16 answers

Why Is My 4 Year Old Having Accidents?

I have a 4 year old daughter who has been potty trained since she was 2 1/2. The first six months after potty training she was perfect- no accidents. It seems since that time she has had an accident at least once or twice a month. More recently (like the last 3 months or so) they have been getting worse, not more often, but she will just go wherever she happens to be, instead of just wetting her underwear while she is racing to the bathroom, like it was before. It is easier to forgive if she is actually trying to get to the bathroom, but when she is just sitting on a chair looking at me... well, I get pretty upset.

She is a very obedient girl-- she isn't doing it out of defiance, and she is more than willing to clean up her accidents. She always promises to not do it again, but then it inevitably happens. I asked her today if she could feel when she needs to go, if she could feel the pee pushing or tickling before it comes out (I tried to use a variety of words since she may have a different sensation) and she said no. She also said she can't stop it once it starts. So, my question is, does this sound like a physical problem she has? Emotional? Mental? Since it is so infrequent it seems strange that it would be a physical problem, but I have no idea.

What can I do next?

So What Happened?™

Thanks for all of your ideas and responses. Soon after I posted I began to put the pieces together and realized that my daughter probably does have a UTI (when I asked her later she told me it does hurt to pee). A visit to the Pediatrician today has pretty much confirmed that. We'll know the culture results in a few days. He put her on antibiotics in the meantime and said we should see some improvement. I just feel bad that she has probably had it for a while and I didn't know!

Thanks again!

Featured Answers

She could be just more consumed by what is going on in her world and not catching the clues til it's too late. I have a daydreamer that did well young and then started wetting the bed or not making it in time too. Also, find out if there is anything going on with her. Has she had some stress at home, school, etc, major (for her age) life changes? That can heavily influence pottying.

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You need to have her checked for a UTI. My daughter has had issues with UTIs for about 5 years now and the only symptom she has had for the last few years is loss of bladder control. I know she has an infection when she wets the bed or has lots of accidents. Usually by the time she knows she needs to go it is too late. Primary Childrens has a great pediatric urology department if you want a specialist.

It is very hard to stop peeing when you start. I would get her checked out to make sure she doesn't have a bladder or kidney infection.
If she is having a hard time at a particular time of day, be on alert and just tell her to go in and go potty.
Even with mine being 4 and 7 and potty trained for some time, I still tell them to go if they haven't before we leave somewhere or if I know they have been drinking a lot, before bed and so on.
Unless something has changed in her routine I wouldn't worry about emotional but more medical maybe.
Kids regress, it is very common and happens to a lot of kids. Just be calm and cool about it, remind her more frequently and see if there is a pattern on when the accidents are happening.

She could be just more consumed by what is going on in her world and not catching the clues til it's too late. I have a daydreamer that did well young and then started wetting the bed or not making it in time too. Also, find out if there is anything going on with her. Has she had some stress at home, school, etc, major (for her age) life changes? That can heavily influence pottying.

She is about to have a new sib. That throws everyones life into a tail spin. Reassure her she is loved and the new baby will nver take her place. Let her continue to clean up her mess. She will stop after a while but it means a bunch of extra laundry for now.
C. B

She's under a lot of stress. New baby coming. Two-yr-old getting a lot of attention. And turning five in the future. (Five is a big stress-causer, too.)

Just put her in pull-ups for a while, don't discuss the pee at all (so she can stop being anxious about not living up to expectations), don't discuss all the cool stuff she gets to do when she's five (because she doesn't inherently believe that she'll able to achieve all that), and just be nice and have fun -- a normal family life. Things will iron out slowly, certainly I would guess by age 5.5 at the latest.

My son called me just last week with the with the same problem with my grandson. I did a bit of research and found the following in a book called What to Expect from your Toddler. I realize a 4 year-old isn't a toddler, but the suggestions still apply. Please forgive any typing errors. Hope this helps.

