Document 55610

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GUIDELINES
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FOR PARENTS
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,'·::,,"7.b~ ·THE PROBLEM
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What to do a'bout
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frequent daytime urination
By Barton D. Schmitt, MD
lux, or .eveti'j\ ',., '
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disease,l~;Lth ~Some young ~hJ1clrel:su~ldenly devel.op the habIt of
SI'ael 'f'ev~(iP'
," ·JfrequcntdaytIme urmatlOn, They 11l1nate every ten
; be attri~itt}~~~
;,1630 mmutes and as often as 30 to 40 tunes a day .
., ,;~~~ ~rheypass small amounts of m'ine each time. The uriit wori't1b~~·k:ilationh, not painful. These children have been toilet
[email protected]~i: i~ained and do not wet themselves duril1g the day.
~so, w~·h!~i~
~~h.eydo ~ot drink excessive amounts of fluid. The
of conditlohSI',';P.r9blem
dIsappears when they are asleep. The peak
a .os¢di~d~\' W~~fo1'
daytime urinary frequency is 401' 5 years, but
~ar~i~~;W; '_~~,~can
occur as l~te ~s 12 years of age ..
,
gmilestoH~~::f.i.Frequent unnatJon usually reflects the spIllmg
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in those few children \vho also have small bladders'
anel wet the beel.
••
~ ..'::~.t~~~:~?-!~r
of emotional tension,
It simp~y not
means
~our child
;;',r'~~~~'"!,~.¥nderpressure.
The symptom]s
delIberate,
It
i1)S~ally
begins within one or two days of a stressful
::1~~~nt
such as a death or illness in the family, a move
:;Wa new hotise, or the start of kindergarten.
~'Physical canses are rare, but your child should be
':~ed
by a physician. 'The only test that is usually
~eededis a check of the mine ..
;wIJ.f parents worry needlessly
about disease, they
ilUJiy actually increase stress on the child and make
'~I!!~
probkm worse. Punishment, criticism, 01'teasing
It.:
••
W·SibJi~lgR
als.o worsens the sy~np.tom.
,.~aytllne
ul'lnary
frequency
IS,its
]tJ general, a harm:.~'."condition
that goes
away on
own. If the cause
:lhechild's st.reSR is identified and dealt with, the
'1fIptolngenerally stops in one Lofour weeks, WiLhany intervention, it usually disappears spontane-
!r
in two or three months. It may recur, hO\vever,
:0---,:/.
!~_~fvlllT is director'of general consultative services, The
" e~ s Hospital 01 Denver. and professor of pediatrics,
~~;Iy
01 Colorado
School of Medicine,
~~~oard
.. of Contemporary PediatJics .
He is a member of the
THE SOLUTION
The following tips can help your child overcome daytime ulinary frequency:
Reassure your child that hc is physically healthy.
He may fear that something is wrong with his body
because people have been concerned about his frequent urination. 'Tell him that his body is fine, and
reassure him once or h•..
ice that he is in excellent
health. We will do the same,
Reassure your child that she can lem'n to wait longer
to w·inate. Assnre her that she won't .•..
yet herself if
she waits, which is a common fear. If she has wet
herself previously, encourage her to talk about her
embarrassment,
and reassure her that it happens
to many children occasionally. Tell her that she
will graduaJly get back to urinating every two to
three hours, or \vhatever her previous pattern was,
] f frequent urination has been quite stressful for you
and YOllr child during shopping trips or other outings, avoid taking her with yon to public places
temporarily.
Try to idcntify specific st1'esses on YOUI' child. Try
to pinpoint a stressful event 01' situation that may
have occurred one or two days before the urinary frequency began. Ask other family members and school
or day-care staff for ideas. Some common stresses
include:
• a death in the family
OCTOBER 1992
83
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••
FREQUENT URINATiON
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II an
accident or other life-threatening
event
tension in the parents' marriage
&I illness
in a parent, sibling, or other close relative
&I starting
schoo] for the first time, or 'changing to a
new schooJ
.
III
III
excessive
II wetting
worry about staying dry at night
himseJf in theJ}resence of other chiJdren.
If you identify a !1tress, talk to your child about it,
. and try to help him overcome it. If YOlt need help with
this, can our office.
wheJher
his c?ndition
the same ..
is improving
or staYiryg:
;/;1
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Make sure that none of your child's caretakers Of!
teachers are punishing or criticizing him about fr~:
quent urination. Stop all family conversation aboutid
and remind ~iblings not to tease. The less that is said
. I~
the Jess your'child ,\ill worry. If your child brings up.;;
the topic, reassure him that he wil1 gradually getbet-i:
tel' but that it may take a few weeks.
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Help yonr child 'reia;'!; in general. Frequent
urination
can be a barometer of inner tension. Make sure your
chi1c1 has free time and fun time every day. If she is
overschedllled
with activities, try to lighten the load.
Maintainin'g 01' increasing harmony \\ithin YOllr home
will usually help restore your child's sense of security. Enlist the cooperation of school or day-care staff
t.o reduce any tensions there, sllch as restrictions on
the use of the bathroom. Children over 8 years of age
may benefit by learning reJaxation exercises.
Atloid bubble bulh and other irritants. Bubble
similar symptoms. As a further precaution, haveyou/~!
child wash the geni tal area with \vater, not soap~~ !
prior to puberty since young children may besensi~~ 'j
tive to soap ..
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.:·":;:~~~
Call our office during regular hours if:
Ignore frequent nrination.
toilet
mind
you.
watch
When your child uses the
often, don't comment on it. Comments only rehim t.hat the symptom is bothcdng or worrying
Don't ask him about his symptom, and don't
him urinate.
If you have been keeping track of the amount or
frequency
of urination, stop doing it. Don't collect
urine samples 01' measure the amounts, and dou't
time the intervals
bet.ween trips to the bathroom.
Your child does not need to ten you when he has
urinat.ed; you wiJJ have a general impression about
bath,.
can irritate the opening of the urinary tract and cause;
frequent urination in children, especially girls. Tak~:!.
ing a bath in water that cont3ins shampoo can causf •
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Adapted from Schmi!! BO: Your Child's Health ec!2. New York, Bania'!)
Books. Inc .. 199 f.
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This parent information aic! on frequent daytime urir.alion may be ..
photocopiec! arKI distributed 10 parents without permission of the PU,.':.,,"
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84
CONTEMPORARY
PEDIATRICS
M
• Your chiJd's frequency of daytime urination is nO,t; J
back to normal ~fter using this program for ..~.~~,;~
,~
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month ..
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• Urination begins to cause pain or buming .. ':"i~i:'!'
• Your child begins to wet himself during the d?~r~r.
• Your child begins to drink excessive fluids
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&I You have
other questions or concems
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