Common causes of potty training regression in young children include: Change in the child-care routine—for example, a new sitter, or starting a child-care or preschool program. The mother's pregnancy or the birth of a new sibling. A major illness on the part of the child or a family member.
When a potty-trained child suddenly starts having accidents at home or wetting themselves at school, there may be physical causes such as constipation, or there may be behavioral or developmental reasons.
Other common causes of daytime wetting include: Constipation (stool in the colon can create pressure on the bladder and cause spasms, which lead to daytime wetting) Poor bathroom habits, such as not emptying the bladder completely or “holding it” for too long. A urinary tract infection.
Many children experience potty-training regression, and many if not most children have potty-training accidents as they're learning how to use the potty or toilet. Every child is different—some may experience many accidents, whereas others may have fewer.
That is not unusual after a toilet-training lapse caused by a medical condition, stress (like a school change), or anything else. After all, adults have spent years using the toilet. A four year old has only been dry for a year. And many, many four year olds do have accidents and phases where they go back into pullups.
Many children start having accidents during times of transition that might cause stress, such as starting a new school or welcoming a new sibling. Chances are, once your lives settle down, your child will master potty training once again.
Causes of Potty Training Regression
Sometimes, regression is simply due to distraction, or an unwillingness to give up a toy or activity. Your child might be waiting until the last minute to go and doesn't make it to the bathroom in time. Many children don't want to take a break from playing to go to the bathroom.
Regression sometimes signals an infection or other disorder that requires medical treatment. If medical causes have been ruled out, however, your child is probably just responding in the only way they know how to a recent change in their environment or some other source of stress in their life.
Up to 20% of 4-‐6 year olds wet their pants occasionally and 5% wet twice or more per week. Why does it occur? Overactive bladder is the most common cause of daytime wetting in children. Not drinking enough water, or drinking caffeine-‐ containing fluids such as cola will worsen overactivity and thus worsen wetting.
This is normal, and you can help your child get back on track. "Potty training regression is a normal part of potty training and temporary," says Norma Perez, MD, a pediatrician with AltaMed Health Services and a fellow of the American Academy of Pediatrics.
If your child has been dry for a while, either at night, during the day or both, and starts wetting themselves again, it may mean they have a bladder infection, constipation, or type 1 diabetes. Ask your GP for more advice. Alternatively, there may be an emotional reason.
Children with more severe ADHD may experience more wet nights. ADHD is linked to central nervous system delays which can cause children with ADHD to have a delay in detecting their bladder signals as well as having decreased arousal to signals of a full bladder.
It's actually a fairly common problem for kids with ADHD. They're about three times as likely to have bedwetting trouble than other kids. It's not totally clear why. Some researchers think it's because bedwetting and ADHD are both linked to a delay in the development of the central nervous system.
When children experience big changes and stressors in their lives, such as introducing a new sibling, moving to a new home, transitioning to a new school or daycare, or, as is the case right now, a global health crisis that is radically changing their and our lives, it can absolutely impact their bathroom habits.
A young child's learning process is linked to his/her developmental stage and is more likely to occur in spurts. During stressful situations or changes in routines, such as starting a new daycare, a new baby sibling at home, divorce or even a global pandemic, regression in learning can occur.
Sometimes children regress with potty training because they want more attention from you. This is particularly true if you have a new baby at home. Your older child will notice the baby getting lots of physical attention, including frequent diaper changes when you drop everything and focus just on the baby.
Get her to voice her feelings – that's extremely important. Ask what it is that makes her angry enough to where she wets herself. Find out if there's something going on at school or in some other area of her life that is causing her to feel sad or worried or afraid.
When a child begins to intentionally urinate on the floors, there may be physical or psychological issues; however, most the time it is a cry for attention or a form of revenge. As upsetting as this may be, there is usually an issue that can be addressed and resolved.
Executive function issue
Both ADHD and autism spectrum disorder (ASD) feature reduced executive function. Self-monitoring is an executive function skill. If your child has weak executive function, they might not pay attention to the signals indicating they need to use the bathroom.
Potty training regressions can be as short as a few days or as long as a few weeks. Regressions lasting a month or more without improvement may indicate that your child was not developmentally ready for potty learning. (Sometimes kids can show signs of readiness, but they aren't quite ready!
A new baby in the family, a move to a new home, family conflict, or any other emotionally stressful situation may cause your child to revert to an earlier level of bathroom mastery. This may involve bedwetting, puddling, withholding of stool and even pooping in inappropriate places.
Only 60 percent of children have achieved mastery of the toilet by 36 months, the study found, and 2 percent remain untrained at the age of 4 years.
Here's how normal bowel habits break down by age:
First 3 months for children who are formula-fed — Expect two to three soft bowel movements daily. 6 months–1 year — Expect two bowel movements daily. 1–3 years — Expect one to two bowel movements daily. 4 years and older — Expect one bowel movement daily.
Parents should base their decision on each child's needs, said Kate Gallagher, an educational psychologist. In general though, a 5-year-old can handle going into a public bathroom but shouldn't be asked to go it alone without being taught “protective behaviors” by about age 3, she said.
Common potty training problems include anxiety, refusal to use the potty, and attempts to delay or avoid defecation. In addition, it's common for kids to have daytime accidents and wet the bed. Children may also feel reluctant to use toilet facilities when they are away from home.