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Bedwetting: Five Things Your Pediatrician May Not Share
by Tara Galles, MS, OTR
An estimated five to seven million children in the United States experience bathroom accidents [source]. While most children outgrow bedwetting by ages five to seven, bedwetting remains a problem for many older children.
Research shows there’s a 70% chance a child who wets the bed at age nine will wet the bed at 19, and 32% of these tweens and teens also have daytime accidents [source].
In severe cases, daytime accidents are both bladder and bowel related.
An estimated five to seven million children in the United States experience bathroom accidents [source]. While most children outgrow bedwetting by ages five to seven, bedwetting remains a problem for many older children.
Research shows there’s a 70% chance a child who wets the bed at age nine will wet the bed at 19, and 32% of these tweens and teens also have daytime accidents [source].
In severe cases, daytime accidents are both bladder and bowel related.
While pediatricians understand the physical dysfunctions that lead to accidents, The American Academy of Pediatricians (AAP) does not use a standardized approach to treating bedwetting. This can leave parents without the necessary information to help their child take CONTROL! of their bladder and/or bowel health.
The following information may surprise you, but it’s information you should know.
Bedwetting is not emotional or behavioral
Loss of urine or feces is almost never due to laziness, a strong will, anxiety, or other emotional problems. Children and adolescents who have accidents are often unfairly blamed and shamed by unknowing parents and even healthcare professionals who believe the peeing and pooping are a behavioral issue. No amount of bribery, sticker charts, or positive reinforcement will stop bedwetting because it is physically out of the child’s control.
The “Deep Sleep” theory is scientifically inconclusive
Medical theories of “deep sleep” are inconclusive [source] [source],explaining why bedwetting alarms may reduce incidences of bedwetting, but are essentially ineffective to cure the physical problem [source], not to mention they woefully disturb everyone’s sleep! Moreover the “deep sleep” theory can benevolently slide the blame onto parents by mentioning inconsistent bedtimes or not enough sleep, which too are not scientifically validated explanations.
Rectum size coorelates with bedwetting
Rsearch also shows that children and adolescents who experience bowel and bladder voiding accidents have abnormal rectal distention with a rectal diameter around 6–7 cm wide, and delayed or disturbed pelvic floor muscle coordination [source]. While the child may have daily bowel movements, they are still retaining fecal matter that creates a condition called megarectum. A megarectum impairs the coordination of the pelvic floor muscles so the child’s urethral function is disturbed or delayed and unable to contract with enough power or speed to stay dry. Megarectum also takes up necessary space in the pelvis that the bladder needs to fill during sleep, so the urine leaks out onto the sheets or pullup.
Bedwetting is a dysfunction of muscular coordination
For any muscle of the body to work effectively, it must first have the neurological ability to feel. Once the muscle feels a neurological impulse, it can then develop the coordination to respond to a sensation appropriately. The muscles and nerves of the urogenital nervous system typically mature around ages three to five [source]. Unlike other systems of the body, the urogenital system functions under conscious and unconscious control. So, while a child, tween, or teen may reliably feel and control bowel or bladder urges when awake, their autonomic nervous system (unconscious control) has not reliably coordinated function with the motor nervous system (conscious control) to stay dry at night [source]. Moreover, the muscles of the pelvic region become overregulated and are typically very tight which makes coordination even more difficult and toileting often becomes a painful experience.
Pelvic floor therapy is an effective treatment option
If a child over the age of five is having accidents it is because they have a delay in developing the necessary nervous system reflexive control functions necessary to stay dry [source]. Pelvic floor therapy specializes in developing the necessary neuromuscular control functions of the urogenital systems so your child can become independent in their personal hygiene. Studies show four months of therapy to be up to 86% effective in helping children develop the neccessary neuromuscular control to prevent bowel and bladder accidents [source].
In Conclusion
Enuresis and encopresis, peeing and pooping accidents, destroy the lives of children. It’s disheartening to hear the experiences of kids who are ridiculed and bullied at school or even at home. Families have a difficult time planning vacations, sleepovers, camping trips. Spending the night with grandma and other relatives is often out of the question. Some teens even delay their college plans because their bladder function is not reliable to live in a dorm.
Bowel and bladder accidents may come and go but may never completely go away without appropriate intervention [source].
You’re In CONTROL! specializes in helping boys and girls seven and older take CONTROL! of their bodies by developing the necessary pelvic floor muscle control for bowel and bladder health.
If your child is experiencing daytime or nighttime accidents, decide to take CONTROL! Talk to your pediatrician about therapy and make an appointment today.
Tara Galles, MS, OTR
Tara Galles, MS, OTR, is owner of You’re in CONTROL! With over 20 years of clinical experience she compassionately moves each woman to take CONTROL! of their body and rehabilitates them to feel like a natural woman again. As a mother of four children she also understands what it’s like to be a pelvic rehab patient. You may contact Tara about your pelvic issue at (765) 319-8420, or make an appointment using the button at the top of the page.