4-Year-old Refuses to Use Potty, Will Hold It in All Day When Wearing Underwear

I would rule out a physical issue as well.
Two other suggestions: Put underpants on and pull up OVER them. Mess contained for you, uncomfortable wet feeling for her. Or have you tried having her clean up the mess? Stool to the sink, rinse out the underpants herself. Be very matter of fact, "you made the mess, you clean it up". Took my son doing this maybe three times and he stopped pooping his pants. But since she is holding it, maybe have her rinse out the Pull Up when she messes in it.
Good Luck! this is a tough one!

This site is for potty training refusers like your daughter -
http://www.rogerknapp.com/medical/pottytrainingrefusals.htm

Read through the info, there's even a plan to move her from going on herself in her pullup to going on the toilet.

Both of my kids used to hold it all day long. For my daughter at a little older than 3, I picked a day when I knew she was ready to burst and I told her she couldn't leave the kitchen until she went in the potty. I told her that I was out of pull ups, I didn't want to have to clean up pee on the carpet, so she would have to stay in the kitchen where we had an easy care floor. She just stared at me for a few minutes. When she asked to play with a toy, "sorry honey, I can't risk you peeing on the floor." Finally she said loudly, "fine!, dragged her potty into the kitchen, slammed it down, sat on it, peed, and said, "I did it!" We called daddy at work and grandma and anyone else that would give her lots of encouragement, and then she got to have her tasty cake reward (Letting her pick the rewards really does help). After that she was trained.

For my son, I again waited until he was filled to the brim, held him on the potty while he went (and he was NOT happy about it), and then it was like the light bulb went off and he got it. I know you said that she has felt it come out, but that could be a fluke. They have to be bursting to get that feeling.

Letting her pick the reward is one of the biggest things. Each of mine was motivated by something different. A neighbor's kid just wanted to ride on our light rail train. So every time he went they took a 5 min ride. She also took him to the pool and had the life guard tell him he couldn't swim until he went. That seemed to work.

Standing is an issue. To this day, my son, age 6, will not sit to poop. We have it now where he stands over the toilet, but that is a whole other issue. She probably needs to either push off of something, or she is afraid of falling into the toilet (his issue). With my daughter, she had bonded with the poop and didn't want to see it flushed down. I had to make up this silly story about sending it to a poopy party in the sea. Silly, but it worked. Have you told her that she can't go to school until the pull ups are gone?

Good luck. I trained my nephew at age 4 in only a day. If all else fails, send her to a relative or friend's house and you will be amazed at how easily she trains without you around.

I would sit her on her potty seat at regular intervals and run water while she sits there. If she's been holding it, the sound of the running water will give her no choice but to go.

I would also toss out the diapers. She gets to choose which potty to use, but not whether or not to use a potty so she still does have some control in this.

Have you talked to your pediatrician to see if there is an actual physical issue? Does she have any sensory issues that might be in her way? This doesn't seem like typical behavior so you may need to look beyond "refusing" and into her possibly having an issue that makes it difficult.

Friend's daughter did the same thing. They threw out the diapers and gave her no choice. Potty or pee on herself. She was also a very strong willed 4 yr old. They said that after a little while, she got over it and has been almost accident-free since.

I would also make it a point to sit her on the potty (as a matter of course) every AM, before and after meals, and before bed or bath. Just "this is what we do, regardless of what comes out". We tell DD we are all checking for "sneaky pee" and everyone uses the toilet before we head out somewhere. It kind of takes the fight out of it. It's just a thing vs "something I can control".

If she doesn't like to sit, consider a toilet seat or a stool where she can put her feet on a surface so they aren't dangling.

I'd also give her other choices. If she wants to make a choice, does she want to potty before or after her bath? Does she want the purple toothbrush or the green one? Does she want a ponytail or pigtails? Give her something else to control.

at 4... I would be done with pull ups.. she can hold it.. she can be trained. she is stubborn.. she is refusing.

ditch the pullups.. tell her she is a big girl.. school starts soon.. big girls do not wear diapers... offer a big reward.. and go from there..

bet she wont like the feeling of pee running down her legs.. plan to stay home for a couple of days to get past this... also offer lots of drinks to help her pee a lot.

she just has to use the potty several times to get over the fear.

Do not give her the pull up!!!!!! She knows you will give in so why use the potty. Ditch the pull ups.

I have no real experience here. Just an idea. I'd wait until summer and dump the pull ups. When she gets upset and wants one you are just sorry and sympathetic because there are none. Tell her to run to the potty and sit down. After a few accidents maybe she will give the toilet a try. It could be a messy week or two with lots of laundry, but I would remain sympathetic with a mantra..... "Oh sorry honey, but we just don't have anymore pull-ups. If you would like to try the potty that might help. What do you want to do?"