5 year old toileting problems

[SCarroll31]

My 5 year old son is still wetting pants during the day (as well as soiling constantly) and is bed wetting too at night. We recently decided to stop using night time nappies to see what would happen. He was dry for the first 3 nights but has wetted the bed every night since then. He doesn't seem to wake up when he is wet and being wet / smelling of poo during the day doesn't seem to bother him either. He is a bright and happy little boy and we have tried so many incentives / rewards but even then that doesn't bother him if he doesn't get his reward! I've spoken to health visitor and said that we were being referred to an incontinent clinic, but not heard anything back about this. He starts school this year and don't want him to be smelly at school. Any advice for parents in this situation?

[Chocolate-chicken]

We have a 5 year old in the same situation in reception at school. I would recommend being completely honest with school at the earliest opportunity and perhaps ask to see the senco ideally before your son starts school to see what they have in place for changes etc. Also see if you can speak to the school nurse as soon as possible too. We waited 9 months to see the continence team, and are now waiting to see a paediatrician. School have been amazing but I think we're incredibly lucky as others here have had very different experiences - that's why I'd try to get in as early as possible to prepared them for the situation, and so they know that you are approachable etc... as for the other kids, so far my daughter has been fine. Apparently they all just take it in their stride and seem to just accept that my daughter needs help with this, and other children need help with other things. She has started wearing incontinence pads to school to try and reduce the changes and also draw less attention to her... And we're also looking into getting some reusable incontinence knickers (apparently better than pads as the wee is not soaked away, so the child should still have a sensation of being wet). All in all its a learning curve, but I think communication with school is key... Good luck xxx

[SCarroll31 in reply to Chocolate-chicken]

Aw thanks for that. I am putting it down to time and eventually he will get there. It’s just so stressful and upsets me as I feel there’s nothing I can do to help him. It’s in his school transition report from Nursery saying he needs reminded to use the toilet. He gets so engrossed in playing he doesn’t realise he’s wet. But I’ll reinforce the message at the parents induction meetings next month. We are in Scotland so not sure if we have “senco”. I’ve started potty training my 2.5 year old daughter so hoping she’s going to sail through it. I’m not ready but think she is! Thanks and good luck to you and your daughter 😊

[SKY01]

Hi. Has anyone checked to see if he's maybe constipated/backed up? My son was the same, soiling all day and wetting too and often made out he didn't care. Several doctors (and a pediatrician!) labelled it as behavioural and something he'd grow out of. Anyhow to cut a long story short we got an x-ray in the end and it turned out he was completely full of poo! I'd never have guessed he was impacted as he pooed regularly, didn't complain of pain etc. but he was and all along he'd had no control over it:(. Just beginning the road to getting him sorted now but it's a relief to know there's a reason for it all. I wonder if it's maybe worth pushing to get him checked if you possibly can?xx

[Jfraser1]

I agree with SKY it sounds like he’s constipated or backed up with poo. That would cause the constant soiling and wetting. If that is the case then he literally won’t feel it and can’t help but have these accidents. Go to your gp and have some Movicol prescribed, a disampaction will prob be a good start. Then it’s a case of finding a good maintenance dose and letting his bowel and bladder ‘heal’ and regain tone.

I’m in Scotland too, my son was referred to continence nurses but 1yr later we’ve still not heard anything!! My son was in exactly the same position as yours last year, gp didn’t take it seriously. I did all my research on here, did a disampaction with the guidance of ERIC . That immediately stopped the soiling and wetting and then it was a case of maintaining that.

I don’t know if you’ve seen your gp but the constipation is always the first thing that they will try and treat in regards to continence. Ask for a referral to a paediatrician too, they’re often far more knowledgable and interested! Ask lots of questions on here too - I don’t know what I would have done without the experience of the other parents on here.

Good luck Xx

[SCarroll31 in reply to Jfraser1]

Thanks for your help. I’ve made an appointment with the GP so will ask a few more questions and maybe a referral to a paediatrician.

This forum has definitely been helpful. I don’t know anyone of his friends who are having to deal with this - so this is very helpful 👍

[SKY01 in reply to SCarroll31]

Good luck!Definitely try the ERIC helpline too. They suggested giving the disimpaction a go and gave us some great advice (as did this forum). If he isn't that backed up then the disimpaction will be quick and if he is then it'll be so worth it!! X

[SKY01 in reply to Jfraser1]

Hi. I was reading your post and saw that you said that when you did a disimpaction it stopped the soiling and wetting immediately. That's great news and gives me a lot of hope as we completed a disimpaction on Sunday and have slowly been reducing the dose this week. Down to 2 Movicol now and things still loose. He pooed all over the nursery floor today, poor thing!! I will reduce the dose again now and hopefully find a good maintenance dose. Wondering if you had any other tips? Did you continue to sit him on 3 times a day after meals? At what point did he start to take himself and is he accident free now? Thanks:). Feeling a bit worried about it all now as am pinning a lot of hope on this!xx

[Jfraser1]

Hi Sky. We disimpacted 1st July last year - I remember as we had just come back from holiday! The accidents stopped completely and I was very strict for a month after by sitting him on the toilet 3 times a day. After that he got into a good routine of pooing once a day at lunch time. He knew if he wanted a tasty treat after lunch he would have a poo and he always managed! I stopped insisting that he sat on the toilet apart from after lunch. I didn’t trust him to take himself as he was a witholder and felt like he needed time to get over the physiological issue. Over the past year there are times that he’s had accidents again and that is always down to his Movicol dose. Sometimes he may need more if he’s been unwell or diet/fluid intake different. The first indication is always the damp pants! I’ve always increased and decreased by a teaspoon each time and find it can take 48hrs to take effect.

A couple of months ago he became backed up again with soft poo. The Movicol is great for softening and bulking out the poo but I felt like he needed a stimulant like Senna to move it all along. That has been working great for him. He’s been accident free since then 😁.

They say it can take a year for the bowel to repair its self and I’m in no rush to stop the Movicol. My paediatrician said that there is often no reason for childhood constipation and it’s something they will grow of. It just takes time, patience and lots of poo analysing haha.

It took 9 months before I could let go and trust him to take himself for his poos. I’m now trusting him to wipe his own bum so I know that he can happily deal with it whilst at his friends or when he starts school in August. He’s over the physiological issue too. Next step is introducing a diary free diet to see if that makes a difference.

Good luck, I know how stressful and frustrating it can be but I promise it will become so much easier once you find your maintenance dose and a sense of ‘normality’ again Xx

[SKY01 in reply to Jfraser1]

Thank you so much for this. Gives me so much hope! I think the nursery accident today was down to things being much too loose still but fingers crossed we can find the right dose and things should improve! We are also using Senna so that should help. Wonderful that you've had so much success. Hope things go really well when he starts school in August. My son starts in September and am really hoping things can be more settled by then! Thanks again for the encouragement. Xx