4 Year Old Holds Her Bladder Until Its Too Late

J.,
I feel your frustration and pain. My now 6 year old does the same thing! I did have her tested for a UTI a a couple of times and had her on some cranberry pills and probiotics when she was four. But that is as far as I went, mainly be caused I noticed when were out and about (like the store) she didn't have the same problem. It was only when she was distracted by something fun or at home. I think it is a conditioned thing. It seams to me that when she is home she puts it off or just doesn't listen to her body's subtle hints, until ... its too late! and then it is a mad dash to the bathroom and either she barely makes it or barely doesn't! Ahhh it is so frustrating!
When she was little she never did "the potty dance". It was so hard for me to realize that she was holding it and procrastinating. Now I can barely see that she squirms just a little, actually it is more like just shifting positions. But at least it is something that gives me a clue.:)
I finally came upon a plan for her because I was done, done feeling resentment toward her and done cleaning up the mess.
I realized that a part of why she did this was it was habit to ignore it. The other reason was she had a hard time feeling the signals until her urine was starting to come out.
I also noticed that along with this habit as with any, there were triggers. Some of these were brushing teeth (or anything with water), getting dressed and undressed, eating, waking up etc.
So first I did what I always do when one of my kids has a problem that is affecting others. I problem solved with her.(if you have read my other posts this might be a repeat)
Write at the top of the paper, the problem. Discuss why it is a problem for you and ask her if it is a problem for her. Tell her you need her help in finding a solution. Divide the paper into two columns. On one side put her name, on the other, yours. (make sure she can see what you are writing and tell her what it says) Then ask her for some ideas, these you write on her side and then tell your your ideas and write them on your side. After you have your two lists you go over them and pick one together that you both agree on. If there is one that you don't like, tell her why you don't think it will work. And if there is one she doesn't like ask her why. Pick a first, a second and a third choice (or a couple at a time). Tell her you are going to try each one until one works. This "talk" will help in getting her cooperation and boasting her confidence.

Some of the things that we did were..
-Hints(her idea), we had a deal that if I said, "potty time" she would go. If I said "listen to your Body", she would stop and think about if she need to, if she did then she would go, if not she would say, "I'm okay".

-Use the triggers to help her. (combined ideas) Before each of the trigger activities she would go to the bathroom first. "So instructions were..."Go potty, then get P.J.'s on", Go potty then get dressed". So any of the times she was most likely to want to ignore her body, I would remind her.

-I put more responsibility with her (my idea). I like consequences, not punishments, but natural things that will come. If she has an accident, she cleans it up. She cleans up herself, her clothes and the floor. (we use wet wipes for her and Clorox wipes for the floor. And she has to put her clothes in the washing machine, not wash them just put them in there. Once I stopped helping her, I realized that it didn't bother me so much if she had an accident, and I didn't feel so angry either.
-Talked about rewards, so there is something she could work towards. We did getting ears pierced,(her idea) if she could go 21 days (my idea)with out an accident she could get her ears pierced. The reason I do 21 days is that is how long it takes to make something a habit. I just made note of it on my calender, to keep track.
It has been about a year since we did this process. It has work rather well. It took about three months and she finally was able to do make it 21 days. She is not 100% accident free, but she maybe has one accident every couple months. Sometimes I will go to do laundry and noticed that she had an accident that I didn't know about that day.:) She just takes care of it now, which is so nice for me, and our relationship. It has helped her confidence too.
I know how long this reply is and I am sorry for the length. I hope that by sharing my experience you will get some new ideas that might work. At least get hope that she can do this and you can get through this!
I wish you all the luck (and patience) you need,
E.

my three year old does the same thing, it comes and goes in phases depending on his moods. he went through a week awhile back where almost every day he was needing to change his underwear at least once. lately he's been perfect. i finally put my foot down and started time outs for accidents (not just little drips, but he full out peed on me while i was trying to help him hurry and take his pants off this last time - not cool!), only had to do that once and it nipped it in the bud, not sure if he just passed that phase or what. i think at this point since she totally knows how to go potty, it should be discipline, after awhile. i mean an occasional accident i can understand, they're little after all. but when it's ALL the time, constantly. my family laughed so hard because while he was visiting my mom, he suddenly said, "I HAVE TO GO POTTY!" then a few seconds later, they heard, "I NEED A BATH!!". they thought it was hysterical but me, not so much. anyway, i think it's fairly common. as far as the sensitivity goes, try just blotting gently instead of wiping. and teach her how to do it herself. i understand she might need help but if she's got some control she may feel more inclined to go at the appropriate time.

