Urinary frequency is defined as voiding more often than typical for an individual and out of proportion to the amount of liquid taken in. This may be indicative of underlying pathology or simply a reflection of a child's inadequate toilet hygiene. Basic lab testing in a pediatrician's office can reveal or rule out the cause.
Urinary Tract Infections
Referred to as a urinary tract infection or UTI, bacteria in the urethra are a common cause of frequency. The urinary system consists of the urethra, bladder, ureters and kidneys--listed in ascending anatomical order. The infection is often accompanied by burning during urination and possibly, fever. Recurrence may indicate an anatomical abnormality causing urine to reflux and not empty properly. Antibiotics will be needed to kill the bacteria.
Vaginitis
The female anatomy lends itself to becoming easily irritated as vaginal mucosa are exposed to soaps, bubble baths and perfumed products. Another frequent irritant is stool, especially among young girls recently potty trained. Girls must be instructed to wipe from front to back to avoid sweeping stool and debris forward. Treatment consists of sitz baths of very warm bath water with one-fourth cup of baking soda filled to thigh level for 10 minute soaks three times per day to promote cleansing and decreased irritation.
Voiding Dysfunction
Parents often worry that there is a problem with a child's bladder in regard to frequent bathroom breaks. This may be a valid concern. Children may experience frequency and even incontinence due to a small bladder volume, incomplete voiding or an inability to voluntarily control bladder contractions that initiate the urge to urinate. The ability to "hold it" is based on development of nerves that control bladder contraction and comes generally by age 5. Because of its variability in nature, treatment must be geared toward the problem, but may consist of medications, biofeedback training or scheduled bathroom breaks every two hours, according to "The Nelson Textbook of Pediatrics."
Diabetes Mellitus
One genuine concern expressed by parents is the possibility of diabetes as a cause for increased urination. Though frequency is a symptom of diabetes mellitus and incidences of Type II childhood diabetes are rising, urinary frequency is not often the sole presentation for diabetes in children. Associated signs and symptoms will alert a physician to pursue further testing, if needed.
The Doctor's Visit
In preparation for your appointment, note your child's daily fluid intake. Does your child seem to be struggling to "hold it" all of a sudden as if the urge came quickly? Is there burning with urination or itching? Does he or she have associated symptoms of fever or fatigue? Be sure to ask staff for a urine collection cup if your child needs to urinate in the office prior to being seen. An in-office urinalysis may give preliminary results regarding infection. A urine culture, however, should be performed for the definitive answer with results available within 48 hours.
References
- Urologic Diseases in America
- Kliegman: Nelson Textbook of Pediatrics, 18th ed.; Chapter 543 - Voiding Dysfunction
