Frequent Urination in Children

Symptoms of Childhood Illnesses

Boy Standing by Toilet
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Frequent urination is a confusing symptom for many parents.

Frequent Urination

It is easy to know to go to the doctor if your child also has a fever or is complaining of pain or burning with urination, but when your child is simply urinating a lot, is that always a problem?

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

At this visit, a physical exam and urinalysis can help to rule out most common causes of frequent urination.

A detailed history of your child's bladder and bowel habits can also be helpful.

  • 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?

These are some of the questions that can help your pediatrician differentiate between the different causes of frequent urination.

Diabetes Mellitus

Juvenile Diabetes or Type I Diabetes is 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), and are likely to also be drinking a lot (polydipsia) and 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 and a high blood sugar.

UTIs

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, are having accidents, and may 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

Also called frequent daytime urination syndrome, this is a common, although not a very well known cause of frequent urination in young children. Most common between the ages of 4 and 6 years, these children begin urinating small amounts of urine about 10 to 30 times each day. They may also wake up at night to urinate, although not as often, but they 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 causeĀ of frequent urination and can either be caused by a lack of antidiuretic hormone (ADH), which is called central diabetes insipidus, or by nephrogenic diabetes insipidus, where the kidneys don't respond to ADH. Either way, the result is that the kidneys can't conserve water, make a lot of extra urine, and the child gets very thirsty.

What To Know About Frequent Urination

Other things to consider when a child has frequent urination might include:

  • that they are getting too much fluid intake (although don't confuse this with diabetes)
  • constipation, as it is often linked to frequent urination
  • having a voiding dysfunction, in which 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 2-3 hours.
  • vulvovaginitis or inflammation around the vaginal area in young girls, which might be caused by not wiping correctly or taking bubble baths
  • meatitis or inflammation of the meatus or opening of the penis

A pediatric urologist and/or nephrologist can also be helpful if your child has frequent urination. Take this quiz if you're concerned your child's symptoms may be related to diabetes.

Sources

Kliegman: Nelson Textbook of Pediatrics, 18th ed.

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