Urination: Frequency and Urgency

What is frequency of urination during the day?

Daytime frequency of urination occurs most often when a child is 4 to 5 years old. You will notice that:

• Your child suddenly starts urinating every 10 to 30 minutes and as often as 30 to 40 times a day.
• Your child passes small amounts of urine each time.
• Your child has no pain with urination.
• Your child does not wet himself during the day.
• Your child does not drink excessive amounts of fluids.
• Your child has been toilet trained.
• The urinary frequency is not a problem during sleep.

What is the cause?

Frequent urination sometimes reflects emotional tension. It means your child is under pressure. The symptom is involuntary, not deliberate. The urinary frequency may begin within 1 or 2 days of a stressful event or change in the child's routine. You can make the problem worse by worrying about disease. Punishment, criticism, or teasing also worsens the symptom.

Although physical causes are rare, your child should be examined by a healthcare provider. The only test that is usually needed is a check of the urine. No X-rays are needed.

How long will it last?

Overall, this is a harmless condition that eventually goes away by itself. If you can identify and deal with whatever is stressing your child, his frequent urination will disappear in 1 to 4 weeks. Without treatment, the symptom usually gets better on its own in 2 or 3 months.

A few children who also have small bladders and problems with bedwetting may have this symptom more than once.

How can I help my child?

• Reassure your child that he is physically healthy.

  Tell your child that his body, kidneys, urine, and any other aspect of his health that he is worried about are fine. Because the family (and also possibly healthcare providers) have been concerned about the child's bladder and urine, he may fear there is something wrong with his urinary tract. Reassure him once or twice that he is quite healthy.

• Reassure your child that he can learn to wait longer to urinate.

  Reassure him that he won't wet himself, which is a common fear. If he has wet himself before, encourage him to talk about his embarrassment and reassure him it happens sometimes to many children. Tell him that he will gradually get back to urinating every 2 to 3 hours, or whatever his previous pattern was. If his frequency of urination has gotten worse during shopping trips or travel in general, don't take him with you to public places for a while.

• Help your child relax.

  Frequency of urination can be a barometer of inner tension. Make sure your child has free time and fun time every day. If he is over-scheduled with activities, try to lighten the commitments. Relaxation exercises may help your child if he is over 8 years old.

  Increasing the happiness and harmony within your home will usually restore your child's sense of security.

  Ask the staff at your child's school or day care to help reduce any tensions there, such as limits on when a child can use the bathroom.

• Try to figure out what is stressing your child.

  Meet with other family members and try to think of a stressful event that may have occurred 1 or 2 days before the frequency began. Also ask school or day care staff for ideas. Talk about your ideas with your child and try to help him overcome the stress. Common stressful events are:

  • Death in the family
  • Accident or other life-threatening event
  • Tension in the marriage
  • A sick parent or sibling
  • School entry or a new school
  • Too much concern about staying dry at night
  • Wetting himself in the presence of peers.
• Ignore the symptom of frequency.

  When your child is using the toilet frequently, don't comment on it. Comments remind him that the symptom is worrying you. Stop keeping any record of amount or frequency of urination. Do not collect any urine samples or measure volumes. Don't ask your child about his symptom or watch him urinate. Do not have your child do bladder-stretching exercises. Your child does not need to tell you when he has urinated; you will have a general impression about whether he is getting better or staying the same.

  Be sure that none of your child's caretakers or teachers is punishing or criticizing him about this symptom.

  Stop all family conversation about the frequency. The less said about it, the less anxious your child will be about it. If your child brings up the topic, reassure him that he will gradually get better.

• Avoid bubble bath and other irritants.

  Bubble bath can cause frequent urination in children, especially girls. Bubble bath can irritate the opening of the urinary tract. Taking a bath in water that contains hair shampoo can also cause similar symptoms. In addition, before puberty, be sure your child washes the genital area with water, not soap.

When should I call my child's healthcare provider?

Call during office hours if:

• The frequency of urination is not back to normal after you have followed these recommendations for 1 month.
• Your child begins to have pain or burning when urinating.
• Your child begins to wet himself during the day.
• Your child begins to drink excessive amounts of fluids.
• You have other questions or concerns.