The child urinates little during illness. Why a baby pees a little and what to do about it: causes of rare urination, treatment options. Rare urination in a child: where to look for causes

Does the child rarely go to the toilet in a small way? This phenomenon occurs in children of all ages. Often, the phenomenon can be eliminated after a slight adjustment in lifestyle and nutrition. But it happens that rare urination becomes a sign of a serious illness. In what cases can the phenomenon be considered the norm, and when does it indicate a pathology of the urinary system? What can parents do?

The rate of urination in a child per day

Before raising a panic, parents should find out: what can be considered the daily rate of urine output for a child.

The authoritative pediatrician A. Papayan, back in the days of the USSR, compiled a table with the norms for urine output according to the age of the child. This table to this day serves as the main guideline for many pediatricians when examining a child for the presence (absence) of pathology.

You need to worry if the child goes to the toilet much less often than his peers, although in this case the reason may not be dangerous at all.

What could be the causes of infrequent urination in a child, and what can parents do?

Doctors say that any deviation from the norm may depend on a violation of the diet, drinking regimen, and also the weather: as you know, in the heat, a child needs more water, although he pees much less often.

Sometimes the child begins to write less often, because he is growing rapidly or is experiencing inconvenience, getting used to the new rules of personal hygiene: when switching from a diaper to a potty.

But attention! If in young children the causes may lie on the surface and require only adjustments to the daily routine or diet, then in children of preschool or primary school age they may require examination by pediatricians and even psychologists. Delayed urination may indicate not only the inability to follow the elementary rules of hygiene, but also psychological discomfort or hidden complexes. Did you notice a similar problem in a child of a schoolboy? First, have a heart to heart talk with him. Perhaps he is just ashamed to go to the toilet in front of his classmates.

When do you need to sound the alarm if the child pees a little? Symptoms of severe illness in children

True rare urination is not always harmless. There are a number of cases when a child pees very rarely due to illness, the presence of a serious pathology that requires immediate and thorough examination by a doctor.

What pathologies can lead to the fact that the child rarely urinates:

• The kidneys suffer, as a result of which their ability to produce the required amount of urine per day is lost.
• There was a partial blockage of the ureters (due to inflammation, infection, trauma).
• The bladder is affected (often this is a consequence of a very long abstinence, when the child suffers, does not go to the toilet, and it is constantly overflowing).
• Sand or stones formed in the bladder, kidneys.
• Pinched urethra.
• The child experiences nervous tension, and as a result, hysteria, hypochondria, and nervous fever set in.
• A neoplasm (benign or malignant) has appeared in the blood vessels.
• Overdose. The child was not properly treated for another disease, prescribed too many diuretics.
• There was a distension of the bladder.
• There was a head or spinal injury.
• In the genitourinary tract, a latent infection "wanders".

The baby is not urinating very well! Don't miss the symptoms!

It is important for parents to remember : any of these pathologies will require a very serious examination, and the treatment will be long and expensive. In some cases, surgery is required to help the child - that is why it is so important to catch the signal of the body in time and show the child to a qualified specialist.

At home, it is quite possible to suspect the presence of a disease.

If your child has become less likely to go to the toilet "in a small way", pay attention to whether he has any of the following symptoms:

1. The stream of urine became thin, the pressure was weak.
2. Urine is excreted not in a stream, but in separate droplets.
3. A child can only pee in one position (squatting, standing or leaning back, but obviously not in the way physiology provides).
4. The child complains that "the pussy burns, cuts or hurts."

In any case, parents should not lose vigilance. Did you notice that the child began to write less often? Watch him. This can be both normal and a sign of a urological disease. Any doubt should lead parents to the doctor's office first of all by passing general urine and blood tests.

Remember that any disease is always successfully treated only at an early stage. .

A small course of medication, a trip to a sanatorium, a light diet will save your child from trouble forever. But in any case, the best medicine at all times is attention and love for the baby.

