Urinary Frequency Syndrome - Two Peds in a Pod®

pee The grand finale… the music blares, a giant grey mouse dances on the stage, and six full tables of kids look on a
s six children wearing sparkling birthday hats simultaneously lean over, puff out their cheeks and blow out candles on six birthday cakes. Immediately after blowing out the candles, your five-year-old birthday boy (at table number three) runs over and says, “Mommy, I have to go to the potty.” You break off your applause to run him to the bathroom where he tinkles a few drops into the toilet. Five minutes later he asks to go again. Fifteen minutes he asks again. By the time you leave, he has asked to pee three more times.

This potty scenario repeats itself later at his older sister’s soccer game and you spend the entire game running him back and forth across two soccer fields in order reach the bathroom. Oddly, he later sits through a movie without interruptions. And despite his urge to urinate frequently during the day, he sleeps through the night and does not wet the bed.

Welcome to urinary frequency syndrome. A couple years after a child potty trains, some kids “over sense” the need to pee and need to be re-taught. In other words, you are back to potty training. But don’t panic, retraining can take only a few days. After your child’s doctor rules out other causes of frequent urination such as urinary tract infections (usually associated with other symptoms such as pain on urination and sometimes fever) or diabetes (symptoms don’t stop overnight and the amount of urine produced is greater than normal), start retraining.

You probably restricted your child’s liquid intake in order to prevent him from urinating too often. Now do the opposite: hydrate him so well that he re-learns the sensation of a full bladder. Have your child fill up his bladder and hold the urine in for half an hour. Just like when he was younger, start by walking him to the potty at the half hour mark and have him try to urinate whether he needs to or not. Fill up his bladder after each void and continue to increase increments between potty visits until he is voiding a healthy 4-6 times a day.

Sometimes stress triggers urinary frequency. Common times for urinary frequency include the beginning of a school year, a change in teachers part way through the school year, a birthday party or vacation. Stress magnifies the worry in a child’s mind that he will have an accident. We have written many school notes asking teachers to allow a child unrestricted access to the bathroom. The child’s need for “potty checking” will dissipate if his bathroom trips are ignored and the child gains confidence that he will not have an accident. Be patient – it can take a few weeks for your child to regain confidence.

Make sure he is not constipated. A distended colon full of stool will sit on top of the bladder causing the bladder to send confusing messages to the brain.

Now, the next time you visit the big grey mouse, maybe you’ll spend more time in the restaurant rather than in the bathroom.

Naline Lai, MD with Julie Kardos, MD