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Self-sufficiency in the bathroom: What to expect when
By the time your child enters kindergarten, he should be completely self-sufficient in the bathroom. He'll need to undress himself, use the toilet, wipe himself, pull his clothes back on, and wash his hands. Typically, 5-year-olds are dry both day and night, with only the odd daytime accident and the occasional nighttime mishap.
Signs of readiness
At this age, your child is more capable of handling the steps involved in toileting. He can, for instance, remove, unbutton, or unzip his clothing with ease. Since he's taller, he can stand in front of the toilet or sit on it without any aid. And he's mature enough to remember to routinely wash his hands after using the toilet. In fact, your child may relish his increasing independence and take pride in his ability to use the bathroom on his own.
What you can do
You can make using the bathroom a snap by keeping toilet paper in reach of little hands. The same goes for soap and a hand towel and maybe a footstool to reach the sink. If your child resists wiping himself after a BM, have him bend down and touch his toes while you do it. And keep encouraging him to take over this task himself. If your child is a girl, teach her to wipe from front to back to avoid infections. And a gentle reminder about hand-washing every once in a while can't hurt.
Don't make a big deal about the occasional mishap. If your child consistently wets the bed at night, downplay these accidents, too, and make sure he understands that it's not his fault. Don't punish him or make fun of him; he really can't help it and you'll only make him feel ashamed. And make sure that his siblings know that teasing their brother about this condition is an absolute no-no. Staying dry all night is a developmental skill that almost all children achieve in time. In the meantime, protect his mattress with a plastic cover.
What to watch out for
If your child has frequent accidents during the day and night, dribbles urine constantly, strains while he pees, or complains of burning or pain when he goes, he may have an infection or other health problem. Call his pediatrician as soon as possible. You should also talk with the doctor if his urine is cloudy or pink, or if he has redness or a rash in his genital area, or if he soils himself. If his underpants, pj's, and sheets are wet even when he regularly uses the toilet, you should also talk to his doctor. If your child has infrequent bowel movements (less than three per week), if he passes either large stools or hard, pebbly stools, or if it is difficult for him to pass a bowel movement, talk with his doctor about possible constipation. These guidelines also apply to girls.
There may be an underlying emotional cause in the case of a child who starts wetting the bed after a long dry period, says Denise Aloisio, a developmental-behavioral pediatrician in Rochester, New York. "Things like going to a new school, changes in the family such as separation or divorce, or physical abuse can all be triggers," Aloisio says. "Talk with his doctor about any emotional stresses you think might play a part."