"Accidents are an inevitable part of learning the the potty---just as falls are an inevitable part o learning to walk. But whether they're occasional or frequent, sincerely accidental or accidentally-on -purpose, the less said about them, the better. Lecturing Threatening, or otherwise making a fuss will only promote resistance in a rebellious toddler and diminish confidence in in a reticent one. Punishment is certainly not warranted; just as you would never have thought of punishing your toddler for falling when learning how to walk, neither should you consider punishing your child when learning to control his bladder. Don'[t demand an apology (it was and accident, remember) or a confession ( unless there's a renegade puppy on the premises, there will be no doubt who did it).

React to an accident as casually as you possibly can. If your child seems upset, be reassuring, "That's okay--you had an accident. Not problem. Maybe next time you'll get to the potty in time." Change his clothes without negative comment and without delay (forcing your child to stay in wet underpants in order to teach "a lesson" is cruel, and will humiliate and /or anger, not motivate). To foster a feeling of self-sufficiency, encourage your child to "help"you clean-up, if he or she seems willing (but make hand washing afterwords a required part of the process).


>STRESS. Separation anxiety, a new baby-sitter, a move, a new sibling, and family distress can all trigger accidents, even in children who have been clean and dry for awhile.

>FATIGUE. Tired children often have less control over all their skills, toileting included, and are also more likely to revert to "babyish" behavior.

>EXCITEMENT. Children often lose control of their bladder when they're can disrupt some of the concentration a child needs to remember to use the potty. They are more prone to accidents when they're engrossed in an activity.

>PARENTAL PRESSURE. A parent's preoccupation with toileting often turns off an independent-minded child.

>CONFLICTED FEELINGS. Some children wet themselves frequently because using the potty represents growing up and they don't feel quite ready to give up their status as the "baby" of the family. Others have "accidents" because they're reluctant to cede control to the older generation by doing what they know their what they know their parents want them to do most.

>POKINESS. Some toddlers have accidents or mini-accidents (they get slightly wet or soiled enroute to the potty) because they wait until the last minute and/or are slow in getting their pants down.

>URINARY TRACT INFECTION. Sometimes, a urinary tract infection can make bladder control tricky for a young child. An infection should always be considered in a child who's had no success "holding it in" (but seems eager to try) or has had success followed by sudden regression, particularly if other symptoms are present.

>A PHYSICAL PROBLEM. though such problems are very rare, it's wise to be on the lookout for signs that point to the possibility of one: The child who is always a little wet ( a sign that urine may be leaking), wets when laughing ( a sign of "giggle incontinence"), or has a weak urine steam, painful urination, or blood in the urine should be seen by the doctor.

Often, dealing with these causes of accidents (reassuring a stressed child, gently "reminding" a preoccupied one, seeing to it that a tired one gets more rest, treating an infection, and so) will put toilet learning back on the fast track.

When a toddler two and one half or older shows all the signs of readiness but after several months of parental effort, still refuses to cooperate in toileting, a parent may feel like it's time to get tough. But, actually, it's much better ---at least in the long run---to let up.

TURN IT OVER. Give your child full responsibility for toileting. Explain, "It's your BM and your urine, and you can make them on the potty when you want to. If there's anything I can do to help you, just ask me."

PRESENT CHOICES. Diapers or training pants, potty or big toilet, now or later. And keep your own opinions to yourself.

STOP REMINDING. As long as your toddler knows the routine, you needn't say a word about it. Anything you do say is bound to be held against you---and to delay potty learning even further.

DON'T TALK ABOUT IT. Make potty learning a non-issue after a while---don't discuss it with your child or in your child's presence.

SWEETEN THE "POT" Casually (as though it doesn't matter whether you toddler accepts the challenge or not) offer an incentive for success at the potty. If your child chosses stickers on a calendar, he or she can even chart the toileting "successes" of other family members so it seems like everyone's in this togeteher. Of course, if your child demands stickers or the present even when they haven't been earned, or gets extremely upset when a reward isn't forthcoming, you'll have to shelve this strategy.

