ADHD/Mild ASD - bathroom/pee issue - 9yo
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Anonymous
| My 9yo daughter is recently diagnosed with adhd/mild autism. I think of her as high functioning, but she is a very quirky kid. Bathroom-wise, I had her toilet trained by age three (wasn’t easy), but anytime she would laugh extremely hard— she used to fully pee in her pants up to age 7ish, maybe once or twice at 8. She is now describing small pee leaks that happen throughout the day, everyday. I learned she was putting toilet paper in her underwear to catch it. It has been just over a month of trying to tackle this. I took her to the pediatrician. She did not have a UTI. There were crystals in her urine, but the doctor said that was likely unrelated. Constipation was the most likely culprit, but she has never been constipated before and it’s still unclear if constipation was the issue. I’ve given her moderate doses (three capfuls) of miralax twice now. We also upped her fiber in general (beans and fruit increased, she was already eating a daily vegetable), although we’ve slowed down a bit with the fiber. I learned that this miralax gave her a first and second experience with diarrhea, but it doesn’t seem to have cut back on the pee leaking. We stopped short of a full miralax clean out (couldn’t bring myself to do 5-7 capfuls with 4oz of liquid per cap, plus ex-lax!). She asked me last night to make these pee leaks stop. I’m wondering if this is an attention thing. I keep asking questions, like a detective, but I’m not getting anywhere. Help, please. |
Anonymous
|
Constipation is still the most likely issue. It can take a bit of time even after a cleanse to see relief.
(My 9 year old has been dealing with encopresis for two years…) |
Anonymous
| Have you ruled out vaginal causes? Normal discharge, yeast infection, etc? |
Anonymous
OP - I think we ruled that out. The pediatrician saw some slight irritation, but that was when we found out she had been washing privates directly with scented soap all summer. I told her to stop doing that and switched to unscented soap. The pediatrician also recommended a sitz bath - we did one. She has never complained of any itching or irritation. The meeting with the pediatrician was our longest ever… but also very unsatisfying. She said this issue could be caused by the irritation or constipation, but my very verbal kid was not complaining of constipation or any sort of discomfort in her private area… just lack of control of her pee. She had pointed out a discharge, but the pediatrician said it was normal for her age. |
Anonymous
| is it really pee that is leaking? or is she feeling the vaginal discharge and feeling like it is pee? |
Anonymous
| Take her to a urologist. |
Anonymous
| Is she peeing at regular intervals so that she’s not dealing with a full bladder? My DD has very low muscle tone and can’t always feel when her bladder is full until she leaks. She just needs to go every 3 hours whether she feels it or not. |
Anonymous
Same PP above. Another thought. Is it only happening at school? Any chance she’s avoiding the restrooms at school or in public? My DD also has OCD and felt the restrooms at school weren’t clean and didn’t want to use them. We were able to get her to go to the nurse every 3 hours until we got her used to that schedule and then worked on using the regular restroom with a therapist. |
Anonymous
Thank you for the suggestions! She uses the restrooms at school. She was amused that she pooped three times today — once at school and twice at home. It does seem like she waits a bit too long to pee sometimes (she is a Roblox player), but I think she’s been trying not to do that lately. I’ve been noticing better habits about peeing before she leaves the house (without a reminder). She was a somewhat low tone baby/toddler. She needed PT to learn to roll over (at 7-8 months!), sit up and crawl… but then was on schedule for walking. And the way she would lose control of her pee when she laughed was pretty bad - we had years of that. I would hear her laughing and suggest she go to the bathroom. I wonder if she could just try to pee every three hours. I learned tonight that she tries to physically pinch her urethra closed through her clothes when this happens. Not a good look for a 4th grader. It could be discharge - I can’t really tell. I should be able to tell… |
Anonymous
| Our school let our kid wear an Apple Watch with a timer, to remind. You can otherwise silence the phone during the school day with parent controls. This can help her remember to go every X number of hours. |
Anonymous
| Can you get her some liners while you figure it out, to spare her any embarrassing incident? |