It's Time to Ask for Help.

She could be having accidents because:
1- She is only 4, and she is busy playing, and she hates to pause her games to go potty
2- possibly she cannot feel that she needs to go. I will explain further in a moment
3-There could be a medical issue (bladder formed incorrectly, etc).
4- She could be wetting due to stress.

My son (now 8) was potty trained for a short time, but around age 3 continued to wet during the night and then started wetting during the day all the time. We tried EVERYTHING from praise to bribes to punishments. I'm sad to say that it went on for years as we had no idea what to do. Even our pediatrician did not help. He prescribed Oxytocin and there were short term improvements but they never lasted. I felt like a slave to the washing machine. It cause much stress within the home. We even had a VCUG done to make sure his bladder was formed correctly (it was). At age 6 we went to a pediatric urologist. It was only an insurance co-pay, and I wish we would have done it sooner. It was so helpful to hear that so many children have this particular problem that they have several offices dedicated to it.

Here is what the pediatric urologist told me: Children are often so BUSY and distracted that they hold their urine when they need to go. They do not want to leave their activity. They hold it and hold it. Finally when their bladder can no longer hold it, they have an accident. If they do this often, the muscles of the bladder become thicker and stronger. This is not good. As the muscles become stronger, they cause accidents because they are too strong. my son no longer FELT like he needed to use the bathroom but then these ultra strong bladder muscles are pushing the urine out at every turn. He was wetting 6 or more times a day.

The first thing the urologist told us to do is to make a "voiding schedule". We taped it up in the bathroom. You must make your child use the bathroom every 2 hours. He will then be made to take time out of his busy play schedule to use the potty. You will avoid accidents. The bladder muscles will start to go back to normal. We saw results within a few weeks but you should keep this up for about a year. When we got lazy with the schedule, we would start having accidents again within a few weeks. Children that age need immediate rewards for doing well. The doctor suggested that every day that our child used the bathroom every 2 hours, they got a small prize (candy, etc.) even if they had an accident that day. They stated not to punish (and I am sorry to say that we had punished at times, because it seemed like he was just being lazy).

The schedule helped immensely. We still had occasional accidents until age 7. So strange, but the very day we moved to a new town, they stopped completely. I personally think that stress contributed largely to this problem. We had a very stressful 2 years trying to sell our home, with Dad working in a different town, and I was always trying to clean the house for showings and I also had insomnia that 2 years and was not a happy person. My insomnia and his wetting seriously immediately stopped once we moved. I would suggest evaluating whether there is stress in the home and seeing if there is anything that can be done to change that.

we have Elmo's Potty Time DVD, and there's a part where Elmo says, "when you gotta go, you gotta go!" and to stop what you are doing and go! So, when ever my daughter starts to do the dance or twitch, I know she has to go, but she's too busy playing, I say, "what does Elmo say?! When you gotta go, you gotta go!" And she will run to the bathroom. It works much better than just me telling her to go. Thanks Elmo! Hahaha...

Kids this age... are not rocket scientists yet, about pottying or their physiological cues. Even if potty trained.

Kids this age... cannot always do what they think they can. They do not have fully developed "deductive reasoning" yet. They 'think' they can hold it longer... but can't. They cannot, succinctly nor accurately predict, how much longer... they can hold it. Then by the time they really feel the urgency... they may piddle a tad, leaking, by the time they RUSH to the toilet.

Kids, have accidents.
Their sense of now and later... are not highly developed yet.

Kids this age, do have accidents or leak/piddle a little in their underpants.
My son is 5, and he does too, occasionally.

ALL of my kids Teachers, from Preschool to 1st grade... ALL said, unanimously... that pee accidents happens. At these ages. And thus, they tell the parents to bring in an extra pair of clothing, for their child, in case that happens. They do not make a big deal of it.

There's a great episode of Dinosaur Train too called "Dinosaur Poop!" about Tiny and her "Tiny Dance" that might be helpful--

i see you said you re- potty trained, i'm not sure if you meant you already did the scheduled potty time every two hours or not, but that would be my suggestion. every two hours on the dot. set a timer or buy her a watch etc.

I'm having trouble that my 6 yo daughter has gone on a wiping strike, we keep having lengthy discussions about how her brother is different but SHE always needs to wipe her pee. do you think wiping might be part of the issue for your DD?

I also wonder if some sort of allergy or sensitivity might play a part in some of these issues. Red dye?? I don't know just my paranoid therory.