School age potty regression

[bright sparks]

She really needs to take him to the doctor! Sure, it could be behavioural, but incontinence can also be caused by UTIs, constipation (even if pooping regularly, there could be a mass in his rectum). And if it is behavioural, she can get professional advice.

If she refuses, and you decide to ride it out, definitely give him a bag, clothes and cleaning wipes and let him be independent. That is NOT a punishment, just a natural consequence. My 1.5yo helps wipe up if she pees through her trainers, and can put her wet trainers in the laundry basket (still needs me to clean up thoroughly, but she is only 1!).

I still don't think a visit to the doctors is necessary. Incontinence is not a common symptom of a UTI, frequent urination is a symptom which would result in more frequent accidents, but that is not incontinence. Second, of all, UTI results in smelly urine and the child would be in significant pain and have other symptoms after a lengthy period like this most commonly a fever. In terms of constipation, I don't see any mention of constipation from the OP so that is irrelevant but if there was a mass there would be other symptoms such as pain and fever. Don't get on at the parent to go to the Drs, its a waste of time and will cause more conflict between you and her. If anything, suggest she contact early years/ROCK for resources to help with toileting. Family Dr is not the best person to help with this and it is just one more person in the waiting room holding up patients who really need to see the Dr when there aren't any actual telltale signs that this child has a medical issue. Stop panicking and accept that some children fall outside of the norm but that doesn't mean there is "something wrong" that "needs to be fixed but that expectations need to be altered and a home daycare may not be the best environment for the child while going through this stage in toileting.

[kindredspirit]

I still don't think a visit to the doctors is necessary. Incontinence is not a common symptom of a UTI, frequent urination is a symptom which would result in more frequent accidents, but that is not incontinence. Second, of all, UTI results in smelly urine and the child would be in significant pain and have other symptoms after a lengthy period like this most commonly a fever. In terms of constipation, I don't see any mention of constipation from the OP so that is irrelevant but if there was a mass there would be other symptoms such as pain and fever. Don't get on at the parent to go to the Drs, its a waste of time and will cause more conflict between you and her. If anything, suggest she contact early years/ROCK for resources to help with toileting. Family Dr is not the best person to help with this and it is just one more person in the waiting room holding up patients who really need to see the Dr when there aren't any actual telltale signs that this child has a medical issue. Stop panicking and accept that some children fall outside of the norm but that doesn't mean there is "something wrong" that "needs to be fixed but that expectations need to be altered and a home daycare may not be the best environment for the child while going through this stage in toileting.

I'm a ER RN. It can be difficult to tell whether a child just isn't making it to the bathroom, or if they can't control it. UTIs can present atypically, not always smelly, not always an aggressive bacteria leading to fever, etc. If the child is incontinent of poop too, there could be underlying constipation (where stool is oozing out around a mass of impacted stool). Depending on the size, that can cause incontinence of both urine and stool. Eventually, when big enough, it would cause pain, but not fever. I've seen it on a 'just in case' X-ray.

I'm not saying there's something wrong with the child. All likelihood is that it is behavioural. But I think it is good practice to rule out any medical issue when a trained child of school age regresses for no apparent reason. If the child can't physically control it because of a medical issue, then behaviour modification approaches won't work, and that would be hard on the child too.

[bright sparks]

I'm a ER RN. It can be difficult to tell whether a child just isn't making it to the bathroom, or if they can't control it. UTIs can present atypically, not always smelly, not always an aggressive bacteria leading to fever, etc. If the child is incontinent of poop too, there could be underlying constipation (where stool is oozing out around a mass of impacted stool). Depending on the size, that can cause incontinence of both urine and stool. Eventually, when big enough, it would cause pain, but not fever. I've seen it on a 'just in case' X-ray.

I'm not saying there's something wrong with the child. All likelihood is that it is behavioural. But I think it is good practice to rule out any medical issue when a trained child of school age regresses for no apparent reason. If the child can't physically control it because of a medical issue, then behaviour modification approaches won't work, and that would be hard on the child too.

This regression started in December which pretty much rules out everything you have said in terms of bowel obstruction and UTI. Symptoms would not have stayed stable and consistent with either of these things for 12-16 weeks. I think an appointment with a dr would be good to talk about strategies for handling this behaviour if they were actually qualified and knowledgeable to do so, which they really aren't. Let's not encourage parents to be neurotic unnecessarily. In the first few weeks of the regression it was the time to rule out physical illness, 3-4 months in, it's common sense to understand that all indications point towards a behavioural issue. Perhaps because I have had first hand experience of this with my own child in addition to working for the NHS in the U.K. and community healthcare, I see no clear indication that there are any health issues to be concerned about. UTI and bowl obstruction would have caused excruciating pain long before the 3 & 4 month mark resulting in emergent care. No additional symptoms, why overthink this.