LOTS of kids, from about 3 years old, 4 and 5 years old... do that. They just wait until the last minute and by then it is too late.
My daughter did that too... but it was a phase. Kids just reach an age where they don't want to stop what they are doing... and "think" they can wait... but then they forget how long its been... and then by that time its too late, and the pee just comes out.

It is simply a situation of them being fully potty trained... BUT their "mind" and their ACTUAL biological ability to "hold" it, is not fully coordinated yet. Thus, peeing on themselves or accidents. Even at this age they cannot always do what their mind is telling them and visa versa. A 4 year old will NOT be "perfect" about their bodily functions yet.

When my daughter was 4 and in Preschool, and then at 5 and in Kindergarten... this happened sometimes. Her Teacher brought no attention to it... and said that this is normal... that at this young age, it DOES STILL HAPPEN. Its not unusual. All the Teacher said was that to bring extra clothing for her. NO problem. AND, when my daughter was in 1st grade, she had that happen twice. AND a couple of the other kids too. BUT... again, the Teacher said this is not anything "wrong." They are still young... they "think" they can hold it but biologically, the pee has to come out.

The thing is... accidents will happen.
You did get her checked by the Doctor and ruled out infections. So good.
BUT, a child this young... is not fully able to control their every biological urgency, ALL the time.

My daughter, SURE she "knew" to go as soon as she needed to go pee... BUT, again, a child thinks they can hold it... but the bladder cannot wait. They don't know that. Mental ability and biological ability are 2 different things. They hold it too long. We know that, they know that... but, again, little children "think" they can hold it... or they are too busy to step away from their fun.

It will pass.

All the best,
Susan

I think Anns right, i would get a second opinion...it does sounds like your daughter may be holding it if it hurts. Out of interest, how many times does she go on a regular day? does it seem to you that shes not going enough, and how much does she drink, if shes not drinking enough, that can make her pee very strong, maybe it does sting alittle.!
I hope it all works out for her.x

I would take her in for a second opinion. Just because there was a negative on the Bladder Infection, it doesn't mean she doesn't have a Urinary Tract Infection or something along those lines.

She's holding it because she hurts. Go back to the doctor or see a different one.

Everyone has given great advice. I just want to add to what everyone else has been saying. I went through this with my daughter as well, one thing that really helped was putting her on a schedule and giving her a chart to put a sticker on to track herself. The schedule is: go as soon as she wakes up, after every meal, once in between each meal and once at bedtime. She's more likely to go herself if she has the schedule - the chart, the stickers, and an incentive. Another piece of advice - my daughter would get irritated down there as well from dampness in her underwear also. Our pediatrician recommended adding vinegar to the bathtub - I can't remember the exact amount - it was either 1/2 or 1 cup. I'm thinking it was 1/2. But it did help soothe the irritation, it helps restore the pH balance down there which gets thrown off with dampness. Hope that helps, good luck!

It has probably become a vicious cycle. Holding it until she leaks encourages soreness, and the soreness encourages her to hold it. My granddaughter did that too.
Try warm baths with a little baking soda at night. Allow her to play in the water (maybe with toys) for awhile so the soda has a chance to soothe and heal. First thing in the morning put a little diaper cream on the sore area. After a few days, you should see a difference.
I wish you well :o)

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Pretty normal, and I agree with Eliza and SH.

One other thought that comes to me about the wiping, though: She may have a moderate sensory issue that makes certain types of touch distressing. Wiping dry tissue across a delicate area may just be too much for her, and could contribute to her reluctance to go.

Have you tried just a gentle blotting motion? It should do the trick for pee, and might be less uncomfortable for your little girl.

My four year old waits until the last minute as well though she has always made it to the bathroom in time (so far). I try to remind her to go pee at certain times of the day... before we leave school, before we sit down for dinner. She'll say she doesn't have to go. I ask her to just try and assure her that "It's okay if nothing comes out. We just want you to try."
It does sound like there may be a medical issue for your daughter... best to rule that out first.