Does your child withhold their wee, procrastinate about weeing or seem anxious about weeing? Wee withholding is actually quite common, and usually stems from fear. Read on to learn how to implement supportive strategies and help your child overcome their fears and build confidence in the potty training process.

Wee holding

Underneath the behaviour (holding onto wee) is usually anxiety. Most commonly this stems from – the fear of weeing itself (e.g. from current pain or past pain such as a UTI)
– fear of weeing in the potty or toilet
– fear of weeing in their pants/clothes and feeling uncomfortable

Wanting to avoid the fearful thing leads to withholding. From your child’s point of view, this is a good solution! These fears usually manifest as refusal to use the potty when prompted, or disengagement from the potty training process. Some kids also realise that they can avoid doing a wee if they drink less, so often refusal to drink accompanies the wee withholding, which of course makes it worse. However, it’s crucial to recognise that this behavior is a symptom, not the problem itself. It’s your child’s way of communicating their anxiety or discomfort and signalling that they need you to help them.

Sometimes, sensitive children or those with neurodivergence may dislike the sensations around a filling bladder, releasing wee or doing it on the potty or toilet rather than in a nappy. This can also present as resistance and refusal and may also be connected to fear and anxiety. Read more about sensory processing disotders and potty learning.

Impact

Avoiding doing a wee means that your child will usually start to feel uncomfortable pretty quickly, and this can exacerbate the behaviours and anxiety. The feeling of an over-full bladder when they do wee can also be uncomfortable and make doing the wee a big ‘event’.
Alternatively, the wee holding leads to accidents, sometimes small leaks to relieve the pressure and at other times, a full bladder release. The impact on the bladder is considerable, as it has to retain the wee and over time, it will become weaker, less flexible and less effective at emptying.

It’s stressful for you as a parent to see your child in discomfort or pain, and you may be tempted to offer bribes, threats etc to try and encourage them to wee. You may get frustrated as well, knowing that they are potentially causing damage to their bladders. You know that if they could just do it, they would get over the fear and the problem would go away. But like so many of these sorts of problems, the issue is emotional (fear or sensory trigger) and cannot be tackled easily using logic.

Personality matters

In my experience as a potty learning consultant, I’ve noticed that children who are highly sensitive, emotionally reactive and those who need more time to process changes and adapt to new things tend to struggle with wee withholding more frequently.  These children often need to experience a sense of control and may be labeled as “stubborn” by their parents. However, what they truly need is space to learn without feeling pressured or overwhelmed. When fear is in the mix, they also need options to wee that help them to go when their body indicates they need to, and in a way that they can feel comfortable with.

How to help

1. Help them to drink enough
Drinking enough is really important. Firstly because, the more they drink, the more they will wee and frequent weeing will help alleviate their anxiety. Aiming for around 1 litre of fluid intake per day with water being the best drink. Sufficient fluid intake will strengthen the bladder and help it empty more effectively. Having repeated filling and emptying will help build the brain-body connection which will also promote night-time dryness. If your child is a reluctant drinker, try these fluid intake tips to help set some better habits.

2. Promote good bladder health
To support good bladder and bowel health, establish a routine of regular toilet breaks, ideally every 1.5-2 hours. Help them to go regularly by making it fun, e.g. “I bet you can’t get there before I count to 10”, or taking dolly with them and having dolly go first. Avoiding them going more than 2 hours without a wee is important, not just for bladder health but because weeing with an overfull bladder is uncomfortable and may increase their anxiety.

Encourage them to drink fluids between each wee to keep the system flowing smoothly. Relaxing the pelvic floor during urination can also help, as it helps the bladder to empty most effectively. Consider using a footstool to elevate their feet to help with this.

3. Avoid prompting more than 1 hourly.
Although it’s sensible to prevent your child getting an over-full bladder, if you prompt too frequently you are actually risking interfering with their body’s signalling process. If you intercept the sensation of a full bladder, your child has reduced opportunity to develop the body awareness they need to help accept the feeling and do a wee when their body tells them to.

4. Give them choices
If your child is still using nappies, or refuses to wee without a nappy, it’s OK to allow them to use their nappy whenever they need it, as long as they are using it in the bathroom or a designated private space. If they have stopped wearing nappies and are potty training, make sure they only use their nappy when they need to rather than wear it all the time. This will help encourage them to continue building their skills of listening to their body and going to the socially acceptable place (the bathroom). From there you can help them to gently relinquish the need for the nappy using my little steps approach.

5. Build cooperation
When faced with resistance, try to see it as your child’s way of telling you they are anxious or sensorily-triggered and need to feel in control. Doing what you need to do to stay calm and not get worked up is important, as your child will pick up on this! Offer praise and encouragement for any cooperation you see, no matter how small. Avoid bombarding your child with questions and only prompt when necessary to avoid overwhelming them. Allow them to go when they feel comfortable, understanding that you can help them through this, but you cannot make them wee, only provide a supportive environment for them to overcome their fear or sensory triggers.

If you are finding it hard to process this information and put the plan in place yourself, you can request a Private Consultation for you (and any co-parents) to work through these issues with my expert support.