ENLIST HELP. Often, a few words from a neutral authority figure, such as a nurse, doctor, or preschool teacher, are more effective than a thousand from a parent.

GIVE IT TIME. Eventually your child will decide it's time. Stop pushing for that time to come, and it will."

I would say that it is a long time being potty trained and her still having accidents. I think that it would be a good idea to talk to her pediatrician. The thing is sometimes they will blow it over like it is nothing so make sure that you keep pushing to make sure that it is nothing medical. But I would trust your instincts. I think though that if it was emotional then it would have started about the time that major changes happened and would have settled down when she realized things were normal again. But talking to the pediatrician could be the thing that helps you know what is going on.

Something kind of similar happened to my daughter - she potty trained at 2 and had zero accidents for years but right about when she turned five she started having accidents. Some suggested to me that she needed to be checked for a UTI, which you ought to do right away. She didn't have a UTI but her doctor told me he sees probably one case per month like hers. She was having "bladder spasms", where the bladder contracts and they involuntarily have accidents. There is a medication they can take that helps with this. My daughter took the medicine for 2 or 3 weeks and that was all it took for her bladder to calm down and for her to be in control of it again. Good luck!

Our daughter did/does the same thing. She was trained pretty quickly just after turning 3. 6 great months, I mean, no peeing at all and we never had poop in the panties, even when she was first training. Then she just started wetting 4 or 5 times a day, varying when and where (sitting on the floor playing, at the store, eating dinner, standing in front of the toilet). We tried everything (punishing, rewarding, ignoring, diapers, having her clean it up, eliminating stresses, more sleep, etc), including a trip to the doctor to test for UTI or any other physical cause. Doctor even asked about the possibility of her being sexually abused as wetting is very common when kids are abused (that's a conversation I pray we never have to again). She would just stop wetting for a few weeks and then start again. We've been through several cycles, but it has now been a couple months, so maybe she's grown out of it. I think, for our girl, it was a matter of finding out what her body could do (like how long from feeling like she had to go to actually having to let the pee out, understanding the process of stopping what she's doing and getting on the toilet, learning to unbutton/zip pants, etc). We've also talked alot about "listening to our bodies" because it will tell us when we have to pee, poop, had enough to eat, need something to drink, are tired, etc. It has been good for many areas of her life. We also pray every night for help to not go potty in her panties. If nothing else, I hope you know you aren't alone in the is situation and that there is hope for an ending.

Hi, A.. Congrats on baby girl due in two weeks! I think that is the key to your 4-year old's potty issues. My potty-trained daughter started having "accidents" as soon as we brought my son home; for a while, she would come sit next to me whenever I was nursing my son, and just pee her pants sitting there. What better way to get mom to stop what she's doing and pay attention to me? I think that your daughter may be worried/anxious about another child entering the family, especially since she knows what it is like, having been through it once with your son. Try to think of it from her perspective, what it must be like for her; my mother-in-law explained it this way: imagine your husband coming home and saying, "Honey, I've brought a new wife home. Having her here doesn't mean I love you any less or that you are not still special to me; it just means that I can't give you as much attention as I did before, you have to share all your things with her, and you have to be nice and loving to her." It would be hard!! LOL Talk to your wonderful girl, remind her that she is special, try to schedule some one-on-one time with her (girls nights are great!), and let her help with getting ready for the baby/taking care of the baby. Maybe try going back to rewards for getting to the potty ("if you make it all day with no accidents, then we'll go get ice cream"). Good luck, and hang in there! I think this will pass once your daughter adjusts to the changes ahead of her; love, love, love is the answer!
Good luck with your delivery!

I would say that the emotional aspect/anxiety of the new baby has A LOT to do with this. A lot of kids revert back to "baby" behaviors when a new one is about to arrive. Make sure you're spending a lot of time with her and rewarding her with special things. Good luck!

