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    Frequency-Urgency Syndrome

    Updated at February 20th, 2022

    Definition

    • New onset of passing urine often while awake
    • This is called urinary frequency
    • Mainly occurs in 4 to 6 year olds

    Health Information

    Symptoms

    • Your child suddenly starts passing urine every 10 to 30 minutes. May pass urine as often as 30 to 40 times a day. Used to go every 2 to 4 hours.
    • 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 is not drinking more than normal.
    • Your child has been toilet trained.
    • The symptom goes away during sleep.

    Cause

    • Usually, passing urine often is from inner tension. It means your child is worried about something. Sometimes, he is simply worried about the risk of wetting himself.
    • The symptom may begin within 1 or 2 days of a stressful event. A change in routine may also be a cause.
    • Passing urine often is not deliberate. Do not punish, criticize or tease your child. This is unfair and will worsen the symptom.
    • Although physical causes are rare, a urine sample needs to be checked.

    Care Advice

    1. Overview:
      • Urine frequency can happen if a child thinks too much about peeing. The bladder then starts sending a signal of fullness before it is full.
      • The symptom is harmless and will go away on its own.
      • But, needing to find a toilet frequently and quickly can disrupt normal routines.
      • Here is some care advice that should help.
    2. Tell Your Child that He is Healthy:
      • Tell your child that his body, kidneys and urine are fine.
      • Checking the urine once is a good idea. Checking his urine again and again can make him worry more.
    3. Tell Your Child that He can Learn to Wait Longer to Pass Urine:
      • Promise that he will slowly get back to urinating every few hours, like before.
      • Tell him that he won’t wet himself, which is a common fear.
      • If he has wet himself, tell him that can happen to anyone.
    4. Help Your Child Relax:
      • Frequency of urination can be a reflection of inner tension.
      • Make sure your child has free time and fun time every day.
      • Increase the harmony within your home. This may make your child feel more secure.
      • Ask the school staff to help reduce any tensions there. Remove any limits on when a child can use the bathroom.
    5. Look at Stressors for Your Child:
      • Try to figure out what is stressing your child. Common stressful events are:
      • School entry or a new school
      • Too much concern about staying dry at night
      • Wetting himself when peers are present
      • A sick parent or sibling
      • Talk about any stresses with your child and try to help him overcome them.
    6. Ignore the Symptom of Frequency:
      • When your child is using the toilet often, don’t comment on it. Comments make him worry more about the symptom.
      • Don’t ask your child about his symptom or watch him pass urine.
      • 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 idea about whether he is getting better or not.
      • Stop all family from talking about the problem if your child is around.
      • If he brings up the topic, reassure him that he will slowly get better.
    7. 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.
      • Before puberty, be sure your child washes the genital area with water, not soap.
    8. What to Expect:
      • Your job is to identify any stressors for your child. Help your child cope with it. If you can do this, his frequency will go away in 1 to 2 weeks.
      • Without treatment, the symptom usually gets better on its own in 2 or 3 months.

    Call Your Doctor If

    • Frequency of urination is not back to normal after using this advice for 1 month
    • Pain or burning when passing urine
    • Wetting during the day
    • Drinking more than normal amounts of fluid
    • You think your child needs to be seen
    • Your child becomes worse

    Author: Barton Schmitt MD, FAAP

    Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

    Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

    #AAP