Infrequent urination in children. Causes

Children never have stable physical indicators, and the younger the child, the more they can vary. At a certain age, a child may have a fairly rare urination. In such situations, most parents ask themselves: what is wrong with the baby's health?

In search of the causes of rare urination in a child, it is worth starting with an understanding of the process itself and its norms.

Urination is the process of filtering and removing urine from the body by voluntary muscle contraction and emptying of the bladder. In urination, there are two important processes - filtration and absorption (absorption). The quality of urination depends on the activity and coherence of these processes.

The frequency of urination is not the same in different age groups. The human kidney is one of the few organs that can develop outside the womb. The cortex and medulla of the kidneys can develop over several years, and the aforementioned processes of absorption and filtration proceed with their own characteristics in each age period.

Intermittent urination in a child is a reason to contact a specialist. Do not hesitate, since any acute pathology of the urinary tract leads to increased intoxication of the body and can be complicated by acute inflammatory processes in other organs and systems. In addition, untreated pathology of the kidneys and urinary tract often develops into a chronic one and worries a person throughout his life.

To understand the facets of pathology, you need to understand what is considered to be the norm. According to the data adopted by the WHO (World Health Organization), the norms for urination in children are as follows.

Accordingly, a decrease in the frequency of urination compared to the lower limit of the age norm can be considered infrequent urination.

Why can the frequency of urination change?

Considering this question, it is necessary to single out two main criteria - the age of the child and physiology. If everything is relatively clear with the first, then the second may raise questions.

The physiological nature of the problem of rare urination is the causes that are not associated with the diseases of the child. Pathological is the opposite of physiological, indicating the presence of a disease.

Physiological causes

1. In the period of newborn and infancy, when the child is on single-component feeding (milk or formula), the reason for rare urination may be the increased fat content of mother's milk. Fatty milk can also cause infrequent stools in babies. The only effective way to avoid such problems is to regularly change the nursing breast. Primary milk, that is, milk from the "new" breast, is the least fat. Supplementation is also acceptable.

3. Any infection, not only inflammation of the urinary tract can be accompanied by a significant decrease in urination. High body temperature, leading to dehydration, and as a result, rare urination. Insufficient replacement of fluid when it is lost will not allow the body to get rid of toxins. That is why everyone knows the statement that in case of diseases with a high temperature, you need to drink as much as possible.

Pathological causes

They explain most often precisely urinary retention - inability to empty the bladder on its own(which is called urinary retention).

There are more than a dozen reasons why this rather painful condition can occur. This is in adults. In children, there are much fewer such reasons, but unlike adults, the contractile capabilities of the bladder in children are relatively small, so urinary retention is much easier to cause.

Urinary retention can occur due to a number of very different reasons:

• obstruction to outflow from the bladder;
• inflammatory processes in the urinary tract;
• diseases of the nervous system;
• factors of a toxic or reflex nature.

Among the reasons obstructing the flow of urine from the bladder, kidney disease can be attributed to both congenital and acquired.

Parents, as a rule, learn about congenital pathologies in the first months. Eg…

The child is already a day old, but he has never urinated? It is necessary to inform the doctor about this, most likely when examining the penis where the external opening of the urethra should be, the doctor will find a small depression covered with a thin film - this is not a resorbed remnant of the embryonic urethra. It is removed with a thin-ended instrument, and the child immediately urinates.

Also congenital phimosis may cause difficulty urinating in young children. Usually, mothers themselves draw the doctor's attention to this cause of urinary retention - they say that during urination the child tenses up, turns red and you can see how his preputial sac swells with urine. This is because the lumen of the external opening of the preputial sac is narrower than the lumen of the urethra. In the event of an infection, acute balanoposthitis, difficulty urinating becomes even more pronounced as a result of swelling of the mucous membrane of the foreskin. In some children, complete anuria is observed.

