when to be concerned about frequent urination

in this article:

• What are the common causes of frequent urination?
• How do I know if my child has a urinary tract or bladder infection?
• What can I do to prevent and treat urinary tract or bladder infections?
• When should I seek medical attention for my child?

Does your child have painful or frequent urination? How can you tell if your child has a urinary tract infection, bladder infection or something more serious? We asked Donald Nguyen, MD, pediatric urologist, to help us understand the common causes of frequent urination and when to seek medical attention for your child.

what are the common causes of frequent urination?

Frequent urination, or peeing eight or more times during waking hours, is common in children 5 years of age or older. Causes can include:

1. Dysfunctional voiding - when the child holds urine and does not obey the bladder's signal to urinate.
2. Infection of the bladder - when the wall is inflamed and irritated, and painful with urination.
3. Constipation with a large stool impacted in the rectum and colon.
4. Frequency syndrome - a non-threatening condition that comes and goes, making a child feel like they need to urinate when they physically don't have to.
5. Diabetes - the kidneys can make excessive amounts of urine in patients with diabetes.

how do I know if my child has a urinary tract or bladder infection?

urinary tract infections

Urinary tract infections (UTIs) are common in kids. UTIs may affect any part of the urinary tract, from the bladder to the kidneys. Most UTIs happen when bacteria infect the urinary tract. Bacteria aren't normally found in pee, but they can easily enter the urinary tract from the skin around the anus. UTIs are more common in females. UTI symptoms can include:

• Pain while peeing
• Frequent and/or urgent urination
• Low back pain or abdominal pain around the bladder
• Fever
• Foul-smelling urine that may look cloudy or contain blood

When UTIs are accompanied by fever, back or abdominal pain, and looking weak, then it might be a kidney infection.

bladder infection (cystitis)

Cystitis is the inflammation of the bladder, also known as a bladder infection. It's the most common type of urinary tract infection. It mostly affects children and adult women. Cystitis is usually caused by bacteria (typically E. coli) that enters the body through the urethra and spread to the bladder. If not treated, the infection can travel to the kidneys and become a more serious problem. Bladder infection symptoms include:

• A persistent urge to pee
• Frequent urination
• A painful sensation when peeing
• Cloudy or strong-smelling urine
• A feeling of pressure or pain in the lower abdomen

what can I do to prevent and treat urinary tract and bladder infections?

Prevention for UTIs and bladder infections follow the same guidance.

• Change infants' diapers frequently.
• Encourage your child to practice good hygiene after being potty trained.
• Remind girls to wipe from front to back after urination.
• Instruct your child not to "hold it" when they have to pee. If urine stays in the bladder, it gives bacteria a good place to grow.
• Schedule "timed voiding" and encourage your child to pee every two hours.

UTIs are very treatable, but it's important to catch them early. Untreated UTIs and febrile UTIs can lead to kidney damage, especially in kids younger than one year of age. Most UTIs are cured within a week with the right medical treatment. 

Bacterial infections are treated with antibiotics. The length of treatment depends on how bad the infection is. It's important to take every dose of antibiotics on time and finish all the doses. The infection could come back if your child stops taking the antibiotics too soon.

Kidney infections are more serious than bladder infections and sometimes require IV antibiotic treatment in the hospital.

when should I seek medical attention for my child?

Not all painful and frequent urination is caused by a UTI or bladder infection. Sometimes, frequent urination can point to a more serious health concern. If your child is experiencing any of the following symptoms combined with frequent urination, call your child's primary care provider.

• Increased thirst/hunger
• Fatigue, looking lethargic
• Vomiting
• Visible blood in urine
• Fever

If it is recommended that your child be seen by a specialist in urology, you can schedule an appointment online.