Bed-wetting is fairly common in children over the age of 3. The usual refrain is: "Don't worry, he'll grow out of it." However, mounting evidence has shown that constipation may be playing a stronger role than previously thought. Even when children don't appear to be constipated, treatment for constipation has shown to hasten the resolution of bed-wetting in some children.

Bed-wetting can take its toll on children and parents. While most parents understand that with time, most bed-wetting will resolve -- but as children age, the waiting game can be frustrating.

Causes of bed-wetting

While bed-wetting occurs in up to 15 percent of children ages 5 and older, it typically resolves on its own in 85 percent of the children affected. Time is indeed often the best treatment.

Most children who wet the bed are simply genetically inclined to, with a close relative who did. Furthermore, these children are thought to have smaller bladders than their peers, produce more urine at night, and are dubbed heavy sleepers. This combination of factors often leads to nighttime wetting.

In some children, obstructive sleep apnea or constipation may be playing a key role.

What does constipation have to do with it?

A recent (albeit small) study in the Journal of Urology revealed a significant link between constipation and persistent bed-wetting in children. Once these children were aggressively treated with the laxative Miralax, 83 percent of the children had resolution of their bed-wetting within 3 months.

Excess stool in a child's rectum can push on a child's bladder, limiting its capacity and interfering with bladder control, particularly at night.

Is my child constipated?

On routine questioning, some parents may be unaware that their child is truly constipated. However, here are some clues: having bowel movements less than 3 times per week, producing hard, dry, large and painful stools. This is often the most telltale sign in children. It hurts and these poor children will often sit on the toilet for over 15 minutes trying to pass a stool. Withholding then becomes a big problem and can further exacerbate a vicious cycle.

Treating constipation

Fiber and water are your child's best friend. Whole grains, fruits and vegetables combined with plenty of water will get your little one on the right track. However, I know how children can be…a little daily prune juice either alone or mixed in a smoothie can work wonders. Fiber gummies can also aid in getting their daily fiber dose, and laxatives such as milk of magnesia may be needed at times to really break a bad cycle.

Dr. Mom's bottom line^Bed-wetting is multifactorial and often, time is really on our side. However, ruling out and treating underlying constipation is an important step not to be overlooked. If your child wets the bed, pay close attention to her bowel habits. Taking constipation out of the equation may hasten the resolution of her nighttime wetting.

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