‘Our daughter, who’s been using the toilet for quite a while, has been wetting her pants almost every day for the last week. We keep trying to remind her to use the toilet, but she always says she doesn’t have to; two minutes later, she’s wet again.’
Between drawing, trike riding, brick building, playing house, and at least a hundred other exciting pursuits, life has become very busy for the toddler. So it’s not surprising that being otherwise occupied is the most common reason why young children have toileting accidents. They may also backslide because they are stressed by an upheaval of some kind in their schedule or routine, or because they are emotionally upset. Sometimes, however; a bladder infection is responsible, especially in girls. So it’s important to check with your toddler’s doctor if the wetting continues or if your child’s urine is cloudy, pink, or blood tinged , or there are other signs of infection or irritation; a urine culture may be in order. If infection or another medical problem isn’t the cause, you can expect that the accidents will stop in time. Meanwhile:
- Don’t blink an eye. Overreacting to a wetting accident with exasperation? (‘You wet your pants – again?’) or humiliating punishment (‘I’m going to put you back in nappies!’) will further upset your child and may prompt encores. Instead, respond casually, with a reassuring. ‘Oh, you didn’t make it to the toilet, did you? Well, next time I bet you’ll make it in time.
- Nix name calling. She’s all dressed up for a party and as you’re about to walk out the door; a river starts flowing right down your toddler’s clean white tights. At moments like these, it’s easy to forget you’re the adult and to start tossing childish insults (‘I thought you were a big girl!’). But insinuating she’s a baby won’t encourage grown-up behaviour, so keep such belittling thoughts to yourself.
- Respond positively. Tell her that accidents happen to everyone, and that next time she’ll use the potty. If she’s willing (never force her), foster grown-up feeling by having her help change her clothes as well as clean up the puddle she’s leaked on the kitchen floor to flush away the bowel movement she’s produced in her pants.
- Evaluate her fluid intake. Toddlers, like everyone else, need an adequate fluid intake. But more than 1.3 liters/ 2 1/4 pints of fluid a day can lead to an increase in wetting in toddlers. (Keep in mind that milk is only two-thirds liquid.) Fluid intake may need to be increased when the weather is hot or when a child is running a fever. Some kinds of fluid are more likely than others to contribute to incontinence, for example: beverages containing caffeine, because they are diuretic, and citrus juices, because they can irritate the urinary tract in some children. (Beverages containing caffeine are, in any case, inappropriate for a young child.)
- Reduce stress. If you believe the recent spate of potty accidents may be due to excessive stress, examine your child’s life and reduce stress as much as possible. Also be sure she’s getting adequate attention and affection.
- Keep her bathwater pure. Bubble baths, bath oils, and harsh bath soaps (as well as harsh detergents used on a child’s underpants) can all lead to urinary tract irritation, a common cause of wetting. Avoid them.
- Cheer her success. A few accidents can deliver a major blow to a child’s self-esteem. To build her back up again, make a conscious effort to recognize the achievement when she does reach the toilet in time. Bolster her confidence, too, by letting her know you admire her other achievements.
- Invite her to join work. A parent of the same sex can encourage a child to take potty breaks by making toilet going a parent-child activity. If you sense your child is in imminent need of a toilet, but she flatly denies it, ask her to come along with you to keep you company while you go. The camaraderie of sharing the bathroom may mover her to participate, too – as many the sight of the toilet and the sound of you using it. If she still refuses to go, however, don’t force the issue.
- Make potty stops routine. Many toddler refuse to go before they leave the house, but need to go urgently as soon as there’s no available toilet. Make it a rule: Everyone in the family uses the toilet before going out. That way, you won’t be picking on your toddler alone, and you may even get her to comply.