Advice about 4 year old

[Spring2019]

My 4 year old is still no where near clean and is still in daytime nappies or pullups (depends on the circumstances). We made this decision as she has no concept of when she needs a poo and having accidents she found very traumatic and was having a big impact on her both emotionally and socially. Most of the time she is in pullups during the day and nappies at night but most recently she has regressed and was having wet pullups to the point where she was leaking and she was getting nappy rash. If we are at home we could deal with accidents but when out and about it wasnt so easy so we reverted to putting her in one of her night nappies if we were away from home. The fact she wears a pullup we kept a secret from family and friends but unfortunately at a family party someone spotted the pullups and was quick to judge. Now it's common knowledge would it be wrong to go back to nappies fulltime for a bit until things settle down and we can refocus on getting her clean and dry? Most of the time if we are at home and she knows she needs the toilet she will take her nappy or pullup off so she is capable of using the toilet when she knows.

[ERIC-Charity Partner]

Hi sorry to hear you have been having some issues with potty training. Potty training is a steep learning curve for little children but it’s even more challenging if they struggle with constipation or bladder problems such as UTIs.

Does she go for a soft, easy to pass poo once or twice a day? If she goes more than 3 times a day or less than 4 times a week that is a sign of constipation or if she has no concept of when she needs a poo - that can be a sign of constipation too.

Having a build-up of poo in your bowel is a common cause of bladder problems especially in little girls. Their bladder has less space to fill and empty properly as the stretched bowel is in the way. The wee that’s left then grows bugs which leads to infections. The full bowel will also bump into their bladder making them need to go little and often. These children are also very unlikely to be getting reliable wee and poo signals which are so important for effective toilet training to take place.

It will be good to rule this out first before attempting potty training again. eric.org.uk/signs-of-consti...

eric.org.uk/how-to-treat-co...

For now it is best that she keeps weeing and pooing wherever she feels comfortable. So giving her a nappy (or letting her get one) when she needs to go is what we would recommend. Keep them in the bathroom and if she's willing to, encourage her to go in the bathroom/toilet area.

Take a look at our resource Children who will only poo in a nappy for more help with this process. Children can get into a pattern of behavior holding on that they find it very difficult to get out of so a ‘tiny steps’ approach is needed to move them forward. The key is starting from where she is at the moment and then moving forward in little steps, but try to be consistent in sticking to the program whether it appears to be making any difference or not. Once she’s back into a regular pooing pattern and able to go for around 2 hours between wees you can resume potty training.

eric.org.uk/pdf-children-wh...

I hope this helps. If you would like to contact one of our Advisors on our free helpline we can discuss this in more detail.

Kind regards,

Amy

Helpline Advisor

ERIC