Can babies pee too much or too often?
Let’s take a look at possible causes of frequent urination in babies.
My baby passes urine very frequently and I am worried that she is ill. She is 4 months old and actually passes urine 2 to 3 times within half an hour! Can a baby pee too much? What could be the problem and what should I do about it? Please help me!
Frequent Urination In Babies: A Problem Or Not?
In this article:
Babies do not have any bladder control yet, and with tiny bladders, which cannot hold their pee for a long period, you would expect that they would go more frequently than adults.
Urination is a process of eliminating organic waste products from the body. In babies, control over their bladder is learned at 2 years up. Initially, a baby is born with a 10 ml bladder capacity. This increases as the baby grow. Taking into account the age of your baby, I would say, at 4 months, her bladder can only hold so little.
Let’s run through more details as to the normal and abnormal problems in urination in babies.
1. Normal Frequent Urination in Babies
Your baby may urinate as often as every 1 to 3 hours or as infrequently as four to six times per day. This is an indication of a healthy bladder for their young age. Usually, this is a sign of a well-hydrated and essentially well baby.
Generally, a baby could produce about 6-8 diapers per day. However, this number can go up or down, depending on their diet or intake.
The normal urine output for babies is about 2ml/kg/hour. In 24 hours, a baby can produce between 800 to 2,000 millilitres.
2. Urinary Tract Infection in Infants and Toddlers
Urinary tract infection (UTI) happens when bacteria accumulate parts of the urinary tract. Common sites for UTI are the bladder, urethra, ureters, and kidneys. This is the second most common type of infection in children; more common in girls.
Causes for UTI include:
- Poor hygiene or bathroom habits – not changing a wet diaper or underwear immediately or not wiping properly
- Frequent constipation or diarrhea
- Not urinating when they need to (“holding it”)
- Urinary tract obstruction (anatomical abnormalities)
Signs and symptoms of UTI in children are often non-specific. Normal urination should not cause pain or distress, so you should consider this when you see your infant in distress or fussy when urinating.
Fever is a common presenting symptom for babies with UTI. Other signs and symptoms include vomiting (more common in older children), blood in urine, lower back pain (in older children), urinary incontinence (also more common in toilet-trained children), loss of appetite, diarrhea, and burning sensation when urinating.
A less common type of UTI, known as pyelonephritis, which is an infection of the kidneys, can also present with an unresolved fever and chills, nausea and vomiting, back pain or abdominal pain, burning sensation or pain in urination, foul-smelling urine that is orange (blood-tinged) or dark cola color.
You should call your doctor once the fever doesn’t subside. Urinalysis and urine culture are common laboratory tests that doctors run to check the presence of bacteria in the urine. UTIs are treated with antibiotics. Your baby should be improving within a day or two.
3. Diabetes in Babies
Neonatal diabetes is characterized by persistent hyperglycemia (increased sugar level) within the first 6 months of life. This is due to an abnormality in the genes that affect the function of the pancreas in producing insulin. This disease can be permanent (lifetime hyperglycemia called permanent neonatal diabetes mellitus), or it can resolve and reoccur later (known as transient neonatal diabetes mellitus).
Babies with this disease do not grow in-utero. The signs and symptoms include increased frequency of urination, increased appetite, yet the baby may appear dehydrated. Diagnosis includes genetic testing, as this is caused by a gene mutation.
Like neonatal diabetes, Type 1 diabetes is an autoimmune disease in which the pancreas stops producing insulin. Insulin is the one that carries and distributes the sugar to different parts of the body. This is a rare disease for babies below 6 months of age.
Signs and symptoms include fatigue, constantly hungry and thirsty (leading to frequent urination), blurring of vision, fruity-smelling breath (in older children). However, these signs and symptoms are difficult to pinpoint in babies.
Do not confuse the two types of diabetes in babies. They may manifest the same signs and symptoms, but neonatal diabetes can occur as early as less than 12 weeks of age, while Type 1 diabetes occurs after 6 months of age.
Do consult your doctor immediately if you suspect your baby to have diabetes.
The video below explains common and less common symptoms of type 1 diabetes and includes families talking about their children’s experiences from having diabetes.
4. Overactive Bladder
A: Spastic Bladder Muscles
This condition is caused by uncontrollable spasms around the urinary bladder that cause urinary incontinence and frequent urination. This may be due to intake of caffeine, anxiety or stress, infrequent urination (holding your urine for a long period), small bladder capacity, constipation, and anatomical abnormalities in the urinary tract.
Children often outgrow this condition. Learning bladder control as the child grows can resolve this condition. However, for kids who do not outgrow the condition, bladder training and medications can help. Avoiding caffeine and other ingredients that may cause a muscle spasm, taking their time to urinate, and having a proper voiding schedule work wonders for an overactive bladder.
Pollakiuria is defined as a daytime urinary frequency. This benign condition causes a previously toilet-trained child to have frequent small voiding episodes, without the presence of infection or polyuria. This is a self-limiting condition that occurs mostly between 3- to 14-year-old and lasts from 7 to 12 months.
The signs and symptoms include:
- Frequent urination that disrupts normal voiding pattern
- The average interval of every 15 to 20 minutes, but can occur every 3 minutes
- The color, smell, and stream of the urine is normal
- No other signs and symptoms observed
- Usually psychological-related
Treatment of this condition includes medications (anticholinergics) and identification of a possible trigger (emotional or psychological).
Baby Passes Urine Very Frequently: What to Do About it
As you can see, a baby who pees frequently does not necessarily indicate illness. It is most likely due to immature bladder control that makes your baby pee as frequently as you’ve mentioned.
If there is no fever, your baby is not in distress or fussy, does not exhibit signs of dehydration, vomiting, or blood in urine, then there is nothing to worry about.
Should you want to have him checked thoroughly though, you can call her doctor to discuss the matter.
Read Next about Babies that Pee Often:
I hope this helps,
P.S. Here are two excellent reference books for baby health issues and injuries:
- My Child Is Sick!: Expert Advice for Managing Common Illnesses and Injuries
- Caring for Your Baby and Young Child by The American Academy of Pediatrics