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4.5 year old wetting


Hi there, our 4.5 year old girl is still having accidents and I'm worried about her attending school in Feb next year. She is bright, happy and confident. But stubborn! I've taken her to the doctor 3 times to see if the problem is physiological or behavioural. We've come to the conclusion it's behavioural. It generally happens when she's playing or busy and doesn't want to miss out, or tired/sick. She is dry at night (no nappies) and has been for most of this year. We have tried everything! Calling plunket for advice, sticker charts, incentives etc etc. any further tips much appreciated!


It is quite common for children to still have “accidents”, but does worry people when their little one is starting school in the near future.  I am assuming the problem is with wetting rather than soiling?

Children do get engrossed in activities and don’t want to leave them for such boring tasks as going to the toilet.  Put her on to a toileting schedule, about two hourly.  Drinking stimulates the urge to void in many, so perhaps after breakfast, morning tea, lunch, afternoon tea, dinner time, and bedtime.  If she is wetting between these times, adjust the schedule to her wetting times, and plan the schedule around these times to avoid the wetting. Reward the attempt at toileting rather than the being dry as this is more easily achievable generally.  If you feel she is not getting much warning to toilet after trying the regular toileting, and wetting between times, it would be worth her seeing a GP to rule out constipation, urinary tract infection, or overactive bladder as causes for her wetting.  It would also be useful to the GP is you could measure how much she passes when she goes to the toilet as this can give an indication of bladder capacity.  To do this, don’t measure the first void of the day.  Put an ice-cream container or similar in the toilet bowl, get her to void on the toilet with an urge, but not “holding on”, and measure how much urine she has passed.  For her age I would expect her to pass 120 – 150ml.

The problem will manifest in some behaviours, but probably more related to her frustration at not being able to control her bladder.   These are normal responses and will get better as the problem resolves.