And it should be attributed to the acquired paraphimosis- wrapping the foreskin with infringement of the glans penis. At the same time, the foreskin noticeably expands, in the suprapubic region, when stroking, an overflowing bladder is felt. Urine is either retained or excreted intermittently, in small portions. The diagnosis is made without difficulty. Another reason for urinary retention is some obstruction in the urethra. This condition can be due to a number of reasons ... For example, an injury to the bladder. Children in games are careless. Therefore, a blow to the perineum when playing football, fighting, even without visible signs of damage to the urethra at the beginning (urethrorrhagia!), Can cause acute urinary retention after a few hours due to the development of edema. Also, an obstruction of the outflow can be a blockage of the urethra with a stone. Some causes are typical for children, for example, urinary retention in young boys after forced stretching of the congenital narrow foreskin and the simultaneous destruction of congenital adhesions between the foreskin and the head, as well as after dissection of the narrow external opening in mild forms of hypospadias. An acute delay occurs here in response to severe pain during the first attempts to urinate after the intervention. Rare causes of urinary retention in boys include tumors of the bladder (myxosarcoma) and prostate (sarcoma). In these cases, the condition is accompanied by a sharp pain during urination. Urinary retention due to compression of the urethra can occur with tumors emanating from the small pelvis; rarely anuria occurs with congenital stricture of the urethra.

Infectious diseases of the urinary tract

They are not so much rare as intermittent urination The child has. In young children, urinary retention can occur with a number of acute infectious diseases. In young children acute cystitis often proceeds differently. If acute cystitis in adults is accompanied by frequent urge to urinate, then in childhood it can cause acute urinary retention. From the stories of the parents, it turns out that the child complains of pain in the lower abdomen, does not urinate, cries when he is served a pot, holds his hand on the penis (if it is a boy). When trying to palpate the abdomen, a small patient, due to pain, cries and strains the abdominal wall, as a result of which it is not possible to determine the distended bladder. Urine in children with acute cystitis is often stained with blood, which can lead to an erroneous diagnosis of acute nephritis (which is also facilitated by false albuminuria). Inflammation of the kidneys or nephritis is characterized by a sharp decrease in the amount of urine excreted and a change in its color - due to the increased number of leukocytes, it becomes cloudy. Appear and other signs: swelling of the face, body and limbs, severe back pain, subfebrile temperature.

Often, urinary retention in children depends on diseases of the nervous system in particular the spinal cord. Most often this occurs with compression of the spinal cord in patients with tuberculous spondylitis, with spinal injury, myelitis. Both urinary retention and urinary incontinence occur in acute meningococcal and tuberculous meningitis. Blum (Blum) and Gohvard (Gohvard) described such cases in two boys aged 13 and 15 years due to foci of poliomyelitis in the sacral spinal cord. Problems with urination in children can also occur due to injuries of the spinal cord and brain (concussion, fracture). In such cases, a bladder catheter is placed in the child for the entire period of recovery and treatment of the injury. Also, hysterical seizures can cause both urinary incontinence and its acute retention. Elimination of the seizure or neurological syndrome resumes spontaneous urination. In this case, symptoms characteristic of neurological pathologies will be observed - tics, paralysis and paresis. With mental disorders, disturbances of consciousness and behavior are immediately evident.

Reflex urinary retention in children occurs in a variety of conditions. Long forced abstinence from urination. After it, a reflex spasm of the bladder and urinary canal occurs, which causes urinary retention in children. Often this condition goes away on its own, but if it lasts a long time and brings severe pain, they resort to bladder catheterization. In this case, painful urges and tension of the walls of the bladder, felt as a spasm, may occur. Reflex urinary retention can be observed in acute appendicitis, helminthic invasion (for example, with ascariasis) and a number of other reasons.

How to help a child?

It is clear that without finding out the root causes of this condition, it is difficult to provide significant assistance to a suffering little man. We can only talk about temporary relief. And this is exactly what needs to be done before the doctor arrives, who will decide what to do next (place a catheter, examine, schedule an examination, etc.).

Help from adults non-specialists with urinary retention accompanied by painful sensations, may be as follows.

