What to Do When Your Potty-trained Child Suddenly Isn’t

Understanding regression — and what to do

Child sitting on toilet - potty training

So, you thought your child was potty trained. While you may feel disappointed or even frustrated, it is very common for children to go back to having accidents — temporarily.

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Having intermittent accidents (for example, wetting themselves a few times one week but not the next) is not potty training regression, however.

If your 3-year-old wets herself twice this week after being dry for eight months, that’s what I call a “bump in the road” — not true regression. If your 5-year-old forgets to go because he’s captivated by his new video game, that’s really not regression either. Variants like that can be expected.

Regression is when the behavior recurs for several weeks, such as when your 8-year-old regularly wets her bed after being dry at night for years. 

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Why some kids regress

While many kids go back a step here or there, true regression is far less common. True regression usually indicates that something needs to be fixed, such as:

  • Psychosocial stress. Stress is the most common reason for regression. Kids can be stressed by a new daycare, moving to a new town, an extended family member’s moving in, a parent’s illness — anything new or different. 

    As children develop, they learn what to expect from their environment and how to gain some control over it. But sometimes what seemed under control suddenly becomes different. Learning to cope with a new reality can take a child’s attention and energy away from staying dry because they have new fears or expectations. That’s why they start having accidents.

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    It can happen to older, school-age kids, too. Stressors can include changing schools or perhaps being bullied. Those kids haven’t lost the skill to be potty trained; they’ve just become mentally and emotionally overwhelmed. They unintentionally ignore their body’s signals to go to the bathroom. 

  • A medical condition. This is much more rare. While there are many potential medical causes for regression, we only begin looking for one if there are unusual symptoms or we’ve ruled out psychosocial stressors. More often, regression is caused by something that’s easier to address.

What you should do

Parents sometimes worry more than they need to about potty training regression. Instead of jumping to conclusions:

  • Consider your child’s emotional stressors. Think like your kid. Is she upset because her favorite TV show isn’t on the air anymore? Is he fretting about going to Grandma’s for the weekend? Potty accidents are usually connected to your child’s environment and a perceived loss of control.
  • Talk to your pediatrician. If you are concerned that your potty-trained kid suddenly isn’t, see your pediatrician. Even if there were just a couple of accidents, if it worries you, come in. Otherwise, if accidents recur for one week or more, it’s time for a doctor’s help.

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Deb Lonzer, MD

Deb Lonzer, MD, is a board-certified pediatrician and the Chair of the Department of Community Pediatrics for Cleveland Clinic Children’s.