Regression in almost 4 year old - any advice?

So DD who is 4 in a few weeks, has been fully TT'd for almost 2 years - day, night 1's and 2's. it was very easy and we've had minimal problems..... Until the last 6 ish months.
Now, she can go to he toilet anywhere up to 20 times a day (not all the time). She usually has small leaks in her undies most days, leading to her needing to change often. She can't seem to hold on very long - when she makes me know that she needs to go, she's at the point of bursting.
Early last month, she had 5 nights in a row where she wet the bed - the longest stretch e ver.
She's now wetting the bed once a week.
I've take her to see the GP a few times. She's had an ultrasound that came back normal. She's tested neg for UTI's. GP doesn't think it's diabetes. She doesn't excessively drink water - in fact because of the bed wetting I've been restricting intake after dinner. Possibly not the greatest idea but it seems to have worked a little. I also called the continence organisation who said it was behavioural and that they count possibly give m any tips or suggestions on what I could do to try and get on top of this. The nurse came across a little rudely like my concern was trivial, so I won't be calling hem again an time soon...

It's just getting out of hand. I can be doing a load of washing a day, half of which is little girl undies. The night time wetting I could handle if the day time stuff was under control but it seems to be getting worse.
I've never used pull ups and I'm very anxious about introducing them and her going even further backwards.

She's a very intelligent little girl who comes across much older than she is, so this has just blown me out of the water. I can't think of anything that might be affecting her apart from her brother starting school the clear, but she's getting so much more attention now, it just doesn't make sense.

Has anyone been through anything like this? Any tips/ suggestions/ ideas? I have no idea what to do or where to turn next.

No real idea - but the past few months we have had quite a few accidents, including two wet overnight, and several leaks and DD has like your DD been trained day and night for almost two years and before 3.5 we never had any accidents at all. So maybe it is not unusual at this age but different children effects to a different extent?

Subbing as I am having similar issues with my ds, will be 4 in August. Today was great, fingers crossed :)

I'd be insisting on her being tested for diabetes....to rule it out.
If you're happy to try alternative treatments.....look into Bowen therapy!
My osteo has been treating my DD1 fir sleep issues ( which included needed to go to toilet during the night) with great results, I'm taking DD2 in two week fir bed wetting, my osteo incorporates Bowen therapy.

I would go back to basics for a bit of 'retraining'. Don't wait for her to tell you she needs to go, take her every hour for a Squeezy Wees (the wee you have when you didn't think you needed to!). Reward her with praise if she goes, get her to change her own knickers and put them in the washing machine if she has an accident but don't make a big deal of it.

Good luck!

I'd want to know on what grounds the continence specialist determined that it was 'behavioural'. I dunno, it could be. But it sounds odd to me and without anything that's obviously triggering or reinforcing a behaviour (stress, need for control, attention issues...) then like you, I'd be wanting a really thorough assessment of bladder, control and frequency issues....
I know of a few kids who have regressed because they went too much 'just in case' and therefore the assessment was that they lost the physical control and awareness around completely full, vs completely empty. If this is the case, then toilet timing is going to make it worse. If it is behavioural, then taking her regularly might be the way forward. I feel like calling up that nurse for you and demanding a better explanation for her fobbing you off. Grrrr.

Did you end up finding an OT for DS? An OT also may be able to assess physical vs behavioural issues of TT, and could help you make a plan to at least test hypotheses.

I wounder if maybe there is some anxiety going on? I know with my older kids bed wetting is a problem with they are stressed out. One of boys needs to use the toilet every time we walk into a shopping center, its anxiety related for him.

Do you think its possible she is putting a lot of pressure on her self maybe? Any reasons for why she might be feeling anxious?

Thanks everyone.

She does seem to need to go more often when we are out, but its even at places she is comfortable - like my sisters house. I can't think of anything that would make her anxious? There are no big changes in circumstances within our family apart from DS being at school. We've never done toilet timing, it's always been about her own feelings of bladder fullness. I do try and get her to sit on the toilet longer and try to get something else out, but she's always empty. I'm really not keen on relinquishing her control on her own toileting, although I may need to head down this road if things don't improve soon.

I have started using an app called be good. It's a rewards based app that for each task completed, the child gets however many points you assign to go towards a goal. I've decided to try adding keeping her bed dry at night as one of the tasks, and putting it with teeth brushing and clearing her dishes will hopefully make it a bit less of a drama and more like a normal, everyday task and thus taking a bit of pressure off. She was pretty stoked when she got her points this morning. Once I get a full week of nights sorted, I'm keen to try it for the day too on the proviso that it works.

It's just so confusing after she's done so well for so long!

As for DS, after being totally fobbed off by the paed, I've decided to tackle it myself.

All I have wanted for my kids is some advice, but no one professional seems to want to give me anything because they aren't 'ill' enough to warrant any form of diagnosis, so how can I be having any issues. *bang head against wall*. Thank goodness for forums!!

So you've achieved what you've done so far with DS without professional support?! Holy moly woman, I knew you were doing well but that's incredible!!! Massive, massive kudos to you, superMum, you have two very blessed little people there.

As for DD...? Well, I still don't know. The app sounds like a great idea and will help test the behaviour theory. If she's really motivated and still wetting then it's even safer to say that it's beyond her control. But I maintain that you deserve a thorough, respectful, professional assessment. Sounds like those are somewhat rare in your neck of the woods. Only thing else I've got it hugs. xoxoxo

All without any support. It's mainly been DS' wish to try things and an insane amount of positive reinforcement. Proud of him.

Ill see how I go with DD. I'm about to wake her up. To use the loo, although she goes on her own every night anyway but can't hurt to try something different can it? :)