• Don't feed the baby. If he is very hungry, then offer a piece of an apple - no more.

• Offer to drink little by little (sweet tea or 5% glucose solution).

• You can try to relieve an acute pain attack and try to relax the bladder by putting the child in a warm bath with the addition of potassium permanganate.

• Give your child a no-shpy or papaverine pill - this will at least temporarily alleviate the pain syndrome.

• Traditional medicine has in its arsenal a lot of tools that help in such situations. Tinctures, decoctions used internally and applied externally; baths with the addition of certain medicinal herbs - all this is possible and helps, but only in cases where it is reliably known what exactly causes this condition. Do not panic and burning with the desire to help the child, start experimenting on him - wait for the doctor. Let him find out the cause and prescribe an adequate treatment. Remember that the main principle of any medicine (and traditional medicine too) is to do no harm!

If urinary retention is not painful

• You can try to provoke it with warm sitz baths, the sounds of running water.

• In case of urination disorders in a child, the first thing to pay attention to is nutrition and water intake. Not every liquid is equated to water, so it is worth accustoming your child to drink ordinary clean water regularly. Fatty and spicy foods, as well as fast carbohydrates and coffee, which tend to retain fluid in the body, should be excluded from the diet.

All of the above remedies for urinary retention are only temporary, so always call your doctor.

The absence or small amount of urination is an occasion to think about the correct care of the baby. This condition of the child requires immediate elimination. It is not worth sounding the alarm if the violation is episodic and does not cause concern to the baby. It is not always a pathology, but dehydration and fluid retention are equally dangerous to health.

Why does the baby drink a lot, but urinate little? Should a baby pee at night? What to do if the amount of urine has sharply decreased with a cold, intestinal infection or sore throat?

Age norms for the volume of urine excreted and the number of urination in children

Water plays an important role in the normal functioning of the human body. Its excess or deficiency can provoke various disorders in the child. The amount and volume of urine excreted indicates the sufficiency of water intake.

If the child rarely urinates and the amount of fluid is small, doctors diagnose oliguria, or insufficient urination. This symptom can indicate both care errors and serious diseases. If there is not enough fluid in the body, the color of urine changes from transparent yellowish to bright yellow or dark.

To understand what kind of urination is normal for a child, pediatricians use the following standards:

As can be seen from the table, a newborn baby pees quite often compared to a one-year-old. As you grow older, the number of urination decreases, but the amount of fluid secreted increases. When assessing the situation, these age characteristics of children should be taken into account.

Why did the child write less?

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A small amount of urine excreted may be due to physiological causes that are easily corrected. It is to them that parents who are concerned about the condition of the child should pay attention. If the measures taken have not yielded results, and the health of the baby is deteriorating, you should immediately seek the advice of a specialist.

Physiological reasons for the rare need to cope

The natural, physiological, causes of infrequent urination include:

• the end of breastfeeding and the receipt of milk formula;
• a small amount of milk from the mother or its insufficient fat content;
• non-compliance with the diet of a nursing mother;
• receiving complementary foods;
• drinking insufficient fluids;
• hot weather or overheating of the baby;
• refusal of a diaper and accustoming to a potty;
• change in the habitual way of life (the beginning of attending a kindergarten or school).

The child of the first months of life is not able to give signals of thirst, so parents should offer him water during the day. Breastfed babies are breastfed on demand. Modern experts are of the opinion that feeding by the hour is harmful to the child's body, because in addition to nutrition, it receives water from milk. In the hot season, babies are given water from a bottle or cup to prevent dehydration.

In hot weather, body fluid is lost through sweat, so the amount of urine produced may decrease. This is a natural process that should not cause concern. However, the amount of fluid consumed should be increased.

The protest against the use of the potty leads to the fact that the baby suffers. This condition is harmful to the child. Perhaps, it is necessary to wait a little with accustoming or change pedagogical methods.

