Why Is My Child Urinating All the Time?

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It can be easy to identify when your child has to go to the doctor, like when he has a fever or is complaining of pain or burning with urination, but could there be a problem when your child is simply urinating a lot? 

Frequent urination is defined by the International Children's Continence Society as urinating eight or more times during waking hours in a child 5 years of age or older.

While it is not always a serious problem, it isn't always quite normal either, so even without other symptoms, children with frequent urination should have a visit with their pediatrician.

Seeing Your Pediatrician for Frequent Urination

To be best prepared, it's wise to have a detailed history of your child's bladder and bowel habits written down or stored away in your brain. Questions that your pediatrician will likely ask in order to tease apart the various causes of frequent urination include:

  • Is your child urinating frequently and also urinating large amounts each time?
  • Is he waking up several times at night to urinate?
  • Is your child having accidents after being potty trained?
  • Does your child have the feeling of needing to urinate frequently, but then doesn't actually have to go?

In addition to going through your child's habits, your pediatrician will also perform a physical exam and urinalysis to rule out certain causes of frequent urination like an infection or diabetes mellitus.

Why Is My Child Urinating a Lot?

There are a number of reasons why your child may be urinating a lot.

Some are more obvious than others, like if your child is urinating a lot because he is drinking voluminous amounts of liquids, even though he is not thirsty, more out of habit than a need.

Also, you may be surprised to learn that constipation can be linked to frequent urination.

Here are some other potential reasons for frequent urination in your child: 

Voiding Dysfunction

With voiding dysfunction, children don't take the time to empty their bladder because they are in too big of a hurry to get back to playing. (This usually causes incontinence.) If you suspect this, encourage your child to fully empty his bladder each time he goes to the bathroom and put him on a schedule of voiding every two to three hours.

Vulvovaginitis or Balanitis

Another consideration is inflammation around the vaginal area in girls (called vulvovaginitis). This might be caused by not wiping correctly or taking bubble baths. In addition, balanitis, or inflammation of the meatus or opening of the penis, may occur in boys.

Diabetes Mellitus

Juvenile Diabetes or Type I Diabetes are among the medical conditions that many parents have in the back of their mind when they bring their child to their doctor with frequent urination.

Unlike other many other conditions that cause frequent urination, children with diabetes urinate large amounts each time (polyuria), are likely to also be drinking a lot (polydipsia), and are often losing weight, which are the classic symptoms of diabetes. Testing for diabetes will likely include a urinalysis that will show sugar or glucose and/or ketones.

Urinary Tract Infection

Children with urinary tract infections often urinate more frequently, but they also often have other symptoms, such as pain and burning with urination (dysuria), cloudy or bloody urine, fever and accidents. They may also have back pain, nausea, and/or feel like they have to urinate all of the sudden (urgency). A urinalysis and urine culture are important tests to evaluate children with urinary tract infection symptoms.

Pollakiuria

Pollakiuria, also called frequent daytime urination syndrome, is common although not a very well-known cause of frequent urination in young children.

Most common between the ages of four and six years, these children begin urinating small amounts of urine about 10 times to 30 times each day. They might also wake up at night to urinate. With this diagnosis, your child should have no other symptoms and a normal urinalysis.

Although sometimes related to stress, no specific trigger is found for many children with pollakiuria and it often goes away in a few weeks or months without any treatment.

Diabetes Insipidus

Diabetes insipidus (DI) is a rarer cause of frequent urination and can be caused by either a lack of antidiuretic hormone (ADH), which is called central diabetes insipidus or by nephrogenic diabetes insipidus in which the kidneys don't respond to ADH.

ADH is a hormone that allows the kidneys to absorb water, so without a response to it or a deficiency in it, the kidneys can't conserve water. This causes the body to lose water and the child gets very thirsty. 

A Word From Verywell

These are just some of the potential reasons for why your child may be urinating often. Remember, though, that there are many causes for frequent urination, so it's worth having your child checked out by your pediatrician. 

If your pediatrician is not able to discern the cause of your child's frequent urination, or if she suspects a condition that requires a more thorough evaluation by a specialist, you will be referred to either a pediatric urologist (a doctor who specializes in treating the urinary tract disorders) and/or a pediatric nephrologist (a doctor who specializes in treating kidney disorders). 

Sources

  • Austin PF et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. J Urol. 2014 Jun;191(6):1863-65.e13.
  • Kliegman: Nelson Textbook of Pediatrics, 18th ed.
  • Nepple KG, Cooper CS. (May 2017). Etiology and clinical features of bladder dysfunction in children. In: UpToDate, Baskin LS (Ed), UpToDate, Waltham, MA.

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