Pee Accidents In A Potty-trained Child

If your child, who is fully potty trained, is starting to have daytime pee accidents, you should be concerned. The medical term is diurnal enuresis. It is not developmentally normal and generally indicates a problem. Now if your child has only been trained for a week, I wouldn’t consider that a consistently trained child. A newly trained child may be losing the motivation to stay dry (e.g., no more stickers or toy rewards). I would consider 6 months or longer a consistently trained child. Here are the common causes for kids to suddenly start peeing their pants.

1. Urinary Tract Infections (UTIs): One of the most common causes of urinary accidents in girls because they have short little urethras (tube that drains the pee out of the bladder) and the pee hole is so close to the poop hole. It is easy for little girls to wipe poop over the pee hole and get infections. UTIs are very uncommon in boys because they have much longer urethras. UTIs usually have other associated symptoms, like painful urination, having to pee frequently, abdominal pain, and/or fever.
2. Incomplete emptying of the bladder (the medical term is dysfunctional voiding): Sometimes kids get so distracted with activities that when they finally stop and run into the bathroom to go pee, they don’t take the time to fully empty the bladder. The bladder is a muscle, if it isn’t used properly, it can become somewhat dysfunctional.
3. Diabetes Mellitus (DM): An important cause of urinary accidents in children. Diabetes causes sugars to be elevated. One of the ways the body tries to fix that is to increase thirst (the sugars essentially cause the fluids in the cells to shift). When you drink more, you pee more and sometimes so much so that you can’t control it. Kids with diabetes will often have weight loss, headaches, and/or mood irritability.
4. Emotional Stress: Major stresses in a kid’s world can cause urinary accidents. Just about any life stressor can do it: parental divorce, death, moving, introduction of a new baby, someone perceived as mean, being bullied, fear, etc. Usually a parent can readily identify the life stressor, but occasionally they don’t know (e.g., if the child is afraid to say something about being bullied). Look for your child to be moody, acting out, withdrawn, clingy, or teary.
5. Sexual abuse: This is a tricky one. On more than one occasion, I have had urinary accidents be the presenting symptom of a child being sexually abused. It can happen in just about any circumstance by just about anyone.
6. Constipation: It may not seem like a readily apparent cause of pee accidents, but is actually relatively common. If there is a ton of stool, it may obstruct the outflow of urine or cause pressure on the bladder and trigger a sudden need to pee.

I read once that kids perceived wetting their pants in class as the number 3 most stressful life event (only after death of a parent and going blind). So believe me, your child is worried about wetting his/her pants also. It’s not a problem you should just wait and watch to see if it gets better on its own. Seek medical care.