When changing the usual way of life, the child also often refuses to write. He may feel embarrassed kindergarten or school, being shy of peers. When a child suffers for a long time, it becomes a habit for him. In this case, parents need to find out the reason for this behavior and talk with the child. You may need the help of a child psychologist.

Finding out the cause of infrequent urination can be easily corrected. To do this, you should change the drinking regimen, diet or lifestyle. However, it is not always possible to resolve the issue without the participation of physicians.

Possible pathological factors that reduce urination

Do not discount diseases and various anomalies. Lack of urination in this case is a formidable symptom that cannot be ignored. Pathologies can be associated with insufficient urine production or the inability to remove it from the body.

Parents should know the first signs of diseases of the urinary system, and if they are found, immediately contact a specialist. In infants, such diseases can be severe and lead to complications.

Pathologies in which the amount of urine excreted is reduced include:

• infections of the genitourinary system;
• consequences of angina, flu, etc.;
• anomalies in the structure and functioning of the kidneys;
• distension of the bladder;
• in boys - narrowing of the foreskin;
• nervous strain, neurosis;
• intoxication, dehydration against the background of the disease, accompanied by vomiting and diarrhea (intestinal infection, tonsillitis, etc.);
• head injury, spinal injury;
• tumors in the urinary system.

What are the warning signs to look out for?

It is impossible to ignore the characteristic changes in the state and behavior of the child:

• urine is excreted drop by drop, very weakly, intermittently;
• urination causes pain to the baby, he complains of pain and burning, cries;
• to cope with the need, the child takes an unnatural position;
• the baby does not pee at night, the next morning the diaper is empty;
• the baby can endure and not go to the toilet all day.

These symptoms should seriously alert parents. If they occur, you should urgently seek medical help, especially when it comes to an infant.

You should also immediately call a doctor if there are signs of inflammation:

• increased body temperature;
• general state of lethargy, weakness;
• urine has changed color or smell, there is an admixture of blood;
• swelling after sleep;
• urination causes pain.

Necessary examinations

If no signs of inflammation are found, and the baby's condition is normal, it is worth visiting the local pediatrician. The doctor will prescribe an examination or refer the patient for a consultation with a nephrologist.

The diagnosis is made on the basis of a medical examination, which includes:

• general urinalysis, according to Nichiporenko, according to Zimnitsky, bakposev;
• Ultrasound of the urinary system;
• computed or magnetic resonance imaging;
• contrast radiography.

Depending on the alleged diagnosis, other studies may be required, which the specialist will tell about. Laboratory tests allow you to determine the inflammation and its pathogen. Ultrasound, X-ray and tomography will reveal abnormalities in the structure of organs, localization of the inflammatory process. If there are neoplasms, specialists will determine their size and location.

Treatment options

Therapeutic actions should be taken only after the recommendation of a doctor. Self-medication in relation to children can lead to sad consequences.

You can not give the child any medications, use alternative methods of treatment. Taking diuretics is contraindicated, because they will only aggravate the course of the disease and blur the clinical picture of the disease.

The first step should be to visit a pediatric nephrologist or urologist. Depending on the diagnosis, medications are prescribed. They should be taken in strict accordance with the doctor's recommendation. With inflammation, antibiotic therapy is indicated. The choice of the drug is carried out depending on the causative agent of the disease.

Often a specialist advises sitz baths for 15 minutes, in which the water temperature gradually rises from 26 to 30C. Medical compresses on the bladder area help well. Be sure to follow a salt-free diet - it is known that salt is able to retain fluid in the body.

If the child cannot relieve himself, a catheter is placed in him, douching is done. With significant dehydration, droppers are indicated. Procedures are best done in a hospital setting. Dehydration is especially dangerous for young children, in some cases it can even be life threatening. If the doctor finds stones or sand in the urinary system or other serious pathologies, a small patient may be shown surgical intervention.

