What You Should Know About Childhood Bedwetting and Accidents

by Kailie Denham, PT, DPT, of Her Physical Therapy

The number one cause of childhood bedwetting and accidents in children is CONSTIPATION! 

Yes, you heard me, constipation. This may sound strange to you, and you may think it’s an easy fix, but I can tell you from clinical and personal experience, nothing about it is “easy.” 

I believe one of the main reasons constipation is an issue is because pediatricians often tell parents, “Don’t worry about it, they will outgrow it.” This is not only a myth, but it leaves the parents doing nothing until the child is much older. The older the child is, the harder and more work to get the child’s constipation under control. 

There is a lack of education in traditional pediatrics when it comes to how to treat constipation. Typically, the only recommendation for constipation is Mirilax. But I want to tell you about what a pediatric pelvic health physical therapist can offer. 

As a pediatric pelvic health specialist, education is my most important job. Sure, I assess things like core strength, perform manual techniques and even assess the pelvic floor muscles with special equipment, but education is key. Here are some of the red flags of constipation in kids:

Babies: You can start screening for signs of constipation in babies who are formula-fed and when you introduce solid foods. Hard pellets, balls of poop, straining and crying to poop, and not pooping everyday are symptoms of constipation.

Toddlers: You will start to see constipation when you toilet train your toddler! There is an increased risk for constipation in children who are toilet trained younger than 3 years old. Why? Because the neurological pathways for peeing are involuntary until at least 3 years old, after which they become voluntary. In other words, young children who are toilet trained are responding to parents telling them to pee or poop, not to their pee or poop centers in the brain.

Pre-teens and teens: At this age, a red flag that your child is constipated is that they are continuing to wet the bed. There maybe other signs like they clog the toilet every time they poop. We call these “soup can poops,” because these poops are the diameter of a soup can. When the poop becomes this size, constipation has been going on for quite a while. Another red flag is your child may have chronic bladder infections or pee ALL THE TIME.