4-year-olds have accidents. Either they get too caught up in what they are doing, or just forget, or sometimes their physical development just goes at weird paces and they are trying to keep up. I really doubt your daughters problem is emotional. I know it's upsetting when she doesn't seem to even notice she needs to go, but try not to get upset - she's probably upset enough already.

I would go to the doctor to rule out UTI or something else physical that could have led to her struggle with it.

Hi A.,
I am no expert by any means... BUT she might be doing this out of wanting attention from mom or dad. You're pregnant again and this time it's with a girl. In her little mind, she might be saying, another girl! Kids do so many things and they don't know they are doing it or don't understand why... they are kids. I know my 4 1/2 y/o regressed a little bit when I had my 2 y/o "girl". Very obedient, like yours... never had an accident until the second one came along. Try not to get upset if you can help it... sometimes they just want a reaction (attention) doesn't matter if it's positive or negative. Yes, easier said than done especially if she's been perfect. Just reassure her sometimes accidents happen and move on. I know you didn't ask about this, and i don't know if you did this with the second child, but i made a basket from the baby to my older daughter. It was filled with a few toys, stuffed animal, crayons and books. I made a card from her baby sister to her. It 'eased the blow' of having another child coming. When her dad brought her to the hospital to meet her baby sister, we gave her the basket. She welcomed her baby sister with open arms! They have been two peas in a pod ever since.. :) I hope this helps. Good luck and most of all enjoy them.

You have lots of good advice, so I'll just add one quick thing. Our daughter's urologist had her do "exercises" to practice holding her urine until she could get to the bathroom. You have to make it a game, of course. Ask her to see if she can stop peeing once she has started to go on the potty. She could see how many times she make make it stop and start again once she has started. This will strengthen those muscles and show her she can stop it if she needs to.

My daughter had this EXACT problem!! It was so incredibly frustrating, so I feel your pain! She was pottytrained at 2 1/2 and then about 6 months later started having accidents. I ignored it at first and then it got worse and worse. I finally talked to her pediatrician about it. We tried several things ( none of it worked) and then finally put her on medication (he didn't want to until we HAD to, that is why we tried the other things first.) He said she had an overactive bladder, but that she had trained her body to do it in this way- she would be playing and not want to go to the bathroom, so she would hold it. Every time the urge came she would just continue holding it until it was too late. pretty soon she had trained her sphincter muscle (the one that you sqeeze to hold urine in) so it was twice the size it should be and kind of "desensitized" herself to know when she truly had to go to the bathroom. he said it is actually pretty common. After we started the medication, I also had her on "times voids" which was pretty much a pee schedule that we stuck to to make sure she was going potty on a regular basis and not holding it in for long periods of time. Anyway, she is now 5 1/2 and she was on medication for overactive bladder for about 2 years. We just weaned her off of it about 6 months ago- YEA!! She is doing awesome now that her sphincter is back to its normal size and she can actually feel when she has to go potty, whereas before she couldn't until she was peeing her pants. It was very hard and I really feel for you. I hope this helps in any way, good luck!!!

Hi A.,
My son went through this from the time he was 4 until he was 9 every few months. First I would make sure there is no urinary tract infection but if not that then this may be a possibility.

My son was using the bathroom for years without a problem and then said he couldn't feel when to go. Went to the pediatrician who said his muscles and nerves were growing at a different pace. The bones and muscles in the area that controls all of this were growing so fast it was stretching the nerves, when the growth spurt had slowed and the nerves caught up then all was well again. After finding this out we used pull ups when necessary, especially at bedtime and for school so in wasn't embarrassing for him. The Dr. told him what was going on and we talked about it, he responds well to scientific explanations and isn't hard on himself then and also lets me know when it is starting to happen again and when he has control again. It was important for me to not let this affect his self esteem and talking about the cause and effect of what was going on with his body helped with everything.
Good luck,

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