Rare urination due to improper care can be quickly eliminated:

• when changing baby food (switching to a new mixture, introducing complementary foods), it is advisable to consult a local pediatrician;
• follow the doctor's recommendations when introducing new foods into the diet, give them one by one in small portions, monitor the baby's reaction;
• give the child a sufficient amount of liquid (especially in summer), for older children water should be constantly available;
• babies completely exclude salt from the diet, older children give it in limited quantities;
• breastfeed the baby on demand, in hot weather and with a cold, offer water at least 2-3 times a day;
• observe hygiene, wash the child after each urination and before going to bed, change diapers more often;
• do not take any medications without a doctor's recommendation;
• do not insist on using the pot if the child does not want to, teach gradually and without negative emotions.

In the early days, the baby pees very little. The first time it can be either during childbirth or immediately after. This is considered normal.

What is the norm?

What are the causes of infrequent urination?

• Warm clothes or a hot room affect the amount of urine.
• If the baby’s stool is liquid, then he will also write little.
• If you have changed the mode or type of feeding. This can also affect the amount of urine. Try to give your baby more fluids.
• When it's hot outside or indoors, always try to give your baby something to drink.
• If you abruptly stop using diapers, this can also cause a decrease in urination.
• If none of the causes or factors are suitable, then consult a doctor for advice.

If the child pees a little at night ...

What symptoms should alert?

• Elevated temperature (if above 36.8˚С)
• The baby is naughty, wants to sleep or is lethargic
• Dark urine, provided that the baby drinks a lot of liquid
• Puffiness of the face and eyes
• The child has urine with blood.

What diseases are possible with rare urination?

• Problems in the work of the kidneys.
• Infection
• Sand or stones in the urinary system
• Pinched urethra
• The nervous state of the baby due to the psychological climate in the family
• Exceeding the dose of diuretics.

Already from the first days of the baby, pediatricians draw the attention of the young mother to the fact that it is important to control the volume of fluid and food consumed, the color of urine and feces. Therefore, when a child goes to the toilet a little in a small way or, conversely, too often, it is necessary to find out the reasons for this behavior and, if possible, consult a doctor.

How many times should a child pee a day?

There is no clear data on how much a child should urinate per day. To your complaint that the child rarely goes to the toilet, the pediatrician can only advise you to monitor the amount of fluid intake. But let's reason on the basis of real observations of children

From birth, the baby pees often (on average 20-24 times a day), there are rarely cases when a newborn remains dry all night from the first days. At 1-1.5 years, the capacity of the bladder increases, and the baby can remain dry for two whole hours. During this period, the baby may remain dry all night due to the fact that the filling of the bladder slows down. Therefore, if the baby goes to bed at 21:00 and gets up at 7:00 in the morning, then on average the child goes to the toilet 8 times a day in a small way.

At 3.5-5 years old, a baby can endure 3-5 hours without a potty, then with this regimen, he can go to the toilet 3-5 times a day in a small way. But these data are purely theoretical, since you need to look at fluid intake. If you think that the child does not go to the toilet well, then you need to track how much water, tea, compote, fruit drink, milk, liquid from the first courses he consumes per day.

For example, in maternity hospitals, children are given boiled water between feedings 1-2 times a day (no more than 30 ml). Pediatricians also say to give the child water for up to a year 1-2 times a day (no more than 60 ml), especially during illness or heat. But one child can drink water with great pleasure, while another prefers to drink a liter of milk per day.

In summer or in a stuffy room, children drink more often and more, and in winter or in a ventilated humid room, respectively, the amount of fluid they drink is less. In this case, of course, there is no reason to worry if the child goes to the toilet a little in a small way. Therefore, mothers should control the amount of fluid intake before panicking in the pediatrician's office.

How to determine what the child goes to the toilet a little in a small way?

Weekly observations will be enough for the pediatrician to see if there are deviations in the development of the baby. Any doctor will say that if the baby is cheerful, cheerful and energetic, then there is no reason to panic. If a child goes to the toilet a little in a small way, and it worries him, hurts, causes whims and mood swings, then you need to contact a pediatrician, urologist, surgeon and take tests.