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My son wets his pants three times a day !
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My son wets his pants three times a day !

My son is 5  years old.  He'll be 6 in 4 months. He started kindergarten this year and it has been a challenge.  He is in jeopardy of being retained as he is not grasping the lessons taught. The first weeks of school he urinated on hisself maybe three times a week.  I took him to the doctor and was told that it maybe regression as I was pregnant at the time.  I had my baby in January and now it's March.  He's back to urinating on himself but now it's three times a day! It baffles me because he literally runs to the bathroom every time he uses it as if he's waiting until the last minute to go. When I ask why he waits, his response is the same, "my pee comes out too fast." I dont get mad or fuss anylonger as I am frustrated and I don't know what to do.
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   I am so sorry I did not get an alert for your question! Hopefully this is not still going on, but I will answer your question if I can. Your pediatrician is right that many young childrne's potty training goes 'off track' when the new baby arrives (my son's certainly did!), but we would expect that situation to be improved by now. I think you have noticed something important when you mentioned that he waits till the last second. This is very common among little boys, though not three times a day. And he probably won't have much useful to say about why he waits, because he is just too little to have a lot of insight into the situation.

I'm glad you had the physician check him. If the physician did not rule out a urinary tract infection, than you may wish to request this. Some children wet themselves because they have small bladders. Sometimes the bladder's growth can be a bit 'out of sync' with that of the rest of their body. Other conditions like pre-diabetes may be causing him to drink a lot. You can talk to your physician about what your son is eating and drinking. If he is having caffeinated drinks or eating a high salt diet, he may be drinking and urinating more.  It may not be his fault that he is not making it to the potty. Its always a good idea to have medical reasons ruled out first, and sometimes you have to be a bit persistent with a busy physician to get their attention. You may even request to be referred to a pediatric urologist.

So lets assume now that the medical reasons have been ruled-out. His behaviors could be related to inattention or even stress. I would meet with the teacher and guidance counselor (if he/she knows him) and school psychologist to have a conference. I don't know how the school is handling this, but if they are punishing him (or sending him home--which would probably be something he would like!) you may need to advocate for them to treat your son with kindness. Some teachers shame children for having accidents, or encourage their peers to tease them, which can make it worse. You will want to be firm with school staff that he should not be humiliated or punished for his accidents.

First you need to know what they are doing now at school, and then you need to learn more about what they think is triggering it. It may be as simple as that the staff are not making him go to the potty on a regular basis. A busy teacher may not be able to keep track of how often each kid goes.  My guess is that this could be fixed in the short term by having a staff member take him to the toilet every half-hour. They can also monitor his fluid intake to see if he is drinking unusual amounts.

You should have the school psychologist in the meeting because this problem may reflect that your son is having trouble with attention and impulsivity. For example, kids with ADHD have trouble estimating time, and some little boys with ADHD leave themselves too little time to get to the potty.You should ask the psychologist to observe your son to look for signs of inattention or impulsivity.

You can also ask the psychologist to design a positive behavior plan that will reward your son for being dry. For the beginning, he can get a small reward (stickers or a small prizes that you supply) for each 10 minute period that he stays dry. Over time, you can gradually increase the length of time that he needs to keep his pants dry. It will be important that the thrust of the behavior plan be positive. There should not be punishment for wetting himself beyond not getting a reward or losing a point or two. Do not let them take away rewards he has already earned. Most of all, he should never lose recess or specials as a consequence for wetting!

If there is no one helpful at school, you should ask your pediatrician to refer you to a child psychologist or behavior specialist (some social workers and counselors also have the right skill set). It may be a good idea to get a professional involved since you mention that your son is having trouble learning. If you can find a psychologist, that would be the best person to start with because that person will be trained in recognizing early signs of learning problems that could be involved in this behavior.

Best Wishes to you
Rebecca Resnik

Disclaimer: This post was written for informational purposes only. It is not intended to replace face to face medical or psychological care. This post is not intended to create a patient-clinician relationship, nor to give or rule-out a diangosis
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