Dear Dr. Debbie,
My five-year-old is in Pre-K. I’ve been told, “No one goes to kindergarten in diapers” but he might just be the first. He’s been in thick underpants since January, but periodically has “accidents” both at home and at school. It seems to happen in spurts – no pun intended. It doesn’t help that he and his older brother go to Dad’s on weekends where there aren’t any rules or schedules. His behavior is the worst, and accidents are more often, the day or two after a visit with Dad.
Back To Pull-ups?
Dear BTP,
Stress is a factor in a child’s toilet accidents. One cause of a child’s stress is his parents’ level of stress. Unfortunately, toilet accidents can add to a parent’s stress level.
Prevention
It’s tough switching homes between extreme contrasts in discipline. Try to address this with reliable transitions on your part. Have a regular routine with your son for packing up what he wants to take with him, allotting plenty of time to do this so he doesn’t feel rushed. Have a song or verbal game that you use during the car ride, such as, asking repeatedly, “Who loves you?” with him responding each time with the name of a family member or friend (or teacher?) until he can’t think of any more. Same goes for the re-entry into Mom’s World. Even having the same menu for the first meal back – one that is a sure-fire favorite – can help to lower a child’s stress level. Keep the meal low-stress with pleasant conversation and no demands that he eat everything on his plate. Serve him a little at a time in case his appetite is low.
The experience of “toxic stress” can lead to an excessive need to urinate among other symptoms. Toxic stress is an amount of stress that affects normal brain development leading to life-long negative effects. Lasting effects of toxic stress go beyond toilet accidents as a five-year-old. High stress in early childhood interferes with learning and controlling one’s emotions both of which can prevent school success and later, success in relationships and employment.
You and Dad might consider going to counseling together to address the dissimilar parenting styles between you. Ideally both households should have standards and consequences for behavior that are not too different. Check in with each other periodically about the children’s growing abilities to take on responsibilities as well as their changing interests. (Note, if your break up is still too raw, please seek counseling for yourself to work through this challenging life event. This will strengthen you and thus reduce stress for the children.)
Try to agree on strategies both you and Dad can carry out to show your son that his two parents are working as a team on his behalf. If you are going to parent successfully from separate households, it’s essential to have good communication and trust between you. This will certainly reduce stress all around.
Check with the pediatrician to rule out any physical causes of the toileting accidents. Carbonated drinks, caffeine, onions, tomatoes, and spicy foods can cause an overactive bladder. It could be that your child is drinking a lot of water or eating a lot of watery foods (grapes, for example). Again mention this to the pediatrician since excessive thirst could be a sign of diabetes. Limiting water intake when a child is thirsty is not a good idea.
Managing An Accident
It is important to keep your cool when an accident happens. Be supportive as you help your child to get cleaned up and changed. Have clean up tools and supplies at the ready. Include him as much as possible in this by using elastic waist pants and by keeping his clean clothes where he can easily get to them.
If he fears that his accidents will make you angry, he may try to hide them from you rather than counting on you for help. There’s little chance he is controlling his wayward urination on purpose just to annoy you.
Same goes for what his teachers should be doing. An experienced Pre-K teacher has dealt with wet pants before. (Most kindergarten teachers have, too, by the way.) It might be a good time to ask for a conference so that, just like with Dad, you can work together to identify causes and agree on management strategies.
Pull-Ups or No Pull-Ups?
Your decision to go back to pull-ups likely considers cost vs. inconvenience. Sounds like the inconvenience of an untimely clean-up has more weight than cost in this decision. Another factor to consider is which would better help your son to reduce his stress? Is he asking for pull-ups? Is he more embarrassed by wet clothes than he would be if his classmates found out he was technically wearing a diaper? Invite him into a discussion of how he feels about wearing pull-ups.
Your son needs to know that you’re on his side.
Dr. Debbie
Write your question to Dr. Debbie! Please include age(s) of your child(ren) and other details about the situation or concern.
Deborah Wood, Ph.D. is a child development specialist and founding director of Chesapeake Children’s Museum, located at 25 Silopanna Road in Annapolis.
The museum is open daily from 10 am to 4 pm. Online reservations are available or call: 410-990-1993. Each Thursday there is a guided nature walk at 10:30 am. Art and Story Times with Mrs. Spears and Puppy the Puppet are on Monday mornings at 10:30 am.
Dr. Wood is leading a virtual workshop for early childhood professionals on Saturday, March 8, 9 am to 12 pm Making Story Time Come Alive! with MSDE certificates granted.
