if that is applicable! Log what they are like according to the Bristol poo chart for children (google it). We call it the ‘log log’ in our house!

I’m sure this all sounds like a lot of work but it just makes me feel like I am doing something useful. I don’t get school to track poos but you can probably train your daughter up to know the chart. Our nursery used to do this for us. School just to tell me time of accidents and then I inspect the pants/tights to judge size.

Hope that helps and keep us posted on how you get on xxxxx

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Ps - have you found the Eric leaflet on day time wetting? eric.org.uk/Handlers/Downlo...

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Hi,

I was really interested to read what you said about squash, my son is terrible if he drinks any kind of squash. He is fine with other drinks but squash just goes through him - have you any idea why??

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Nope! I’ve always assumed it’s the additives /colours. Blackcurrant literally goes through my daughter in about 10 minutes and makes her have a full accident so it’s like it irritates her bladder in a different way. I have friends who don’t let their kids have blackcurrant for the same reason but they have no other wetting problems! You’ve got me thinking about orange squash now which I do let my daughter have... I think she’ll hate me forever if I make her drink her movicol without that but I might try cutting it out otherwise!

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Wow, that's really helpful! I think if I go into our appointment armed with all that information, they will have to take notice! :)

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Hee hee! It’s basically what they would probably ask you to go away and do, but probably over a few appointments as they try to rule out different issues. Hopefully it will just get you to a successful course of action faster. Good luck :)

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We have been warned about squash by the school nursing team... They said to ideally stick to water, and if she must have squash give v weak orange squash with breakfast...but not any later, and never blackcurrant... She also didn't know why. To be honest it seems to have made v little difference to us but at least I'm actually doing something...

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