Some young children suddenly develop the habit of frequent daytime urination. They urinate every ten to 30 minutes and as often as 30 to 40 times a day. They pass small amounts of urine each time. The urination is not painful. These children have been toilet trained and do not wet themselves during the day. They do not drink excessive amounts of fluid. The problem disappears when they are asleep. The peak age for daytime urinary frequency is 4 or 5 years, but it can occur as late as 12 years of age.

Frequent urination usually reflects the spilling over of emotional tension. It simply means your child is under pressure. The symptom is not deliberate. It usually begins within one or two days of a stressful event such as a death or illness in the family, a move to a new house, or the start of kindergarten. Physical causes are rare, but your child should be examined by a physician. The only test that is usually needed is a check of the urine.

If parents worry needlessly about disease, they may actually increase stress on the child and make the problem worse. Punishment, criticism, or teasing by siblings also worsens the symptom.

Daytime urinary frequency is, in general, a harmless condition that goes away on its own. If the cause of the child's stress is identified and dealt with, the symptom generally stops in one to four weeks. Without any intervention, it usually disappears spontaneously in two or three months. It may recur, however, in those few children who also have small bladders and wet the bed.

The following tips can help your child overcome day-time urinary frequency:

• Reassure your child that he is physically healthy. He may fear that something is wrong with his body because people have been concerned about his frequent urination. Tell him that his body is fine, and reassure him once or twice that he is in excellent health. We will do the same.
• Reassure your child that she can learn to wait longer to urinate. Assure her that she won't wet herself if she waits, which is a common fear. If she has wet herself previously, encourage her to talk about her embarrassment, and reassure her that it happens to many children occasionally. Tell her that she will gradually get back to urinating every two to three hours, or whatever her previous pattern was. If frequent urination has been quite stressful for you and your child during shopping trips or other outings, avoid taking her with you to public places temporarily.
• Try to identify specific stresses on your child. Try to pinpoint a stressful event or situation that may have occurred one or two days before the urinary frequency began. Ask other family members and school or day-care staff for ideas. Some common stresses include:
  
  • a death in the family
  • an accident or other life-threatening event
  • tension in the parents' marriage
  • illness in a parent, sibling, or other close relative
  • starting school for the first time, or changing to a new school
  • excessive worry about staying dry at night
  • wetting himself in the presence of other children.
• If you identify a stress, talk to your child about it, and try to help him overcome it. Help your child relax in general. Frequent urination can be a barometer of inner tension. Make sure your child has free time and fun time every day. If she is over scheduled with activities, try to lighten the load.
• Maintaining or increasing harmony within your home will usually help restore your child's sense of security. Enlist the cooperation of school or day-care staff to reduce any tensions there, such as restrictions on the use of the bathroom. Children over 8 years of age may benefit by learning relaxation exercises.
• Ignore frequent urination. When your child uses the toilet often, don't comment on it. Comments only remind him that the symptom is bothering or worrying you. Don't ask him about his symptom, and don't watch him urinate.
• If you have been keeping track of the amount or frequency of urination, stop doing it. Don't collect urine samples or measure the amounts, and don't time the intervals between trips to the bathroom. Your child does not need to tell you when he has urinated; you will have a general impression about whether his condition is improving or staying the same.
• Make sure that none of your child's caretakers or teachers are punishing or criticizing him about frequent urination. Stop all family conversation about it, and remind siblings not to tease. The less that is said, the less your child will worry. If your child brings up the topic, reassure him that he will gradually get better but that it may take a few weeks.
• Avoid bubble bath and other irritants. Bubble bath can irritate the opening of the urinary tract and cause frequent urination in children, especially girls. Taking a bath in water that contains shampoo can cause similar symptoms. As a further precaution, have your child wash the genital area with water, not soap, prior to puberty since young children may be sensitive to soap.

Call our office during regular hours if:

• Your child's frequency of daytime urination is not back to normal after using this program for one month.
• Urination begins to cause pain or burning.
• Your child begins to wet himself during the day.
• Your child begins to drink excessive fluids.
• You have other questions or concerns.