4yr old having accidents frequently, VUR

[gentle_mommy]

My daughter was daytime potty trained at 2 1/2 years old.  She has done well, with about an average of one accident a week since potty training a year and a half ago.  Over the last couple of months, she has begun having accidents more frequently.  She holds her urine longer than she ought to at times, but often the accidents occur without warning.  She also is not nighttime potty trained at all and doesn't wake to go.  I doubt she feels the urge strongly enough for it to wake her.

I'm not personally concerned about it, but it turns out my ex is very upset about it.  He punishes her by making her sit in the corner if she has an accident or wakes with urine in her overnight pull-up.  She has become very distressed about it and has begun crying and begging not to be "in trouble" when she does have an accident.  

She was diagnosed with grade 4 VUR on the right side when she was 9 months old.  Last year her annual VCUG showed that it has resolved to a grade 1.  I wonder, though, if it is possible that she has some kind of bladder dysfunction as well?  

She has had some emotional stressors over the last year.  Her father was a very absent father for the first three years and only started seeing her regularly about a year ago.  The court ordered that he could have her every other weekend, plus the typical holiday and summer visits.  I thought at first that this would be good for her, that she would get to know her father finally, etc.  Now I am scared that he is causing her lasting damage due to his treatment of her.  

Is there anything for me to worry about with regard to the accidents?  Should I set up an appointment with her pediatrician or call her pediatric urologist?  Am I just being an overprotective mom?  I need some advice!

Thanks,

[Kevin Kennedy, Ph.D.]

Yes, absolutely you want to cover the bases medically, particularly in light of her medical condition. Her father's behavior is exactly the opposite of what she needs and is a sign for concern. If he cannot be reasoned with about this, and come to see that his punitive approach will exacerbate the problem and harm the relationship between him and your daughter, you should seek the intervention of the court. It is not reasonable that she should be the ongoing victim of his anger and his poor judgement.