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Ask Dr. Sears: Potty Setbacks

[BOLD {Q. Our daughter is toilet trained but is starting to have accidents again. Why is this happening --and how can we get her back on track?}]

[BOLD {A.}] In all phases of development, children often take two steps forward and one step back. This is especially true with potty training. Still, you should first rule out any possible medical causes for your daughter's accidents. If she's wetting herself while sleeping at night and during the day, she may have a bladder infection, so have her doctor examine her. Constipation is also a hidden cause of many bladder and bowel accidents; full intestines can put pressure on the bladder, causing urine to leak, and loose stools can accidentally slip out if a child has been constipated for a few days.

If she's healthy, toilet regression is usually due to a shift in routine: a move to a different home, getting a new caregiver, starting preschool, or the arrival of a sibling. Or she may simply forget to listen to her bladder and use the toilet until it's too late.

To get your child back on the potty, identify possible triggers in family life that could be upsetting her, change what you can, or talk to her about what you can't. If that doesn't seem to be the problem, try to pinpoint where she is and what she's doing when she has the accidents. If they tend to happen when she's playing, for instance, remind her that she can go back to the fun after she goes to the bathroom.

Above all, don't punish. Use this opportunity to connect with your child by talking to her about how her body works --and why it's important for her to listen to what it's trying to tell her. Increase the positive attention you give her in ways that reinforce her maturity. Take her shopping, let her help you with enjoyable activities around the house, and remind her that these are things that "big girls" do.

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