Restroom Regression

opinion 1
I currently have 4 charges. The youngest are almost 4 year old twins. Both twins have been potty trained for about half a year now, but the little girl seems to be regressing. She'll have multiple accidents a day and doesn't seem to really care. The odd thing is, she was the first of the two to be potty trained and was the most excited about it! Does anyone have tips on how to deal with this toileting regression?


nannytothree said...

It's funny because the same thing happend to me with twins. One regressed after about 6 months of being potty trained. Must be a twin thing! :) We had to start up the sticker chart again, give him an m&m for poops, and offer lots of reminders throughout the day. It was frustrating, sometimes it felt like we were starting all over again. But he was fine, and went the pre-k the following year in underpants!

Mom To Three Kids said...

My second daughter was super easy to potty train at 2 1/2. It took her one day and she rarely had accidents afterwards. Six months later, soon after turning three, it was total regression. She was peeing everywhere - her car seat, chairs, the floor, places she never had accidents before. And, yes, she didn't even care! After a week of this I decided to put her back in diapers and to no longer make an issue out of it. If she asked to wear underpants, I would tell her she could wear them right after she peed in the potty like a big girl. If she had an accident, the diaper went back on. My older daughter wanted to help and made a new sticker chart for encouragement. Two weeks later she made a turnaround, and was back wearing underpants and using the potty again.

ericsmom said...

Could something be bothering her??
Did anything change with her schedule against her other siblings??
Did she get a new teacher in class?
How is the family situation? Any family problems? Parents divorce, fighting?

Not saying its anything like the above. Just throwing some stuff out there

Kat said...

I hate to suggest it but is there any chance she is being sexually abused? Regression like that is a classic sign.

Fiona said...

If you can rule out other issues like those already mentioned. i would also rule out somethin physical/medical going on maybe it's how the accidents are being handled?

One of my children went through something like this. After everything serious had been ruled out, our pediatrician at the time suggested we have her clean herself up after an accident. I was hesitant at first, because it seemed a little harsh, but it worked after a few times of having to be the one to clean her own bum and take off the messy clothes. she stopped and got to the toilet in time.

Also, sometimes kids that age still need reminders now and then or scheduled potty breaks or tries. she might just be so into what's going on she holds on too long.

Phoenix said...

Kat, you think that a child who is not using the toilet is being sexually abused?

Don't jump to conclusions or anything.

I think you just need to put up the sticker rewards chart and start from the beginning. It's just a lapse and will soon be fixed. But I also might mention that she may be afraid of something in the bathroom.

Logical Skeptic said...

There's new research that suggests that children who have been "fully trained" but who regress and have accidents--especially bedwetting--are suffering from an impacted bowel that is irritating their bladder, *even if they seem to have normal poops some or all of the time*.

Little kids often think that going to the bathroom is a total waste of time, so as soon as they figure out how to hold it, they do so for as long as possible. This is why you don't "ask" a kid if s/he needs to go potty, because the answer is often "no" even if it isn't true, because they want to keep playing or watching their movie or whatever; you have to TELL them that it's time to go potty at regular intervals and then make them do it.

(This is going to get gross; I apologize for anyone's delicate sensibilities.)
The "holding pattern" means that they can get a wad of stool stuck in their rectums. It irritates the bladder muscles and causes wetting and "accidents". Even if they have normal poops, that can just mean that the softer poop is sliding by the mass and not solving the problem.

Here are two articles about it:

All that said, though, I agree with the previous posters to try a behavioral approach first--more frequent potty breaks, maybe some more fiber in her diet (although the scary thing about bowel impaction is that increased dietary fiber doesn't help!)--charts, reward stickers, etc. If those things don't work, take a look at external stressors as ericsmom said (especially check the preschool to make sure that there aren't obstacles to using the toilet), and finally, if nothing helps, go to a pediatric urologist and insist on an x-ray to locate rectal masses.

Finally, yes, Phoenix, toilet regression *is* a classic sign of sexual abuse. It's one of the possibilities that needs to be considered if an otherwise normal child suddenly becomes incontinent. It should not be disregarded. Kat is not jumping to conclusions. Jumping to conclusions would be if OP and the kid's family immediately assumed sexual abuse without trying all the other options above first.

ericsmom said...

Logical Skeptic

I had to take my child to a Children's Gastroenterologist.

Also, recommended to have ABA therapy done at my home

Phoenix said...

well before anyone jumps to conclusions (cough) an impacted bowel is usually quite painful and it is one of the causes of acute appendicitis.

I would ask the Dr what happened then tell him that you read something off the wall on the internet that said she could have an impacted bowel. I'm not saying it can't be a possibility but ALL doctors like to lead up to diagnosis of impacted bowels. They need to rule out all the small things first. If a child shows no symptoms besides the accidents it is still possible she could have UTI. Most girls at that age get them from taking baths. The soap in the water can cause it. Or if she was cleaning herself after she went to the bathroom and didn't wipe front to back then that is another way she could have gotten it. Impacted bowel is a little different in the fact that most people how have this issue with be gassy, may vomit, cramping, being tired, blood in stool.

Ever think the kid had a bladder infection? My sister had one and she was in pain but she was wetting herself and she was potty trained.

Take her temperature and see if its elevated. Even slightly can indicate a simple infection that is easily treated with antibiotics. Just to be safe call her dr and see what could be wrong and ask the doctor if she could be squeezed in to rule out dangerous diagnosis. And do your research online and bring your "notes" in with you. Doctors have it when their patients are informaed. I've gotten to the point with my doctor that I just call him and tell him what I need and he calls it into my pharmacy.

Phoenix said...

***sorry meant to say my sister WASNT in pain***

Logical Skeptic said...

Actually, Phoenix, I think I used the wrong terminology. You are correct that impacted bowels are painful. I'm not talking about an impacted bowel per se, because the issue brought up by the guy I'm quoting specifically says that softer poop sort of squishes around the wad of "stuck" poop and makes it seem like the kid is having normal poops despite the big lump that's causing the accidents by irritating the bladder muscles. From what I understand, this isn't particularly painful because the rectum just stretches to accommodate the mass.

It's interesting you mention UTIs, though, because the doctor quoted in the articles also thinks there's a link. Read it and see what I mean.