It's not necessary or even healthy to be overly focused on what comes out of your child's body. But being alert to the urinary symptoms outlined here can ensure that if there is a problem, your child will get the treatment he needs. Most urinary problems are easily fixed if they are identified early.
Even after your preschooler learns to use the toilet and stays dry all day, usually between ages 2 and 4, she may still wet the bed at night at least once in a while. Until the age of 6 or 7 this is normal and not important. After this age, bedwetting is still normal, but it can be upsetting to your child and keep her from enjoying social activities such as overnights and sleepovers.
Never, ever punish or criticize your child for wetting the bed. It is not intentional and not under his control. Often the age at which nighttime dryness begins runs in families; fathers who wet until age 10, for example, may have sons who do the same thing. A variety of techniques can be used to address this problem. Talk it over with your health care provider if you have a child over 6 who wets at night.
When Is It an Infection?
Urinary tract problems often go undetected or are discovered after they fester a while. But there are some telltale signs to look for. If your child suddenly needs to urinate more frequently (every five minutes, say) but produces only a small amount of urine each time, look for other symptoms. If the change to frequent urination is accompanied by pain, fever, or foul smell, she may have a urinary infection. But increased frequency of urination without pain or other symptoms also may be a response to anxiety or stress and not an infection at all.
To complicate things, abdominal pain or unexplained fever may be signs of a urinary infection even without frequent urination, though not all children with infections run a fever. Consult your pediatrician, who will check for infection with a urinalysis.
Girls Get More Infections
Urinary tract infections are more common in girls than in boys because the opening of the urethra, the tube leading from the bladder to the outside, is short and close to the anus. Bacteria can easily enter the bladder. Be especially careful if Mom has had frequent bladder infections, as this susceptibility can run in families. There are some precautions you can take to minimize the risk of a urinary infection:
When to Worry
Alert your pediatrician if a child who seldom or never wets at night begins to do it often. This could be a sign of urinary infection, or it could signal diabetes, kidney disease, or constipation. Similarly, when a child who has been dry during the day begins to have daytime wetting, there is almost always a physical reason. It may be as simple as your child holding urine too long because he doesn't want to use the bathroom at preschool, or it can be an infection or other bladder problem. Any change requires some detective work and maybe a checkup.
How It Flows
Watch your child's urine stream, especially if you have a boy. A nice, strong flow that arcs well away from the body is normal in boys. A weak, dribbling stream, or the constant release of small amounts of urine that leave underwear or diapers perpetually damp, can signal an abnormality of the urinary tract. If a child has to strain to urinate or has a hard time starting, let your healthcare provider know; there may be a problem with the urinary tract.
Color and Odor
If your child's urine is pink or cola-colored or is very dark or smells unusual, bring it to your health care provider's attention right away. Kidney or liver problems may be the cause, and this needs immediate investigation. Early treatment may avoid kidney damage.