Dr Catherine
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4-7 years

She usually doesn't cooperate when told to go to the potty. She is very intelligent and is very active to the point where I would not be surprised if she has ADD. Why is she still wetting herself?

Dear T.J., It’s always a good idea to have children seen by their GP if they are over 5 years of age and experience regular daytime accidents. There are a number of reasons why children may experience daytime accidents. The most common reason is that they have overactive bladders, not drinking enough fluid throughout the day (quite common among preschoolers and young school-age children) and consuming drinks high in caffeine such as chocolate or coca-cola can worsen overactive bladders and contribute to daytime wetting. Other less common causes of daytime wetting include emotional stress, urinary tract infections and chronic constipation (particularly in children who were previously dry). Young children are easily distracted and can find it difficult to tear them self away from a game or favourite toy in order to make it to the toilet in time. If you think this may be the cause it is important to remind her that whatever she is doing will still be there when she returns – and in fact wetting her pants will only result in her being away from the game even longer. For some children daytime wetting is a matter of control – this is often the case where there are lots of changes occurring in children’s lives. In these cases it is important that we transfer the control back to the child so that they feel it is their decision to use the toilet. While the use of rewards and incentives are useful in the early stages of toilet training, you need to try and encourage self-motivation and a desire to achieve. You can do this by discussing with your daughter the many benefits of being dry. Some children regress back to wetting their pants at times of stress. Common childhood stressors include the birth of a sibling, starting a new preschool, bullying or friendship difficulties. If you think stress may be contributing to her daytime accidents then the best approach is to spend calm, relaxed time with her, help her to verbalise any fears or concerns. Try to involve her in situations where she can succeed. If stress is a contributing factor, then once she feels secure her wetting should subside. All the best! Regards, Dr Cathrine