As your daughter’s urine tests have come back clear, her GP will have ruled out a bladder infection. The most likely explanation for her problem is that she‘s developed what is known as ‘dysfunctional voiding’. This is relatively common in girls of this age. Basically it means that she has got into the habit of going to the toilet very frequently. Parents are often surprised to hear that this is usually associated with not drinking enough, rather than drinking too much.
It’s a good idea to get this problem sorted out, and get your daughter back into the habit of going to the toilet at intervals that suit her rather than the other way round. This may be achieved at home without the need for further investigations. It would be sensible for you to check with your daughter’s GP that nothing else is suspected though.
A useful first step to take would be to record how much your daughter drinks at the moment, what she drinks and when she drinks it. Then record when she passes urine, roughly how much (this can be done with an old measuring jug) and when she is wet if at all. This will give you a clear picture of the current situation and will be useful if you do decide to seek further medical advice.
The next step is to make sure she’s drinking plenty. A child of four needs around 1500mls of fluid a day, but be careful about what she’s drinking. It’s best to cut out all manufactured drinks as many of them have ingredients that can irritate the bladder. She should stick to natural drinks: water, milk and natural fruit juices, with her intake spread out through the day. If she’s started school, or goes to nursery, perhaps she could take two bottles of water to school every day and drink one in the morning before lunch, and the other with her lunch. Have a word with her teacher or nursery leader to explain why this is important, and ask for support in encouraging her to drink water. She could also have a drink at home with breakfast, another when she gets home and one at bedtime.
Then it will help if your daughter can get into the habit of visiting the toilet at regular, set times through the day. For instance her routine could involve going when she gets up, when she gets to school/nursery, at break, at lunchtime, when school finishes, at tea time then before she goes to bed. This will help to ‘train’ her bladder and encourage regular filling and emptying.
In many cases, this technique works very well and the problem often settles down quite quickly. If things don’t improve though, you could take her back to her doctor as there are other medical interventions that could be tried.
Last reviewed by Great Ormond Street Hospital: 7 March 2007
This information has been written to provide general information only, and does not replace health or medical advice. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.
