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When a Potty-Trained Child Experiences a Lapse
Laura Jana, MD posted:
Every now and then, a potty-trained child will regress and start having accidents. This can be a very uncomfortable and frustrating experience for parents. A potty training lapse usually generates a fair number of questions and concerns by worried parents.

When a child reverts to pre-potty training behavior, parents need to first ask themselves what might be causing the change in their child's actions.

As a pediatrician, I can tell you that it's always important to determine whether there's a physical or medical reason to blame. Here are some of the most common causes of potty training accidents:

Urinary Tract Infection
A urinary tract infection can definitely cause children to have accidents. The sense of urgency and frequency typically associated with urinary tract infections can get the best of a child, and make it almost impossible for a child to avoid peeing in their pants. Other signs of a UTI, like foul smelling urine, a fever, or your child complaining that it hurts to pee, might not be present.


Potty training regression can also be caused by constipation. Once kids are out of diapers and using the toilet more independently, constipation can creep up when you've stopped watching every trip to the potty. Ironically, constipation can be the cause of soiled underwear. Medical explanations can be ruled out by your pediatrician fairly easily.

Emotional Issues
One of the most common causes for regression is an emotional issue. You probably don't need me to tell you that young children experience strong emotions -- like fear, anxiety, independence or unease -- that they may not be quite ready to handle or express. These feelings and emotions sometimes lead to potty mishaps months after they've mastered their potty skills.

Accidents can occur in preschoolers, and in early elementary age children, too. Potty accidents definitely warrant a closer look at what's going on in your child's life. For some, it may be a new baby brother or sister, or a recent household move. For others, it may be a new fear of the toilet, the bathroom, the sound of the flush, or other aspects of potty use. In some children, it can be a case of defiance or the need for attention.

Try to handle the situation as calmly as possible. Accidents should be cleaned up matter-of-factly without any punishment or criticism. The specifics of how you get your child back into a routine that includes putting his/her pee and poop in the potty will depend on what's to blame for derailing it in the first place.

Fortunately, whether it's due to a recent move or a fear of the flush, regression in previously toilet-trained children doesn't typically last too long -- especially if you can determine the cause. Remain calm and work to communicate with your child.

Let me set aside my "pediatrician hat" for a moment to mention one more cause for children with wet pants: child-themed restaurants, family fun centers and birthday parties. That's right! For each of my three children, big events with ball pits, clowns, balloons and games (not to mention endless drinks) had a way of making my potty trained kids so excited and distracted that they'd forget to pay attention to the need to pee -- until it was too late. I suggest a two-drink limit and a mandatory bathroom break every hour, on the hour. And even then, I'd still bring a change of clothes.

Have you had a child undergo a lapse in potty training? How did you handle the situation? Tell others in the community about your experiences with potty training accidents.

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