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Dr Catherine
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4-7 years

My daughter has been toilet training since 2 years old and now at 4 and 3 months she is still having many accidents. Sometimes up to 6 per day! I have tried everything and not sure where to go from here. What would you recommend? Thank you!

With respect to her daytime accidents the first question to ask is whether this is contextual, that is, does it only happen when she is at home or when she's at preschool, or does it occur all the time? If it is contextual then it most likely has an underlying behavioural cause. If it is all the time then there maybe something physical. Given the frequency of her accidents I would actually recommend that you have her assessed by her GP or pediatrician. In a small number of cases children wet the bed due to an overactive or small bladder capacity – these children often need to urinate frequently during the day also and do not have much time between feeling the urge and actually urinating. Your doctor will want to know things like how often she experiences daytime accidents, if there are changes in her wetting patterns (i.e., what makes her wetting worse), are there other symptoms along with the wetting (i.e., strong odour or pain), as well as information regarding her bowel movements. Diagnostic tests will include a urinary analysis, you may be asked to keep a fluid diary, which will involve logging how often, and how much your daughter drinks and how frequently she urinates. The doctor will also want to determine her bladder capacity to see if a small bladder capacity is a contributing factor. All the best,